Milbemax Tablets can be used for the treatment of mixed infections by immature and adult cestodes and nematodes. Milbemax tablets are film coated tablet. Oblong shaped, beige to brown, artificial beef flavoured tablet with a score on both sides. Milbemax has three strengths available: Milbemax worming tablets for cats and kittens, Milbemax worming tablets for small dogs and puppies and Millbemax worming tablets for dogs.

Milbemax Tablets for Small Cats and Kittens contain 4mg of Milbemycin oxime and 10mg Praziquantel PhEur per tablet. One side bears the imprint "BC", the other side "NA".

Milbemax Tablets for small Dogs and puppies contain 12.5mg Milbemycin oxime and 125mg Praziquantel PhEur per tablet. One side bears the imprint "CCA", the other side "NA".

In cats: treatment of mixed infections by immature and adult cestodes and nematodes of the following species:
Cestodes: Dipylidium caninum, Taenia spp., Echinococcus multilocularis
Nematodes: Toxocara cati, Ancylostoma tubaeforme
Prevention of heartworm disease (Dirofilaria immitis) if concomitant treatment against cestodes is indicated.
Milbemax can be used in pregnant and lactating bitches and in breeding animals.

The product should be administered with or after some food. Doing so ensures optimum protection against heartworm disease. Milbemax can be inserted into a programme for prevention of heartworm disease if at the same time treatment against tapeworms is indicated. Milbemax has a duration of heartworm prevention of one month. For regular prevention of heartworm disease the use of a monosubstance is preferred.

Do not use the ‘tablets for Small cats and Kittens’ in cats of less than 6 weeks of age and/or weighing less than 0.5 kg. Do not use the ‘tablets for Cats’ in cats weighing less than 2 kg.

Do not use either strength of tablet in dogs weighing less than 1 kg. Do not use Milbemax Chewable Tablets for Dogs in dogs weighing less than 5 kg.
Do not use in case of hypersensitivity to the active substances or to any of the excipients.

Studies with milbemycin oxime indicate that the margin of safety in certain dogs of Collie, or related breeds, is less than in other breeds. In these dogs, the recommended dose should be strictly observed. The tolerance of the product in young puppies from these breeds has not been investigated. Clinical signs in Collies are similar to those seen in the general dog population when overdosed

The product should not enter water courses as this may be dangerous for fish and other aquatic organisms. Milbemax can be used in breeding cats including pregnant and lactating queens. As per good veterinary practice, animals should be weighed to ensure accurate dosing.

Echinococcosis represents a hazard for humans. In case of Echinococcosis, specific guidelines on the treatment and follow up and on the safeguard of persons have to be followed. Experts or institutes of parasitology should be consulted. No studies have been performed with severely debilitated cats or individuals with seriously compromised kidney or liver function. The product is not recommended for such animals or only according to a benefit/risk assessment by the responsible veterinary surgeon.

In very rare occasions, especially in young cats, systemic signs (such as lethargy), neurological signs (such as ataxia and muscle tremors) and/or gastrointestinal signs (such as emesis and diarrhoea) have been observed after administration of the veterinary medicinal product. In case of overdose, in addition to signs observed at the recommended dose drooling was observed. This sign will usually disappear spontaneously within a day.

For animal treatment only. Wash hands after use. In the event of accidental ingestion of the tablets, particularly by a child, seek medical advice immediately and show the package leaflet or the label to the doctor. Do not store above 30°C. Keep blister in the outer carton to protect from light. Shelf-life of the veterinary medicinal product as packaged for sale: 3 years. Shelf-life after first opening of the immediate packaging: 6 months. Keep out of the reach and sight of children.

Any unused product or waste material should be disposed of in accordance with national requirement.
Milbemycin oxime belongs to the group of macrocyclic lactones and is active against mites, against larval and adult stages of nematodes as well as against larvae of Dirofilaria immitis.

The concurrent use of Milbemax with selamectin is well tolerated. No interactions were observed when the recommended dose of the macrocyclic lactone selamectin was administered during treatment with Milbemax at the recommended dose. In the absence of further studies, caution should be taken in the case of concurrent use of Milbemax and other macrocyclic lactones. Also, no such studies have been performed with reproducing animals.
Praziquantel is an acylated pyrazino-isoquinoline derivative active against cestodes and trematodes.

Milbemax is effective against Dirofilaria imitis, which is endemic in the USA and some parts of continental Europe. The product is also effective against Echinococcus multilocularis which is endemic in some parts of continental Europe and prophylactic treatment is required in all pets entering the UK under the PETS scheme or under quarantine conditions.