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ピロキシカム

Piroxicam

Oxicam derivative

非ステロイド性抗炎症薬（NSAID）、抗腫瘍薬POPRIMIV犬猫小型哺乳類馬

別名: Feldene · Brexidol · CP-16171 · piroxicamum

VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス

0.3 mg/kg PO once a dayPO· q24h
— 🐕

用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。

動物種別用量

🌎 NA — North America🌍 EU — Europe

犬

適応用量経路頻度期間地域
Adjunctive therapy of transitional cell carcinomas, squamous cell carcinomas, and palliative therapy for other neoplastic diseases0.3 mg/kg PO once a dayPOq24h—🌎 NA
Adjunctive therapy of neoplastic diseases (for dogs who tolerate NSAIDs poorly)0.3 mg/kg PO once a day. Give with food. Consider adding misoprostol at 3 micrograms/kg, PO q8hPOq24h—🌎 NA
Adjuvant therapy for splenic hemangiosarcoma (stage II)0.3 mg/kg PO every dayPOq24hUntil disease recurrence/progression🌎 NA
Transitional cell carcinoma after laser ablation of the primary tumor0.3 mg/kg PO once dailyPOq24hRemaining life of the dog🌎 NA
Inhibit local recurrence in dogs with incompletely resected soft tissue sarcomas0.3 mg/kg PO once dailyPOq24h—🌎 NA
Antiinflammatory/analgesic0.3 mg/kg PO every other day (q48h)POq48h—🌎 NA
Cancer pain0.3 mg/kg PO q24-48hPOq24-48h—🌎 NA
Adjunctive treatment of Idiopathic lymphoplasmacytic rhinitis (LPR)0.3 mg/kg PO q24hPOq24hMinimum of 6 months, if not indefinitely🌎 NA
All uses (e.g., transitional cell carcinoma, prostatic carcinoma)0.3 mg/kgPOq24-72hLong-term🌍 EU
Colorectal polyps/neoplasia20 mg/dogPRq2-3daysLong-term🌍 EU
  • Adjunctive therapy of neoplastic diseases (for dogs who tolerate NSAIDs poorly): Discontinue if severe irritation or ulceration occurs.
  • Adjuvant therapy for splenic hemangiosarcoma (stage II): Given with Etoposide and Cyclophosphamide protocols.
  • Transitional cell carcinoma after laser ablation of the primary tumor: Given with Mitoxantrone.
  • Inhibit local recurrence in dogs with incompletely resected soft tissue sarcomas: Given with cyclophosphamide at 10 mg/m2 PO once daily. Decrease to every other day if unacceptable adverse effects develop.
  • Adjunctive treatment of Idiopathic lymphoplasmacytic rhinitis (LPR): Combined with doxycycline or azithromycin.
  • All uses (e.g., transitional cell carcinoma, prostatic carcinoma): Start at least frequent administration and slowly increase if no side effects observed.
  • Colorectal polyps/neoplasia: Dose equivalent to 0.24-0.4 mg/kg/day. Uses human suppositories.

猫

適応用量経路頻度期間地域
Adjunctive therapy of transitional cell carcinomas0.3 mg/kg PO q24-72hPOq24-72h—🌎 NA
Adjunctive therapy of transitional cell carcinomas/neoplastic diseases0.3 mg/kg PO every 24-48 hoursPOq24-48h—🌎 NA
Cancer pain0.3 mg/kg PO q24-48h or 1 mg (total dose) per cat PO q24hPOq24-48hMaximum of 7 days🌎 NA
Antiinflammatory/analgesic1 mg per cat (total dose) PO once dailyPOq24hMaximum of 7 days🌎 NA
Idiopathic chronic rhinosinusitis0.3 mg/kg PO once daily or every other dayPOq24-48h—🌎 NA
All uses (e.g., various neoplasms)0.3 mg/kgPOq24-96hLong-term🌍 EU
  • Adjunctive therapy of transitional cell carcinomas: Gastric protectants may be useful. Use with caution in pre-existing renal disease.
  • All uses (e.g., various neoplasms): Start at least frequent administration and slowly increase if no side effects observed.

小型哺乳類

適応用量経路頻度期間地域
Fracture associated limb swelling (Rabbits)0.1-0.2 mg/kg PO q8hPOq8h3 weeks🌎 NA

馬

適応用量経路頻度期間地域
Mucocutaneous squamous cell carcinoma80 mg (total dose) PO once dailyPOq24h—🌎 NA
Squamous cell carcinoma of the third eyelid after surgical excision80 mg (total dose) PO once dailyPOq24h—🌎 NA
  • Mucocutaneous squamous cell carcinoma: Dose was eventually reduced to every other day or every third day due to colic signs.

用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。

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概要

ピロキシカムはオキシカム系の非ステロイド性抗炎症薬（NSAID）です。標準的なNSAIDの特性（抗炎症、鎮痛、解熱）を持っていますが、獣医学における主な用途は、犬の膀胱の​移行上皮癌（TCC）​や、扁平上皮癌、乳腺腺癌などの他の腫瘍の​補助治療​です。

​臨床のポイント：​ ピロキシカムは、新しいCOX-2選択的NSAIDと比較して、犬や猫における治療域が非常に狭いです。胃腸潰瘍のリスクが高いため、現在では変形性関節症の痛みの治療に単独で使用されることはまれです。

血管新生を抑制し免疫系を調節することで肉瘤の再発を防ぐため、シクロホスファミドなどの薬剤とともに​メトロノミック（低用量・持続的）化学療法​プロトコルで使用されることが増えています。

作用機序

Like other NSAIDs, piroxicam non-selectively inhibits ​cyclooxygenase (COX)​ enzymes, thereby blocking the conversion of arachidonic acid to prostaglandins and thromboxanes. This reduces inflammation and pain.

Its anti-tumor effects are not fully understood but are believed to be indirect. Mechanisms include:

  • Inhibition of COX-2 expressed by tumor cells (especially TCC)
  • Anti-angiogenesis (preventing new blood vessel formation to the tumor)
  • Immune system modulation
  • Inhibition of superoxide formation

安全性・警告

禁忌

  • Hypersensitivity to piroxicam, aspirin, or other NSAIDs
  • Active or history of gastrointestinal ulcer disease
  • Bleeding disorders
  • Gastric ulceration
  • Renal disease
  • Concurrent use of corticosteroids
  • Concurrent use of other NSAIDs
  • Dehydration (relative contraindication due to renal risk)

有害事象

  • Gastrointestinal ulceration and bleeding (melena, hematemesis)
  • Vomiting, anorexia, and diarrhea
  • Renal papillary necrosis
  • Peritonitis (secondary to GI perforation)
  • Decreased hematocrit (anecdotal in cats)
  • Peripheral edema
  • Elevated liver enzymes
  • Gastrointestinal toxicity
  • Gastric ulceration
  • Ulcerative skin lesions (reported in cats)
  • Potential precipitation of cardiac failure (known in humans, unknown risk in animals)

注意事項

​Extreme Caution:​ Use in cats is controversial and must be done with extreme caution due to lack of safety studies and potential for severe GI/renal toxicity. ​Caution:​ Use carefully in patients with severely compromised cardiac function due to potential for peripheral edema. The therapeutic window in dogs is very narrow; doses as low as 1 mg/kg daily have caused severe GI ulceration and peritonitis.

医薬品相互作用

Aminoglycosides (gentamicin, amikacin)

Increased risk for nephrotoxicity

Anticoagulants (heparin, LMWH, warfarin)

Increased risk for bleeding

Aspirin

Decreased piroxicam plasma levels and increased likelihood of GI adverse effects (blood loss); do not use concurrently

Bisphosphonates (alendronate)

May increase risk for GI ulceration

Cisplatin

May potentiate the renal toxicity of cisplatin

CorticosteroidsMajor

Significantly increased risk for GI adverse effects and ulceration

Furosemide

May reduce the saluretic and diuretic effects of furosemide

Highly protein-bound drugs (phenytoin, valproic acid, sulfonamides)

Piroxicam is 99% protein-bound and may displace other drugs, increasing their serum levels and duration of action

Methotrexate

Serious toxicity has occurred when used concomitantly; use with extreme caution

Other NSAIDsMajor

Increased risk of severe gastric ulceration and GI toxicity

DiureticsModerate

Increased risk of nephrotoxicity and renal papillary necrosis

AminoglycosidesModerate

Increased risk of nephrotoxicity

Highly protein-bound drugsMinor

Piroxicam is highly protein-bound and may displace other drugs, potentially increasing their free plasma concentrations

監視

  • Adverse Effects (particularly GI bleeding: melena, hematemesis, pale mucous membranes)
  • Liver function tests (occasionally with chronic use)
  • Renal function tests (occasionally with chronic use)
  • Renal function (BUN, Creatinine, SDMA, Urinalysis)
  • Liver enzymes
  • Clinical signs of GI ulceration (vomiting, melena, anorexia)
  • Hydration status
  • Skin integrity (especially in cats)

薬物動態

半減期

猫12-13 hours犬40 hours

吸収

Well absorbed from the gut. Food decreases the rate of absorption but not the total amount absorbed. Oral bioavailability is 100% in dogs and ~80% in cats. Peak plasma levels occur around 3 hours post-dosing.

分布

Volume of distribution is ~0.3 L/kg in dogs. Highly bound to plasma proteins (99%). Synovial levels are ~40% of plasma levels. Maternal milk concentrations are ~1% of plasma levels.

代謝

Undergoes hepatic biotransformation.

消失

Principally excreted as metabolites in the urine. Total body clearance in dogs is 0.066 L/hour.

過剰投与

Overdosage can lead to severe ​gastrointestinal (ulceration, perforation)​ and ​renal (papillary necrosis, failure)​ effects. Dogs may be more sensitive to the ulcerative effects than humans.

​Treatment:​

  • Decontamination with emetics and/or activated charcoal if recent.
  • Gastrointestinal protectants (e.g., misoprostol, omeprazole, sucralfate) are strongly warranted.
  • Fluid diuresis should be considered to protect renal function.
  • Monitor carefully and provide supportive care.

製品

製剤

  • Oral capsules
  • 10 mg capsule
  • 20 mg capsule
  • 20 mg dissolving tablet
  • 20 mg/ml injectable solution
  • 20 mg suppository

ヒト用医薬品

  • Piroxicam Oral Capsules: 10 mg & 20 mg; Feldene® (Pfizer); generic
  • Brexidol
  • Generic Piroxicam capsules, dissolving tablets, suppositories, and injectable solutions

規制ステータス

European Union✗ 未承認処方箋医薬品EMA

POM. Human authorized products used off-label under the cascade.

United Kingdom✗ 未承認処方箋医薬品VMD

POM. Human authorized products used off-label under the cascade.

規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

保管・安定性

Capsules should be stored at temperatures less than 30°C (86°F) in tight, light-resistant containers. Expiration is typically 36 months after manufacture when stored properly.

飼主向け情報

ピロキシカムは強力な抗炎症薬であり、ペットの特定の種類の癌の治療を助けるためによく使用されます。

  • ​食事と一緒に与える：​ これにより、胃の不調を軽減できる場合があります。
  • ​胃潰瘍に注意する：​ ペットが食事をやめたり、嘔吐したり（特にコーヒーの粉のように見えたり血が混じっている場合）、黒っぽいタール状の便をした場合は、すぐに薬を中止し、獣医師に連絡してください。
  • ​薬を混ぜない：​ 獣医師の明確な指示がない限り、ピロキシカムの服用中はアスピリン、他のNSAID（リマダイル、メタカムなど）、またはステロイド（プレドニゾンなど）を絶対に与えないでください。
  • ​用量の厳守：​ この薬はペットにとって安全域が非常に狭いため、処方された用量を絶対に超えないでください。

VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。