吡羅昔康
Piroxicam
Oxicam derivative
別名: Feldene · Brexidol · CP-16171 · piroxicamum
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
小型哺乳類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Fracture associated limb swelling (Rabbits) | 0.1-0.2 mg/kg PO q8h | PO | q8h | 3 weeks | 🌎 NA |
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
吡羅昔康是一種非類固醇消炎止痛藥 (NSAID)。雖然它具有標準的 NSAID 特性（消炎、鎮痛和退燒），但其在獸醫學中的主要用途是作為犬膀胱移行細胞癌 (TCC) 以及其他腫瘤（如鱗狀細胞癌和乳腺腺癌）的輔助治療。
臨床要點： 與較新的 COX-2 選擇性 NSAID 相比，吡羅昔康在犬貓體內的治療指數非常狹窄。由於胃腸道潰瘍的風險很高，現今很少單獨用於治療骨關節炎疼痛。
它越來越多地用於節拍式（低劑量、連續）化療方案中，與環磷酰胺等藥物併用，透過抑制血管生成和調節免疫系統來預防肉瘤復發。
作用機制
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
安全性與警告
禁忌症
- 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)
不良反應
- 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.
藥物相互作用
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
監測
- 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)
藥物動力學
半衰期
吸收
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.
分佈
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.
排除
Principally excreted as metabolites in the urine. Total body clearance in dogs is 0.066 L/hour.
過量
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.
可用產品
劑型
- Oral capsules
- 10 mg capsule
- 20 mg capsule
- 20 mg dissolving tablet
- 20 mg/ml injectable solution
- 20 mg suppository
人用標示
- Piroxicam Oral Capsules: 10 mg & 20 mg; Feldene® (Pfizer); generic
- Brexidol
- Generic Piroxicam capsules, dissolving tablets, suppositories, and injectable solutions
各地核准狀態
POM. Human authorized products used off-label under the cascade.
POM. Human authorized products used off-label under the cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
吡羅昔康是一種強效消炎藥，常被用來協助治療寵物的某些癌症。
- 隨餐服用： 這有助於減少腸胃不適的機會。
- 注意胃潰瘍的跡象： 如果您的寵物停止進食、嘔吐（特別是嘔吐物看起來像咖啡渣或帶血），或排出黑色柏油狀糞便，請立即停藥並聯絡您的獸醫師。
- 請勿混合用藥： 除非獸醫師明確指示，否則在寵物服用吡羅昔康期間，絕對不要給予阿斯匹靈、其他 NSAID（如 Rimadyl、Metacam）或類固醇（如潑尼松）。
- 嚴格遵守劑量： 請勿超過處方劑量，因為此藥物在寵物體內的安全範圍非常狹窄。
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