Combinex 50 mg/ml + 37.5 mg/ml Oral Suspension for Sheep

Efficacy of this product against roundworms is reduced if levamisole resistant
strains are present. Efficacy of this product against liver fluke is reduced if
triclabendazole resistant strains are present.

i. Special precautions for use in animals
Assess bodyweight as accurately as possible before calculating the dosage.
Animals must not be treated within a period of 14 days before or after
treatment with organophosphorus compounds.
Clean drenching equipment before and after use.
Intensive use or misuse of anthelmintics can give rise to resistance. To
reduce this risk, dosing programmes should be discussed with your Veterinary
Adviser.
Care should be taken to avoid the following practices because they increase
the risk of development of resistance and could ultimately result in ineffective
therapy:
•
an extended period of time.
•
misadministration of the product, or lack of calibration of the dosing device
(if any).
Suspected clinical cases of resistance to anthelmintics should be further
investigated using appropriate tests (e.g. Faecal Egg Count Reduction Test).
Where the results of the test(s) strongly suggest resistance to a particular
anthelmintic, an anthelmintic belonging to another pharmacological class and
having a different mode of action should be used.
Resistance to levamisole has been reported in TeladorsagiaCooperia and
Trichostrongylus
the EU. There are reports of resistance in Haemonchus in sheep outside the
EU. Resistance to triclabendazole has been reported in Fasciola species in
small ruminants in a number of countries including ones in the EU. Therefore

Revised: June 2025
AN: 00553/2025
the use of this product should be based on local (regional, farm)
epidemiological information about susceptibility of nematodes and
trematodes and recommendations on how to limit further selection for
resistance to anthelmintics.
ii. Special precautions to be taken by the person administering the
veterinary medicinal product to animals
When using, do not eat, drink or smoke.
Wash splashes from eyes and skin immediately.
Take off immediately any contaminated clothing.
Wash hands and exposed skin before meals and after work.
Levamisole can cause idiosyncratic reactions and serious blood disorders in
a very small number of people. If symptoms such as dizziness, nausea,
vomiting or abdominal discomfort are experienced when using the product,
or sore mouth/throat or fever occurs shortly afterwards, then medical advice
should be sought immediately.