Product Type

Milbemax is an oral broad-spectrum anthelmintic tablet for the treatment of mixed infections with roundworms, hookworms, whipworms and tapeworms, reduction of infection of lungworms and the prevention of heartworm disease in dogs and for the treatment of mixed infections with roundworms, hookworms and tapeworms, and the prevention of heartworm disease in cats.

Description and Composition

Oral tablets of 2 strengths for each species are available:

• MILBEMAX Film-coated tablets for cats: a tablet containing 16 mg milbemycin oxime and 40 mg praziquantel.
• MILBEMAX Film-coated tablets for small cats and kittens: a tablet containing 4 mg milbemycin oxime and 10 mg praziquantel.
• MILBEMAX tablets for dogs: a tablet containing 12.5 mg milbemycin oxime and 125 mg praziquantel.
• MILBEMAX tablets for small dogs and puppies: a tablet containing 2.5 mg milbemycin oxime and 25 mg praziquantel.

Properties

Milbemycin oxime belongs to the group of macrocyclic lactones, isolated from the fermentation of Streptomyces hygroscopicus var. aureolacrimosus. It is active against mites, larval and adult stages of nematodes as well as against larvae of Dirofilaria immitis.

The activity of milbemycin is related to its action on invertebrate neurotransmission: Milbemycin oxime, like avermectins and other milbemycins, increases nematode and insect membrane permeability to chloride ions via glutamate-gated chloride ion channels (related to vertebrate GABA_A and glycine receptors). This leads to hyperpolarisation of the neuromuscular membrane and flaccid paralysis and death of the parasite.

Praziquantel is an acylated pyrazino-isoquinoline derivative. Praziquantel is active against cestodes and trematodes. It modifies the permeability for calcium (influx of Ca2+) in the membranes of the parasite inducing an imbalance in the membrane structures, leading to membrane depolarisation and almost instantaneous contraction of the musculature (tetany), rapid vacuolization of the syncytial tegument and subsequent tegumental disintegration (blebbing), resulting in easier expulsion from the gastrointestinal tract or death of the parasite

Indications

MILBEMAX for dogs is indicated for the treatment of mixed infections by gastrointestinal nematodes such as roundworms (Toxocara canis, Toxascaris leonina), hookworms (Ancylostoma caninum), whipworms (Trichuris vulpis) and cestodes such as (Dipylidium caninum, Taenia spp., Echinococcus spp., Mesocestoides spp.). MILBEMAX can also be used in the prevention of heartworm (Dirofilaria immitis) disease.

Further Milbemax is indicated for the reduction of the level of infection of Crenosoma vulpis and Angiostrongylus vasorum (according to specific treatment schedule as advised by veterinarian)

MILBEMAX for cats is indicated for the treatment of mixed infections by gastro-intestinal nematodes such as roundworms (Toxocara cati), hookworms (Ancylostoma tubaeforme) and cestodes such as (Dipylidium caninum, Taenia spp., Echinococcus spp.).

Prevention of heartworm disease (Dirofilaria immitis) if concomitant treatment against cestodes is indicated.

Dosage and Administration

MILBEMAX is given orally to dogs at the minimal dose rate of 0.5 mg of milbemycin oxime and 5 mg of praziquantel per kg body weight according to the following table:

The product should be administered with or after some food.

MILBEMAX is given orally to cats at the minimal dose rate of 2 mg of milbemycin oxime and 5 mg of praziquantel per kg body weight according to the following table:

The product should be administered with or after some food.

Treatment of dogs with a high number of circulating microfilariae can sometimes lead to the appearance of hypersensitivity reactions, such as pale mucous membranes, vomiting, trembling, laboured breathing or excessive salivation. These reactions are associated with the release of proteins from dead or dying microfilariae and are not a direct toxic effect of the product. The use in dogs suffering from microfilaremia is thus not recommended.

In heartworm risk-areas, or in the case it is known that a dog has been travelling to and from heartworm risk regions, before using MILBEMAX, a veterinary consultation is advised to exclude the presence of any concurrent infestation of Dirofilaria immitis. In the case of a positive diagnosis, adulticidal therapy is indicated before administering MILBEMAX.

Echinococcosis represents a hazard for humans. In case of Echinococcosis, specific guidelines on the treatment and follow up and on the safeguard of persons have to be followed. Experts or institutes of parasitology should be consulted.

Special Precautions and Warnings

Studies with milbemycin oxime indicate that the margin of safety in certain dogs of Collie or related breeds is less than in other breeds. In these dogs, the recommended dose should be strictly observed.

The tolerance of MILBEMAX in young puppies from these breeds has not been investigated.

Formulations and Packages

There are 2 tablet strengths for each species, with different colours and/or shapes, in colour-coded packs:

MILBEMAX film-coated tablets for cats: dark red boxes containing 2 blisters with 10 oblong dark red tablets each.

MILBEMAX film-coated tablets for small cats and kittens: pink boxes containing 2 blisters with 10 oblong pink tablets each.

MILBEMAX FOR DOGS: blue boxes containing 5 blisters with 10 round white tablets each.

MILBEMAX FOR SMALL DOGS AND PUPPIES: light-blue boxes containing 5 blisters with 10 oblong white tablets each.