Diminazene
Diminazene aceturate is an aromatic diamidine derivative primarily used as an antiprotozoal agent. It is highly effective against **Babesia** and **Trypanosoma** species. Although not FDA-approved in the USA, it is a global staple for tick-borne and tsetse-fly-transmitted diseases in livestock and companion animals. **Clinical Pearls:** * It is often used as a rescue therapy for *Babesia gibsoni* infections in dogs when standard azithromycin/atovaquone protocols fail, though it may only suppress rather than clear the parasitemia. * The drug is slowly metabolized, allowing for suppression of clinical signs or prophylaxis for several weeks after a single dose. * It can be legally imported into the USA for compassionate use in animals under specific FDA guidelines.
Mechanism: Diminazene binds to the AT-rich regions of the kinetoplast DNA in protozoa, interfering with **DNA synthesis** and replication. It is also thought to inhibit **aerobic glycolysis**, depriving the parasite of essential energy. **Mechanism Pathway:** Drug enters protozoan โ Binds kinetoplast DNA & inhibits aerobic glycolysis โ Halts parasite replication โ Allows host immune system to clear or suppress the infection.
Dosing by species
- Treatment of susceptible protozoal (Trypanosomes, Babesia) infections (West Africa) ยท 3.5 mg/kg (up to 8 mg/kg depending on susceptibility) ยท IM ยท one time ยท Do not exceed 4 grams total dose per animal.
- Treatment of susceptible protozoal (Trypanosomes, Babesia) infections (West Africa) ยท 3.5 mg/kg (up to 8 mg/kg depending on susceptibility) ยท IM ยท one time ยท Do not exceed 4 grams total dose per animal.
- Treatment of cytauxzoonosis ยท 3-5 mg/kg ยท IM ยท one time ยท Tick control remains the best means of preventing disease as treatment attempts meet with little success.
- Treatment of cytauxzoonosis ยท 2 mg/kg ยท IM ยท repeat in one week
- Treatment of susceptible protozoal (Trypanosomes, Babesia) infections (West Africa) ยท 3.5 mg/kg (up to 8 mg/kg depending on susceptibility) ยท IM ยท one time ยท Do not exceed 4 grams total dose per animal.
- Treatment of susceptible protozoal (Trypanosomes, Babesia) infections (West Africa) ยท 3.5 mg/kg (up to 8 mg/kg depending on susceptibility) ยท IM ยท one time ยท Do not exceed 4 grams total dose per animal.
Routes of administration
Contraindications
- Camelids (highly susceptible to toxic effects)
Adverse effects
- Vomiting
- Diarrhea
- Pain and swelling at the injection site
- Transient decreases in blood pressure
- Ataxia (rare, <0.1%)
- Seizures (rare, <0.1%)
- Death (rare, <0.1%)
Monitoring
- Surveillance for potential adverse effects (especially neurological signs)
- Clinical efficacy
- Serial CBCs
- BUN and liver enzymes (in severe cases)
- Serum potassium (hypokalemia in severe cases)
- PCR test at 60 and 90 days post-therapy to determine 'clearing' of Babesia gibsoni
Overdose
Diminazene appears most toxic in dogs and camels. * **Camels**: Dosages greater than 7 mg/kg can be very toxic. * **Dogs**: Dosages above 10 mg/kg IM can cause severe gastrointestinal, respiratory, nervous system, or musculoskeletal effects.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturerโs current label.