Milpro 4 mg/10 mg Film-coated Tablets for Small Cats and Kittens

Composition

Each tablet contains:

Active substances:

Milbemycin oxime 4 mg

Praziquantel 10 mg

Excipients:

Oval shaped, dark brown tablets with a score on both sides.

The tablets can be divided into halves.

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Pharmacological properties

4.1 ATCvet code: QP54AB51

4.2 Pharmacodynamics

Milbemycin oxime belongs to the group of macrocyclic lactones, isolated from the fermentation of Streptomyces hygroscopicus var. aureolacrimosus. It is active against mites, against 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 GABAA 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.

4.3 Pharmacokinetics

In the cat, praziquantel reaches peak plasma concentrations within 1-4 hours after oral administration.

The half life of elimination is around 3 hours.

In the dog, there is rapid hepatic biotransformation, principally to monohydroxylated derivatives.

The principal route of elimination in the dog is renal.

After oral administration in the cat, milbemycin oxime reaches peak plasma concentrations within 2-4 hours. The half life of elimination is around 32 to 48 hours. In the rat, metabolism appears to be complete although slow, since unchanged milbemycin oxime has not been found in urine or feces. Main metabolites in the rat are monohydroxylated derivatives, attributable to hepatic biotransformation. In addition to relatively high liver concentrations, there is some concentration in fat, reflecting its lipophilicity.

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Target species

Cats (small cats and kittens).

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Indications

In cats: treatment of mixed infections by immature and adult cestodes (tapeworms) and adult nematodes (roundworms) of the following species:

Cestodes:

Echinococcus multilocularis, Dipylidium caninum, Taenia spp.,

Nematodes:

Ancylostoma tubaeforme,

Toxocara cati

The veterinary medicinal product can also be used in the prevention of heartworm disease (Dirofilaria immitis), if concomitant treatment against cestodes is indicated.

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Dosage

Oral use

To ensure a correct dosage, body weight should be determined as accurately as possible.

Minimum recommended dose rate: 2 mg of milbemycin oxime and 5 mg of praziquantel per kg are given once orally as a single dose.

The veterinary medicinal product should be administered with or after some food. The veterinary medicinal product is a small size tablet.

To aid with administration, the veterinary medicinal product has been coated with a meat flavour.

The tablets can be divided into halves.

Depending on the bodyweight of the cat, the practical dosing is as follows:

The veterinary medicinal product can be inserted into a programme for prevention of heartworm disease if at the same time treatment against tapeworms is indicated. The veterinary medicinal product has a duration of heartworm prevention of one month. For prevention of heartworm disease the use of a monosubstance is preferred.

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Contraindications

Do not use in kittens of less than 6 weeks of age and/or weighing less than 0.5 kg.

Do not use in cases of hypersensitivity to the active substances or to any of the excipients.

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Adverse reactions

Cats (small cats and kittens):

1 Especially in young cats.

Reporting adverse events is important. It allows continuous safety monitoring of a veterinary medicinal product. Reports should be sent, preferably via a veterinarian, to either the marketing authorisation holder or its local representative or the national competent authority via the national reporting system. See the package leaflet for respective contact details.

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Warnings

Special precautions for safe use in the target species:

No studies have been performed with severely debilitated cats or individuals with seriously compromised kidney or liver function. The veterinary medicinal product is not recommended for such animals or only according to the benefit-risk assessment by the responsible veterinarian.

Studies have shown that 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 veterinary medicinal product. In the absence of data on cats with microfilaraemia, its use should be according to a benefit risk assessment by the attending veterinarian.

The tablets are flavoured. In order to avoid any accidental ingestion, store tablets out of reach of the animals.

As per good veterinary practice, animals should be weighed to ensure accurate dosing.

Ensure cats and kittens weighing between 0.5 kg and ≤2 kg receive the appropriate tablet strength (4 mg MBO/10 mg praziquantel) and the appropriate dose (1/2 or 1 tablet) for the corresponding weight band (1/2 tablet for cats weighing 0.5 to 1 kg ; 1 tablet for cats weighing >1 to 2 kg – 1 tablet).

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

Do not handle this veterinary medicinal product in case of hypersensitivity to the active substances or to any of the excipients.

Wash hands after use.

Part tablets should be returned to the open blister pack and stored in the carton.

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.

Special precautions for the protection of the environment:

Not applicable.

Other precautions:

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

3.11 Special restrictions for use and special conditions for use, including restrictions on the use of antimicrobial and antiparasitic veterinary medicinal products in order to limit the risk of development of resistance

Not applicable.

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Use during pregnancy, lactation or lay

Pregnancy and lactation:

In a study, this combination of active substances was demonstrated to be well tolerated in breeding queens, including during pregnancy and lactation.

As a specific study with this veterinary medicinal product has not been performed, use during pregnancy and lactation only according to the benefit-risk assessment by the responsible veterinarian.

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Interactions

The concurrent use of the combination praziquantel/milbemycin oxime with selamectin is well tolerated. No interactions were observed when the recommended dose of the macrocyclic lactone selamectin was administered during treatment with the combination at the recommended dose. In the absence of further studies, caution should be taken in the case of concurrent use of the veterinary medicinal product and other macrocyclic lactones. Also no such studies have been performed with reproducing animals.

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Overdose

In a study conducted with the veterinary medicinal product administered at 1X, 3X and 5X the therapeutic dose, and for a duration which exceed the therapeutic indication, i.e. 3 times at 15 day-intervals, signs uncommonly reported at the recommended dose (see section 3.6) have been observed at 5-fold the therapeutic dose after the second and third treatments. These signs disappeared spontaneously within a day.

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Special warnings

It is recommended to treat all the animals living in the same household concomitantly.

In order to develop an effective worm control programme local epidemiological information and the living conditions of the cat should be taken into account and therefore it is recommended to seek professional advice.

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

When Dipylidium caninum infection is present, concomitant treatment against intermediate hosts, such as fleas and lice, should be considered to prevent re- infection.

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Withdrawal period

Not applicable.

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Incompatibilities

Not applicable.

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Immediate packaging

Aluminium/ Aluminium blister pack (Oriented polyamide/Aluminium/Polyvinyl chloride sealed to Aluminium film).

Available pack sizes:

Cardboard box of 2 tablets containing 1 blister of 2 tablets

Cardboard box of 4 tablets containing 2 blisters of 2 tablets

Cardboard box of 24 tablets containing 12 blisters of 2 tablets

Not all pack sizes may be marketed.

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Storage

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

Half tablets should be stored in the original blister and be used for the next administration.

Keep the blister in the outer carton.

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Shelf life

Shelf life of the veterinary medicinal product as packaged for sale: 3 years.

Shelf life after first opening the immediate packaging (for half tablets): 6 months.

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Disposal of unused product

Medicines should not be disposed of via wastewater.

The veterinary medicinal product should not enter water courses as milbemycin oxime may be dangerous for fish and other aquatic organisms.

Use take-back schemes for the disposal of any unused veterinary medicinal product or waste materials derived thereof in accordance with local requirements and with any national collection systems applicable to the veterinary medicinal product concerned.

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Additional information

Vm 05653/5082

8 DATE OF FIRST AUTHORISATION

07 August 2014

9 DATE OF THE LAST REVISION OF THE SUMMARY OF THE PRODUCT CHARACTERISTICS

January 2026

10 CLASSIFICATION OF VETERINARY MEDICINAL PRODUCTS

Veterinary medicinal product subject to prescription.

Find more product information by searching for the ‘Product Information Database’ on www.gov.uk.

Gavin Hall Approved: 31 March 2026

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Registration holder

Virbac

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