Eprinomectin + Praziquantel

What is eprinomectin + praziquantel?

Eprinomectin + praziquantel (brand name Centragard®) is a topical (spot-on) antiparasitic drug used to treat and control hookworm, roundworm, and tapeworm infections, and to prevent heartworm disease in cats and kittens that are at least 7 weeks of age and weigh at least 1.8 lb (0.8 kg).

It may be used off label (extra label) in other species. Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How do I give my pet eprinomectin + praziquantel?

• Eprinomectin + praziquantel comes in topical solution form.
• Topical solutions are applied directly to the skin. Part the fur at the base of the head and apply the product directly to visible skin according to manufacturer instructions.
• Do not apply to broken skin or wet fur.
• Do not allow your pet to contact the application site for at least 5 hours after applying the medication.
• Do not allow this medication to touch the eyes or mouth.

This medication should take effect within 1 to 2 days; however, effects may not be noted outwardly for several days.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once or give extra doses.

Are there any potential side effects?

Eprinomectin + praziquantel may cause the following side effects:

• Scratching or irritation at site of application
• Lack of appetite 
• Lack of energy
• Vomiting
• Fur loss

Serious adverse reactions may occur. If any of the following signs develop, stop giving eprinomectin + praziquantel and contact your veterinarian immediately:

• An allergic reaction such as irregular breathing, rash, fever, puffiness and swelling around the face
• Unsteady gait (ataxia)
• Drooling
• Tremors
• Weakness or partial paralysis
• Coma
• Seizures
• Death 

Drug sensitivities can develop over time with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment and notify your veterinarian if you have any concerns.

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This moderate-acting medication lasts for several days, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE eprinomectin + praziquantel in:

• Cats that are allergic to any component of the medication
• Cats that are under 7 weeks of age or under 1.8 lb (0.8 kg)
• Cats that are known to have two copies of the MDR1 mutation

USE WITH CAUTION in:

• Cats that are pregnant or used for breeding
• Cats that have tested positive for heartworm disease

Some cat breeds are more sensitive than others to certain medications. This sensitivity is usually caused by a genetic mutation called ABCB1 (also known as MDR1), which reduces their ability to tolerate high doses of some drugs. Use eprinomectin + praziquantel cautiously in these cats.

Are there any drug interactions I should be aware of?

Certain medications should be USED WITH CAUTION when given with eprinomectin + praziquantel, including:

• Albendazole
• Azole antifungals
• Cimetidine
• Medications that affect CYP34A (e.g., dexamethasone, phenobarbital, rifampin, fluoxetine)
• Medications that affect P-glycoprotein (e.g., amiodarone, cyclosporine, digoxin, spironolactone)
• Medications or supplements containing grapefruit juice

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is any monitoring needed with this medication?

• Your veterinarian may schedule follow-up visits for monitoring. In this case, follow your veterinarian’s directions.
• At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian. 

How do I store eprinomectin + praziquantel?

• Store at or below 86°F (30°C).
• Protect from light.
• Keep medication out of reach of children and pets.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms.