# Toceranib: veterinary dose and monograph

> Toceranib is a veterinary drug. An oral receptor TYROSINE KINASE INHIBITOR (TKI) — the first veterinary-licensed anti-cancer "targeted therapy" (Palladia) — for canine MAST CELL TUMOURS (recurrent/non-resectable grade II–III, especially KIT-mutation-positive), and used… Indications include 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). This monograph lists 2 reference doses for dogs and cats, each with route, frequency and source.

Source: https://vetmasterji.com/drugs/toceranib · Last reviewed: 2026-10-01

## 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

*Toceranib doses for dogs*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Mast cell tumour (and off-label solid tumours) | 2.5–2.75 mg/kg | PO | every other day (e.g. Mon/Wed/Fri) | — |

- 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

*Toceranib doses for cats*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Neoplasia (extra-label) | 2.5–2.75 mg/kg | PO | three times weekly or every other day | — |

- 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

> **Caution:** 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

> **Caution:** 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.

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## Frequently asked questions

### What is the dose of Toceranib for dogs?

Reference doses for Toceranib in dogs: 2.5–2.75 mg/kg PO every other day (e.g. Mon/Wed/Fri) (Mast cell tumour (and off-label solid tumours)). Confirm against the label and the patient before use.

### What is the dose of Toceranib for cats?

Reference doses for Toceranib in cats: 2.5–2.75 mg/kg PO three times weekly or every other day (Neoplasia (extra-label)). Confirm against the label and the patient before use.

### When should Toceranib not be used?

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.

### What are the side effects of Toceranib in animals?

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.

## Sources

- Plumb's Veterinary Drug Handbook
- Merck Veterinary Manual, 11th edition
- Papich, Papich Handbook of Veterinary Drugs, 5th edition

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VetMasterJi is a clinical decision-support and education platform for veterinary professionals and students. It does not provide veterinary advice, diagnosis or treatment for specific animals. All drug doses, calculators and differentials are references that must be independently verified before clinical use; the attending registered veterinarian remains solely responsible for every clinical decision.