Emodepside and Praziquantel
**Emodepside/Praziquantel** (commonly known by the brand name Profender®) is a broad-spectrum, topically applied antiparasitic combination primarily labeled for cats. * **Emodepside** is a novel cyclooctadepsipeptide that provides excellent efficacy against nematodes (roundworms and hookworms). * **Praziquantel** is a well-established isoquinoline-pyrazine derivative highly effective against cestodes (tapeworms). **Clinical Pearls:** * The topical formulation offers a significant advantage for feline patients that are difficult to pill, minimizing stress for both the pet and the owner. * While labeled for cats, it has seen off-label use in exotic medicine, particularly in reptiles where oral dosing is challenging. * Systemic absorption occurs transdermally; therefore, preventing the animal from licking the application site is crucial to avoid gastrointestinal upset and ensure proper dosing.
Mechanism: The combination utilizes two distinct mechanisms to eradicate parasites: * **Emodepside (Nematocide):** Binds pre-synaptically at the neuromuscular junction to a **latrophilin-like receptor** → increases intracellular calcium and diacylglycerol → triggers fusion of vesicles containing inhibitory neuropeptides → releases **PF1- and/or PF2-like receptors** into the synaptic cleft → stimulates postsynaptic receptors. This cascade results in the profound inhibition of pharyngeal pumping and locomotion, leading to **flaccid paralysis and death** of the nematode. * **Praziquantel (Cestocide):** Interacts with phospholipids in the parasite's integument → causes rapid intracellular ion fluxes (sodium, potassium, and **calcium**) → induces severe, irreversible tetanic contraction of the worm's musculature. At higher concentrations, it causes irreversible focal vacuolization and subsequent disintegration of the cestodal integument, making the parasite susceptible to the host's immune system.
Dosing by species
- Treatment and control of hookworm, roundworm, and tapeworm infections · Minimum dose is 3 mg/kg emodepside & 12 mg/kg praziquantel applied to the skin on the back of the neck as a single topical dose. If re-infection occurs, the product can be re-applied after 30 days. · topical · once · Single dose · A second treatment should not be necessary unless re-infection occurs.
- Parasitic infections (off-label) · 4 drops/100 g body weight · topical · once · Single dose · Aquatic species must be kept in a dry place for 48 hours after treatment. Caution is advised until further studies verify safety and efficacy, particularly in sick animals.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Routes of administration
Contraindications
- Cats less than 8 weeks of age
- Cats weighing less than 1 kg (2.2 lb)
Adverse effects
- Application site reactions (alopecia, dermatitis, pyoderma, edema, erythema, pruritus)
- Salivation/hypersalivation (especially if licked)
- Lethargy
- Vomiting
- Diarrhea
- Agitation or nervousness
- Tremors or twitching
- Ataxia
- Eye or respiratory irritation
- Rare post-approval reports: facial swelling, rear leg paralysis, seizures, hyperesthesia, morphea-like (scleroderma) lesion
Drug interactions
- P-glycoprotein inhibitors/substrates (e.g., ivermectin, erythromycin, prednisolone, cyclosporine) · Emodepside is a P-glycoprotein substrate; concurrent use may cause pharmacokinetic interactions and potentially increase toxicity or alter efficacy.
Monitoring
- Clinical efficacy (resolution of clinical signs, negative fecal flotation/sedimentation)
Overdose
Both drugs generally have a wide margin of safety. * **Topical Overdose:** In 8-week-old kittens treated topically at 5X the recommended dose, transient salivation and/or tremors were observed but were self-limiting. In 7- to 8-month-old cats treated at 10X the dose, transient salivation, tremor, and lethargy occurred. * **Oral Exposure:** Accidental oral ingestion (e.g., licking the application site) can cause salivation, vomiting, anorexia, tremors, abnormal respirations, and ataxia. These signs typically resolve without specific treatment. * **Praziquantel Toxicity:** Parenteral doses of 50-100 mg/kg in cats caused transient ataxia and depression; injected doses of 200 mg/kg were lethal.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.