Toceranib: veterinary dose and monograph

At a glance

Drug class

Veterinary drug

Also known as

Palladia, Toceranib phosphate

Species with doses

Dogs and Cats

General dose range

2.4–2.75 mg/kg PO every other day (Mon/Wed/Fri) — check the species tables for the indication

Routes

PO

Last reviewed

1 October 2026

Indications

• Canine cutaneous mast cell tumour (recurrent, non-resectable grade II–III; particularly KIT/c-kit mutation-positive)
• Off-label: anal sac apocrine adenocarcinoma, thyroid carcinoma, and other solid tumours (metronomic/anti-angiogenic use)

Toceranib dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Mast cell tumour (and off-label solid tumours): Papich 5e: label 3.25 mg/kg PO every other day, but oncologists recommend 2.5–2.75 mg/kg per dose on a Monday/Wednesday/Friday schedule; minimum effective 2.2 mg/kg every other day. Plumb’s p.1130: label 3.25 mg/kg q48h with 0.5 mg/kg reductions (minimum 2.2 mg/kg) and up to 2-week holidays for toxicity; 2.5–2.75 mg/kg better tolerated (London 2010). Do not split tablets; wear gloves.

Cats

• Neoplasia (extra-label): Papich 5e: cats 2.5–2.75 mg/kg three times per week or every other day. Oncologist supervision.

Contraindications

GI bleeding/ulceration or perforation (it can cause/worsen this). Significant hepatic or renal impairment. Pregnancy/lactation. Recent major surgery/wound healing (anti-angiogenic — impairs healing). Concurrent significant myelosuppression. Known hypersensitivity.

Species-specific warnings

Dogs: Withhold around surgery (impaired wound healing) and stop for GI bleeding; monitor CBC, liver, urine protein and blood pressure throughout therapy.

Adverse effects

• GI: diarrhoea (can be severe/haemorrhagic), vomiting, anorexia — dose-limiting
• Neutropenia, thrombocytopenia
• Lethargy, weight loss
• Hepatotoxicity; proteinuria/nephropathy; hypertension
• Impaired wound healing; lameness/muscle cramping; localised depigmentation

Drug interactions

• CYP3A inhibitors (azoles, macrolides): may raise toceranib levels
• NSAIDs / corticosteroids: increased GI ulceration/bleeding risk (gastroprotectant often co-prescribed)
• Other myelosuppressive drugs: additive marrow suppression
• Anticoagulants/antiplatelets: increased bleeding risk

Pregnancy and lactation

Contraindicated in pregnancy/lactation (anti-angiogenic/cytotoxic, teratogenic potential). Handle with cytotoxic precautions; pregnant staff should not handle.

Monitoring

• CBC, biochemistry (liver), urinalysis/UPC (proteinuria) and blood pressure before and during therapy
• GI signs — instruct owners to STOP and call for diarrhoea/melaena/anorexia (drug-holiday approach)
• Body weight and tumour response
• Mast cell tumour patients: consider gastroprotectants/antihistamines for tumour-related GI effects

Toxicity and overdose

The dose-limiting toxicities are GASTROINTESTINAL (diarrhoea/melaena — sometimes severe) and myelosuppression (neutropenia/thrombocytopenia); also hepatotoxicity, proteinuria, hypertension, and impaired wound healing. Mast cell tumour patients can also have tumour-related GI ulceration, which toceranib may aggravate (consider gastroprotection/antihistamines).

Management: No specific antidote. STOP the drug ("drug holiday") and dose-reduce on recovery. Manage GI toxicity aggressively (fluids, anti-emetics, gastroprotectants, and stop for melaena), neutropenic sepsis (antibiotics ± G-CSF), and other effects supportively. Monitor CBC, liver, renal values and blood pressure.

Clinical pearls

• The veterinary targeted-therapy landmark — an oral TKI for canine mast cell tumours (best in KIT-mutant tumours) with both direct anti-KIT and anti-angiogenic action
• Most oncologists dose BELOW label (~2.4–2.75 mg/kg EOD) to improve tolerability, and use a "treat-to-toxicity then drug-holiday/dose-reduce" approach
• GI toxicity (diarrhoea/melaena) is the usual dose-limiter — arm owners with a clear "stop and call" plan and gastroprotection
• Anti-angiogenic effects impair wound healing and can cause proteinuria/hypertension — monitor and avoid around surgery
• Handle as a cytotoxic drug (gloves, don't split tablets); also used off-label (often metronomically) for several other carcinomas

Mechanism of action

A small-molecule multi-targeted receptor tyrosine kinase inhibitor: it blocks KIT (the receptor mutated/activated in many mast cell tumours — direct anti-tumour effect) and the VEGFR and PDGFR receptors (anti-angiogenic effect, cutting the tumour's blood supply). By inhibiting these signalling pathways it slows tumour proliferation and angiogenesis. The anti-angiogenic action also underlies side effects such as impaired wound healing, hypertension and proteinuria.

Formulations and products

• 10 mg tablet (Palladia)
• 15 mg tablet
• 50 mg tablet
• Palladia (Zoetis) — 10 / 15 / 50 mg tablet, Tablet (cytotoxic — handle with care)

Storage

Tablets: 15–30 °C, dry; handle as a hazardous cytotoxic drug (gloves; do not crush/split; keep away from children and pregnant individuals).

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other hormones, emergency drugs, supplements and other drugs

• Succimer (DMSA)
• Terbutaline
• Theophylline
• Thiamine (Vitamin B1)
• Toldimfos sodium (Organic Phosphorus)
• Tranexamic Acid
• Trilostane
• Vinblastine

Frequently asked questions