피록시캄
Piroxicam
Oxicam derivative
다른 이름: Feldene · Brexidol · CP-16171 · piroxicamum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Adjunctive therapy of transitional cell carcinomas, squamous cell carcinomas, and palliative therapy for other neoplastic diseases | 0.3 mg/kg PO once a day | PO | q24h | — | 🌎 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 q8h | PO | q24h | — | 🌎 NA |
| Adjuvant therapy for splenic hemangiosarcoma (stage II) | 0.3 mg/kg PO every day | PO | q24h | Until disease recurrence/progression | 🌎 NA |
| Transitional cell carcinoma after laser ablation of the primary tumor | 0.3 mg/kg PO once daily | PO | q24h | Remaining life of the dog | 🌎 NA |
| Inhibit local recurrence in dogs with incompletely resected soft tissue sarcomas | 0.3 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Antiinflammatory/analgesic | 0.3 mg/kg PO every other day (q48h) | PO | q48h | — | 🌎 NA |
| Cancer pain | 0.3 mg/kg PO q24-48h | PO | q24-48h | — | 🌎 NA |
| Adjunctive treatment of Idiopathic lymphoplasmacytic rhinitis (LPR) | 0.3 mg/kg PO q24h | PO | q24h | Minimum of 6 months, if not indefinitely | 🌎 NA |
| All uses (e.g., transitional cell carcinoma, prostatic carcinoma) | 0.3 mg/kg | PO | q24-72h | Long-term | 🌍 EU |
| Colorectal polyps/neoplasia | 20 mg/dog | PR | q2-3days | Long-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.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Adjunctive therapy of transitional cell carcinomas | 0.3 mg/kg PO q24-72h | PO | q24-72h | — | 🌎 NA |
| Adjunctive therapy of transitional cell carcinomas/neoplastic diseases | 0.3 mg/kg PO every 24-48 hours | PO | q24-48h | — | 🌎 NA |
| Cancer pain | 0.3 mg/kg PO q24-48h or 1 mg (total dose) per cat PO q24h | PO | q24-48h | Maximum of 7 days | 🌎 NA |
| Antiinflammatory/analgesic | 1 mg per cat (total dose) PO once daily | PO | q24h | Maximum of 7 days | 🌎 NA |
| Idiopathic chronic rhinosinusitis | 0.3 mg/kg PO once daily or every other day | PO | q24-48h | — | 🌎 NA |
| All uses (e.g., various neoplasms) | 0.3 mg/kg | PO | q24-96h | Long-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.
소형 포유류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Fracture associated limb swelling (Rabbits) | 0.1-0.2 mg/kg PO q8h | PO | q8h | 3 weeks | 🌎 NA |
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Mucocutaneous squamous cell carcinoma | 80 mg (total dose) PO once daily | PO | q24h | — | 🌎 NA |
| Squamous cell carcinoma of the third eyelid after surgical excision | 80 mg (total dose) PO once daily | PO | q24h | — | 🌎 NA |
- Mucocutaneous squamous cell carcinoma: Dose was eventually reduced to every other day or every third day due to colic signs.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
피록시캄은 옥시캄 계열의 비스테로이드성 항염증제(NSAID)입니다. 표준 NSAID 특성(항염, 진통, 해열)을 가지고 있지만, 수의학에서의 주요 용도는 개 방광의 이행세포암(TCC) 및 편평세포암, 유선선암과 같은 기타 종양의 보조 치료입니다.
임상 요점: 피록시캄은 최신 COX-2 선택적 NSAID에 비해 개와 고양이에서 치료 지수가 매우 좁습니다. 위장관 궤양의 위험이 높기 때문에 오늘날 골관절염 통증 치료에 단독으로 사용되는 경우는 드뭅니다.
혈관 신생을 억제하고 면역 체계를 조절하여 육종 재발을 방지하기 위해 시클로포스파미드와 같은 약물과 함께 메트로노믹(저용량, 지속적) 화학요법 프로토콜에 점점 더 많이 사용되고 있습니다.
작용 기전
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
안전성·주의사항
금기사항
- 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)
부작용
- 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)
주의
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.
약물 상호작용
Increased risk for nephrotoxicity
Increased risk for bleeding
Decreased piroxicam plasma levels and increased likelihood of GI adverse effects (blood loss); do not use concurrently
May increase risk for GI ulceration
May potentiate the renal toxicity of cisplatin
Significantly increased risk for GI adverse effects and ulceration
May reduce the saluretic and diuretic effects of furosemide
Piroxicam is 99% protein-bound and may displace other drugs, increasing their serum levels and duration of action
Serious toxicity has occurred when used concomitantly; use with extreme caution
Increased risk of severe gastric ulceration and GI toxicity
Increased risk of nephrotoxicity and renal papillary necrosis
Increased risk of nephrotoxicity
Piroxicam is highly protein-bound and may displace other drugs, potentially increasing their free plasma concentrations
모니터링
- 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)
약동학
반감기
흡수
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.
분포
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.
대사
Undergoes hepatic biotransformation.
배설
Principally excreted as metabolites in the urine. Total body clearance in dogs is 0.066 L/hour.
과다투여
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.
제품
제형
- Oral capsules
- 10 mg capsule
- 20 mg capsule
- 20 mg dissolving tablet
- 20 mg/ml injectable solution
- 20 mg suppository
인용의약품
- Piroxicam Oral Capsules: 10 mg & 20 mg; Feldene® (Pfizer); generic
- Brexidol
- Generic Piroxicam capsules, dissolving tablets, suppositories, and injectable solutions
규제 현황
POM. Human authorized products used off-label under the cascade.
POM. Human authorized products used off-label under the cascade.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
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.
보호자 정보
피록시캄은 반려동물의 특정 암 치료를 돕기 위해 자주 사용되는 강력한 항염증제입니다.
- 음식과 함께 투여: 위장 장애의 가능성을 줄이는 데 도움이 될 수 있습니다.
- 위궤양 주의: 반려동물이 식사를 중단하거나, 구토(특히 커피 찌꺼기처럼 보이거나 피가 섞인 경우)를 하거나, 검고 끈적이는 변을 본다면 즉시 약물 투여를 중단하고 수의사에게 연락하십시오.
- 약물 혼합 금지: 수의사의 명확한 지시가 없는 한, 피록시캄을 복용하는 동안 아스피린, 다른 NSAID(리마딜, 메타캄 등) 또는 스테로이드(프레드니손 등)를 절대 주지 마십시오.
- 정확한 용량 준수: 이 약물은 반려동물에게 안전 범위가 매우 좁으므로 처방된 용량을 초과하지 마십시오.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.