EziWormer Plus Tablets for Dogs

Composition

Each tablet contains:

Active substances:

Praziquantel 50 mg

Pyrantel 50 mg (equivalent to 144 mg pyrantel embonate)

Febantel 150 mg

Excipients:

For the full list of excipients, see section 6.1.

6.1 List of excipients

Lactose monohydrate,

Microcrystalline cellulose,

Magnesium stearate,

Colloidal anhydrous silica,

Croscarmellose sodium,

Sodium laurilsulfate

Pork flavour

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Pharmaceutical form

Tablet Pale yellow tablet with a cross breakline on one side.

The tablets can be divided into halves or quarters.

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Pharmacological properties

Pharmacotherapeutic group: Anthelmintic, praziquantel combinations.

ATC vet code: QP52AA51

5.1 Pharmacodynamic properties

This product contains anthelmintics active against gastrointestinal roundworms and tapeworms. The product contains three active substances, as follows: 1. Febantel, a probenzimidazole 2. Pyrantel embonate (pamoate), a tetrahydropyrimidine derivative 3. Praziquantel, a partially hydrogenated pyrazinoisoquinoline derivative In this fixed combination, pyrantel and febantel act against all relevant nematodes (ascarids, hookworms, and whipworms) in dogs. In particular, the activity spectrum covers Toxocara canis, Toxascaris leonina, Uncinaria stenocephala, Ancylostoma caninum and Trichuris vulpis.

This combination shows synergistic activity in the case of hookworms and febantel is effective against T. vulpis.

The spectrum of activity of praziquantel covers all important cestode species in dogs, in particular Taenia spp., Dipylidium caninum, Echinococcus granulosus and Echinococcus multilocularis. Praziquantel acts against all adult and immature forms of these parasites.

Praziquantel is very rapidly absorbed through the parasite’s surface and distributed throughout the parasite. Both in vitro and in vivo studies have shown that praziquantel causes severe damage to the parasite integument, resulting in the contraction and paralysis of the parasites. There is an almost instantaneous tetanic contraction of the parasite musculature and a rapid vacuolization of the syncytial tegument. This rapid contraction has been explained by changes in divalent cation fluxes, especially calcium.

Pyrantel acts as a cholinergic agonist. Its mode of action is to stimulate nicotinic cholinergic receptors of the parasite, induce spastic paralysis of the nematodes and thereby allow removal from the gastrointestinal system by peristalsis.

Within the mammalian system, febantel undergoes ring closure, forming fenbendazole and oxfendazole. It is these chemical entities which exert the anthelmintic effect by inhibition of tubulin polymerisation. Formation of microtubules is thereby prevented, resulting in disruption of structures vital to the normal functioning of the helminth. Glucose uptake in particular is affected, leading to a depletion in cell ATP. The parasite dies upon exhaustion of its energy reserves, which occurs 2 – 3 days later.

5.2 Pharmacokinetic particulars

Perorally administered praziquantel is absorbed almost completely from the intestinal tract. After absorption, the drug is distributed to all organs. Praziquantel is metabolized into inactive forms in the liver and secreted in bile. It is excreted within 24 hours to more than 95% of the administered dosage. Only traces of non-metabolised praziquantel are excreted.

Following administration of the product to dogs, peak plasma concentrations of praziquantel were achieved by approximately 2.5 hours.

The pamoate salt of pyrantel has low aqueous solubility, an attribute that reduces absorption from the gut and allows the drug to reach and be effective against parasites in the large intestine. Following absorption, pyrantel pamoate is quickly and almost completely metabolized into inactive metabolites that are excreted rapidly in the urine.

Febantel is absorbed relatively rapidly and metabolized to a number of metabolites including fenbendazole and oxfendazole, which have anthelmintic activity.

Following administration of the product to dogs, peak plasma concentrations of fenbendazole and oxfendazole were achieved by approximately 7-9 hours.

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Target species

Dogs.

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Indications

Treatment of the following gastrointestinal roundworms, tapeworms, hookworms and whipworms in dogs and puppies of the following species:

Ascarids: Toxocara canis, Toxascaris leonina (adult and late immature forms). Hookworms: Uncinaria stenocephala, Ancylostoma caninum (adults).

Whipworms: Trichuris vulpis (adults).

Tapeworms: Echinococcus species, (E. granulosus, E. multilocularis), Taenia species, (T. hydatigena, T. pisiformis, T. taeniformis), Dipylidium caninum (adult and immature forms).

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Dosage

For oral administration only.

The recommended dose rates are: 15mg/kg bodyweight febantel, 5 mg/kg pyrantel (equivalent to 14.4 mg/kg pyrantel embonate) and 5 mg/kg praziquantel. This is equivalent to 1 tablet per 10 kg (22 lbs) bodyweight. It is important to follow the treatment recommendations as presented here. Do not deviate from the recommendations without the advice of your veterinary surgeon.

Dosage table:

For oral administration, the tablets can be given to the dog or disguised in food. No starvation is needed before, or after, treatment.

Puppies should be treated at 2 weeks of age and every 2 weeks until 12 weeks of age. Thereafter they should be treated at 3 month intervals. It is advisable to treat the bitch at the same time as the puppies. Not for use in dogs weighing less than 3 kg.

For the control of Toxocara, nursing bitches should be dosed 2 weeks after giving birth and every two weeks until weaning.

For routine worm control adult dogs should be treated every 3 months. For routine treatment a single dose is recommended.

In case of suspected heavy roundworm infestation, please contact your veterinary surgeon for diagnosis and treatment recommendation.

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Contraindications

Do not use simultaneously with piperazine compounds as piperazine may block the action of pyrantel embonate contained in EziWormer Plus Tablets for Dogs. Other worming products may contain piperazine.

Do not use in animals with a known sensitivity to the active ingredients or to any of the excipients.

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Adverse reactions

In very rare cases slight and transient digestive tract disorders such as vomiting and /or diarrhoea may occur. In individual cases these signs can be accompanied by nonspecific signs such as lethargy, anorexia or hyperactivity.

The frequency of adverse reactions is defined using the following convention:

- Very common (more than 1 in 10 animals treated displaying adverse reaction(s))

- Common (more than 1 but less than 10 animals in 100 animals treated)

- Uncommon (more than 1 but less than 10 animals in 1,000 animals treated)

- Rare (more than 1 but less than 10 animals in 10,000 animals treated)

- Very rare (less than 1 animal in 10,000 animals treated, including isolated reports)

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Warnings

i. Special precautions for use in animals

Any part used tablet should be discarded.

To ensure administration of a correct dose, body weight should be determined as accurately as possible.

Do not exceed the stated dose when treating pregnant bitches.

ii. Special precautions to be taken by the person administering the veterinary medicinal product to animals

In case of accidental ingestion, seek medical advice and show the package leaflet to the physician.

In the interests of good hygiene, persons administering the tablets directly to the dog, or by adding them to the dog’s food, should wash their hands afterwards.

Echinococcosis represents a hazard for humans. As echinococcosis is a notifiable disease to the World Organisation for Animal Health (OIE), specific guidelines on the treatment and follow-up, and on the safeguard of humans, need to be obtained from the relevant competent authority.

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Use during pregnancy, lactation or lay

Consult a veterinary surgeon before treating pregnant animals. It is recommended that the product is not used in dogs during the first 4 weeks of pregnancy. Do not exceed the stated dose when treating pregnant bitches.Teratogenic effects attributed to high doses of febantel have been reported in sheep and rats. No studies have been performed in dogs during early pregnancy.

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Interactions

Do not use simultaneously with piperazine compounds (see section 4.3 above). Concurrent use with other cholinergic compounds can lead to toxicity.

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Overdose

The combination of praziquantel, pyrantel embonate and febantel is well tolerated in dogs. In safety studies, a single dose of 5 times the recommended dose or greater gave rise to occasional vomiting.

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Special warnings

Fleas serve as intermediate hosts for one common type of tapeworm – Dipylidium caninum. Tapeworm infestation is certain to reoccur unless control of intermediate hosts such as fleas, mice, etc. is undertaken.

Tapeworm infestation is unlikely in pups less than 6 weeks of age.

Parasite resistance to any particular class of anthelmintic may develop following frequent, repeated use of an anthelmintic of that class.

Dogs may become infected with worms by eating insects (including fleas and lice), birds, small rodents, rabbits or raw offal from affected sheep, goats and cattle. Dogs will continue to be re-infected unless the route of infection is controlled e.g. treating a flea infestation or preventing a dog from scavenging or hunting.

Echinococcus multilocularis is a tapeworm of foxes, dogs and cats which is common in parts of Europe. It can also infect humans potentially causing severe liver disease which can be fatal. To prevent Echinococcus multilocularis establishing in the UK and Ireland it is a requirement that all dogs must be treated with a product containing praziquantel before entering the country.

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Withdrawal period

Not applicable.

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Incompatibilities

Not Applicable

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Immediate packaging

The product is presented in either:

Individual strips composed of aluminium foil 30 µm/30 gsm extruded polythene, containing 2, 4, 6, 8, 10, 12, 14, 16, 18 or 20 tablets.

or

Individual blisters composed of 45 µm, soft temper aluminium foil and 25 µm hard temper aluminium foil, containing 2 or 8 tablets.

The strips or blisters are packed into cartons containing either 2,4, 6, 8, 10, 12, 14, 16, 18, 20, 24, 28, 30, 32, 36, 40, 42, 44, 48, 50, 52, 56, 60, 70, 80, 84, 90, 98, 100, 104, 106, 120, 140, 150, 180, 200, 204, 206, 250, 280, 300, 500 or 1000 tablets.

Not all pack sizes may be marketed.

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Storage

This veterinary medicinal product does not require any special storage conditions.

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Shelf life

Shelf life of the veterinary medicinal product as packaged for sale: 3 years Discard any unused divided tablets.

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Disposal of unused product

Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.

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Additional information

Vm 40162/4000

9 DATE OF FIRST AUTHORISATION

15 March 2012

10 DATE OF REVISION OF THE TEXT

August 2018

Approved: 17 August 2018

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Registration holder

C&H Generics Ltd c/o Michael McEvoy and Co

Seville House

New Dock Street

Galway

Ireland

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