Elanco Milbemycin - Praziquantel 2.5 mg/25 mg Chewable Tablets for Small Dogs and Puppies

It is recommended to treat all the animals living in the same household concomitantly.
When infection with the cestode has been confirmed, concomitant treatment
against intermediate hosts, such as fleas and lice, should be discussed with a veterinarian to
prevent re-infection.
The use of the product should follow the implementation of appropriate diagnostic measures
towards mixed infections by nematodes and cestodes with consideration of animal history
and characteristics (e.g. age, health status), environment (e.g. kennelled dogs, hunting
dogs), feeding (e.g. access to raw meat), geographical location and travel. Judgement of the
administration of the product in dogs at risk from mixed re-infections or in specific at risk
situations (such as zoonotic risks), should be made by the veterinarian responsible.

Special precautions for use in animals
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 the product in young puppies from these breeds has not been investigated.
Clinical signs in Collies are similar to those seen in the general dog population when
overdosed (see section 4.10 “Overdose”).
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 the product, 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 the product.
No studies have been performed with severely debilitated dogs or individuals with seriously
compromised kidney or liver function. The product is not recommended for such animals or
only according to a benefit/risk assessment by the responsible veterinarian.

Issued December 2022
AN: 00874/2022
In dogs less than 4 weeks old, tape worm infection is unusual. Treatment of animals less
than 4 weeks old with a combination product may therefore not be necessary.
Parasite resistance to any particular class of anthelmintic may develop following frequent,
repeated use of an anthelmintic of that class
Special precautions to be taken by the person administering the veterinary medicinal
product to animals
Wash hands after use.
People with known hypersensitivity to any of the ingredients should avoid contact with the
veterinary medicinal product. In case of accidental ingestion of the tablets, particularly by a
child, seek medical advice immediately and show the package leaflet or the label to the
physician. 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.