What is toceranib phosphate?
Toceranib phosphate (brand name: Palladia®) is an anticancer medication used to treat mast cell tumors in dogs and may also be useful for treating sarcomas, carcinomas, melanomas, and multiple myeloma in dogs. It may be useful in treating cancers in cats. While its use in dogs for mast cell tumors is on label, its use in cats to treat various cancers is off label (extra label). Many drugs are commonly prescribed for off-label use in veterinary medicine.
“Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.
How is toceranib phosphate given?
- Toceranib phosphate is given by mouth in the form of a tablet.
- Do not split or crush the tablets unless directed by your veterinarian.
- Make sure your pet receives the entire dose.
- Toceranib phosphate may be given with or without food. If vomiting occurs when dosed on an empty stomach, give future doses with food.
- Do not use for 3 days before surgery or 2 weeks after surgery, as it can prolong healing time and can increase risks of swelling and blood clots.
Precautions for human safety when giving the medication:
- Wear gloves when administering this medication.
- Use gloves when handling bodily waste (urine, feces, blood, vomit) for a few days after each dose.
- Seal the waste in a plastic bag before discarding.
- Avoid contact with bare skin, eyes, or mouth.
- Do not let your pet lick your skin for the first hour after administration; if this occurs, wash the area thoroughly with soap and water.
- If you are pregnant, do not handle this medication or any bodily waste while your pet is on this medication.
This medication can take a few weeks before full effects are noted, but side effects can occur immediately. Gradual improvements are usually noticeable after a few days.
What if I miss giving my pet the medication?
If you miss a dose, contact your veterinarian for further instructions, as this medication must be dosed very carefully.
Are there any potential side effects?
Toceranib phosphate may cause the following side effects:
- Diarrhea
- Decreased or lack of appetite
- Lameness or weight loss
- Muscle pain
- Low white blood cell counts
- Low blood protein levels
- Blood clots (may appear as leg swelling or difficulty breathing)
- Pancreatitis
- Loss of nose color
- Skin and coat changes
- Nose bleeds
- Seizures
- High blood pressure
- Itchiness
In cats, toceranib phosphate may also cause the following side effects:
- Gastrointestinal effects (vomiting, diarrhea, lack of appetite)
- Low blood cell counts
- Liver and kidney problems
- Hair loss
Serious adverse reactions may occur. If any of the following signs develop, stop giving toceranib phosphate and contact your veterinarian immediately:
- Prolonged lack of appetite
- Severe diarrhea or bloody stools
- Bruising or bleeding
Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This moderate-acting medication should stop working in a few days, although effects can be longer in pets with liver or kidney disease.
Are there any risk factors for this medication?
DO NOT USE toceranib phosphate in:
- Pets that are allergic to it
- Pets that are breeding, pregnant, or lactating
- Dogs less than 24 months of age
- Dogs that weigh less than 11 lb (5 kg)
- Pets having surgery within 3 days
- Pets that have had surgery in the past 2 weeks (it can prolong healing time and increase risks of swelling and blood clots)
USE WITH CAUTION in pets with:
- Bulky or systemic mast cell tumors
- Liver or kidney problems
- Gastrointestinal problems
- Bone marrow problems
- Infection
Do not vaccinate your pet with live or modified live vaccines while they are on this medication.
Are there any drug interactions I should be aware of?
Several medications should be used with caution when given with toceranib phosphate, including:
- Calcitriol
- CYP3A4 inhibitors
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Other cytotoxic anticancer agents
Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.
Is any monitoring needed with this medication?
- Your veterinarian will monitor complete blood cell counts, percent red blood cells, blood proteins, kidney values, and phosphate levels weekly for the first 6 weeks, and every 6 weeks thereafter.
- Your veterinarian may monitor blood pressure, urinalysis, chemistry profiles, and urine protein:creatinine ratios every 6–8 weeks.
- Your veterinarian may monitor your pet to be sure the medication is working and monitor tumor size.
- At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian. If diarrhea persists after a few days or if there is blood in stools for more than 2 days, contact your veterinarian.
How do I store toceranib phosphate?
- Store this medication at room temperature, between 68°F and 77°F (20°C and 25°C).
- Protect from light.
What should I do in case of emergency?
If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet’s weight and symptoms.
