Praziquantel (with special reference to Hedgehogs, Elephants, Lagomorphs, Ferrets and Great Apes)

• White or practically white crystalline powder, hygroscopic, odourless or with a faint odour, but bitter tasting. (B263)

• Very slightly soluble. (B263)

• Freely soluble in alcohol. (B263)

• Induces ion influx across the tegument of the parasite causing immediate muscular spasm. (B201.2.w2); 
  • Low concentrations appear to impair the function of the suckers and to stimulate motility of the worm, while at higher concentrations contraction of the chain of proglottids (the strobila) is increased, this being irreversible at very high concentration of the drug. (B263)
• Disruption of the tegument occurs which makes it more easily attacked by proteolytic enzymes. (B201.2.w2); 
  • irreversible focal vacuolisation at specific sites of the integument of the cestode. (B263)

In trematodes and in schistosomes:

• Directly kills the parasites, possibly by increasing flux of calcium ions into the worm. (B263)

• Store at room temperature in tight containers; protect from light. (B263)

Associated Techniques

• Effective against all tapeworms in dogs/cats, including all intestinal forms of Echinococcus. (B201.2.w2)
• Effective against Monezia in sheep. (B201.2.w2)
• Effective against both Anoplocephala and Anoplocephaloides in horses. (B201.2.w2)

• In cats and dogs for treatment of tapeworms (Dipylidium, Echinococcus, Taenia). (B201.2.w2)
  • In dogs in Echinococcus-endemic areas: treatment every six weeks to ensure no infective eggs are passed. (B201.2.w2)
• In horses for treatment of Anoplocephala and Anoplocephaloides. (B201.2.w2)
• In lambs/calves to treat Moniezia infection. (B201.2.w2)
• Has been used for treatment of infections with susceptible parasites (cestodes (tapeworms) and some trematodes (flukes) in other mammals, in birds and in reptiles. (B263)
• In humans: used in the treatment of schistosomiasis, trematodes (flukes) of the lung, liver and intestines, and tapeworms. (B263)

Indications:

• (UK): Tapeworms in horses, sheep, dogs, cats. (B201.2.w2)
• (USA): treatment of Dipylidium caninum, Taenia pisiformis and Echinococcus granulosis infections in dogs, and against Taenia taeniaeformis infections in cats. (B263)

• Tapeworms have an indirect lifecycle; long-term control involves control of invertebrate intermediate hosts such as fleas and lice, or access to vertebrate intermediate hosts in the form of prey/uncooked meat. (B201.2.w2)
• In humans: not routinely effective in the treatment of Fasciola hepatica. (B263)

• Fasting prior to drug administration is neither required not recommended. (B263)
• Considered safe for use in pregnant dogs and cats. (B263)

• Following oral administration, rapid and nearly complete absorption but a significant first-pass effect. (B263)
• In dogs: peak serum levels after 30-120 minutes. (B263)

• Distributed throughout the body; crosses the blood-brain barrier, crosses the intestinal wall. (B263)

• Metabolised in the liver; the activity or otherwise of the metabolites is not known. (B263)
• Excretion mainly in urine. (B263)

• Dog: about three hours. (B263)

• In humans: reported synergistic activity against schistosomiasis when combined with oxamniquine. (B263)

• Droncit (Bayer) UK.
  • Tablets, scored, containing praziquantel 50mg, for dogs, cats. (B201.2.w2)
  • Injection, containing praziquantel 56.8mg/mL, for dogs, cats. (B201.2.w2)

Use of Drugs (Medication):

• Before administration of any pharmaceutical product the manufacturer's datasheet must be consulted regarding operator safety, relevant withdrawal times etc.
• Many drugs are not registered for use in particular species and additional care should be taken in their use, with proper regard for possible toxic effects. 
• Consideration should be given to relevant legislation regarding the use of drugs.
• In the UK, guidelines regarding the use of drugs are set out in the Royal College of Veterinary Surgeons' Guide to Professional Conduct 2000: (See: LCofC1 - RCVS Guide to Professional Conduct 2000 - Choice of Medicinal Products).

Erinaceus europaeus - West European Hedgehog:

• Dose not provided. Orally or subcutaneously. (J15.21.w1)
• 25 mg for hedgehogs >500 g bodyweight, 12.5 mg or 10-15 mg/kg for animals <500g bodyweight, oral, once only. For Brachylaemus and Hymenolepis infections. (B22.27.w3)
• 10-15 mg, oral. For treatment of trematodes [see: Hedgehog Intestinal Fluke Infection]. (B117.w2)
• 5.68 mg/kg (0.01 ml/kg of Droncit Injectable, Bayer). For treatment of intestinal flukes, particularly Brachylaemus nacei. (B151)
• 10-20 mg/k, intramuscularly or subcutaneously. For treatment of tapeworms [see: Hedgehog Tapeworm Infection] and Brachylaemus sp. flukes. (B284.6.w6)
• 7.5 mg/kg, intramuscularly, single treatment. (D93)
• 10 mg/kg subcutaneously, one treatment (British Hedgehog Preservation Society). For tapeworm.  (D107)
• 0.4ml (i.e. 22.72 mg) subcutaneously, one treatment. Repeat if necessary. (Jersey Hedgehog Preservation Group). (D107)
• 25 mg/kg orally one treatment. (Pro Igel) (D107)

Atelerix albiventris - Four-toed hedgehog:

• 7 mg/kg oral or subcutaneous; single dose, repeat after two weeks. For cestodes. (J204.59.w1)

• 7 mg/kg oral or subcutaneous; repeat after 14 days.. For cestodes and trematodes. (B267)
• 7 mg/kg subcutaneous or oral; repeat after two to three weeks. (B150.w1)
• 7 mg/kg oral or subcutaneous once, repeat after two weeks. For cestode infections. (J34.24.w1)

Elephants:

The following information is taken with permission directly from the Elephant Care International website (W580.Aug2005.w28):

Lagomorphs - Oryctolagus cuniculus domesticus - Domestic rabbit:

• 5.0 - 10.0 mg/kg orally or subcutaneously, repeated after 10 days. (B546)
• 5.0 -10.0 mg/kg orally, subcutaneously or intramuscularly, repeated after 10 days. (B548.w8)
• 6 mg/kg subcutaneously, repeated after 10 days. For the treatment of cestode infections. (B600.4.w4)
• 5.0 - 10.0 mg/kg orally, subcutaneously or intramuscularly, repeated after 10 days. If giving parenterally, use the lower end of the dose range. (B601.15.w15)
• 5.0 - 10.0 mg/kg orally, subcutaneously or intramuscularly, repeated after 10 days. (B602.41.w41)

Ferrets - Mustela putorius fero - Ferret:

• 5 - 10 mg/kg orally, subcutaneously or intramuscularly; repeat after 10 days. (B602.41.w41)
• 12.5 mg/kg once orally, repeated after two weeks. (B626.App.w22)
• 5 - 10 mg/kg subcutaneously or orally; repeat after 10 days. For the treatment of cestode infections. (B631.21.w21)
• 5 - 10 mg/kg orally, repeated two weeks later. For the treatment of cestode infection. (J213.3.w1)

Great Apes

• 15 - 20 mg/kg orally or intramuscularly as a single dose. For the treatment of cestode infections. (B336.39.w39)
• 40 mg/kg orally or intramuscularly as a single dose. For the treatment of trematode infections. (B336.39.w39)
• Adult Pan troglodytes - Chimpanzee: 20 mg/kg orally three times daily for one day. (W768.Jun2012.w1)
• In orphaned Pan paniscus - Bonobo in Democratic Republic of Congo, 5 - 25 mg single dose, for the treatment of cestode infections (dose dependent on the species of cestode). (D386.4.3.w4c)
• Primates:
  • 40 mg/kg orally, intramuscularly or subcutaneously once. In the treatment of trematode infections. (D425.3.15.w3o)
  • 15 - 20 mg/kg orally, intramuscularly or subcutaneously once. In the treatment of cestode infections (Cestode Infection in Bonobos).(D425.3.15.w3o)

• Clinical efficacy. (B263)

• Contraindicated in unweaned puppies or kittens. (B201.2.w2)
• USA: "The manufacturer recommends not using praziquantel in puppies less than 4 weeks old or in kittens less than 6 weeks old. However, a combination product containing praziquantel and febantel from the same manufacturer is approved for use in puppies and kittens of all ages. No other contra indications are listed for this compound by the manufacturer." (B263)
• Injection is contraindicated in hounds. (B201.2.w2)
• Humans: contraindicated in individuals hypersensitive to praziquantel. (B263)

• Subcutaneous injection may occasionally cause pain. (B201.2.w2)
• Dog: 
  • Oral administration may (in less than 5% of cases) result in anorexia, vomiting, lethargy and diarrhoea. (B263)
  • Injection of the drug may result in pain at the site of injection, vomiting, drowsiness and/or staggering gait. These are more common than side-effects following oral administration. (B263)
• Cat: 
  • Oral administration may (less than 2%) result in salivation and diarrhoea. (B263)
  • Injection of the drug may (in 9.4%) result in diarrhoea, weakness, vomiting, salivation, sleepiness, transient anorexia and/or pain at the site of injection. (B263)

• Wide safety margin. (B263)

• Rat, mouse: oral LD₅₀ at least 2 g/kg. (B263)
• Dog: no oral LD₅₀ determined as vomiting was induced when dogs were given doses above 200mg/kg. (B263)
• Cat: parenteral doses 50-100 mg/kg resulted in transient ataxia and depression; dose of 200 mg/kg (injected) was lethal. (B263)

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