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Combination Treatments

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Infographic published April 2020

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Combination Treatments

  1. 1. OM BIN AT ION T R E AT MENT S The American Consortium for Small Ruminant Parasite Control (ACSRPC; wormx.info) recommends that clinically- parasitized small ruminants be given combination treatments. A combination treatment is when you give more than one drug (dewormer) at the same time to kill the same worms. Combination treatments have an additive effect on the worm population. The purpose is to kill as many worms as possible. Worms which survive one drug can be killed by the second (or third) drug. To be beneficial, each drug in the combination should reduce fecal egg count by at least 60 percent. A combination treatment with copper oxide wire particles (COWP) may also be effective (dewormer + COWP). Combination treatments should only be given to clinically- parasitized animals, as evidenced by FAMACHA© score, body condition score, the Five Point Check®, or other targeted selective treatment (TST) criteria. Treating all animals in a flock or herd will result in accelerated resistance to all dewormers in the combination. Veterinary approval (Rx) is required to give combination treatments to goats and camelids, as non-FDA-approved drugs are usually recommended. ALBENDAZOLE (VALBAZEN®) + MOXIDECTIN (CYDECTIN®) + LEVAMISOLE (PROHIBIT®, LEVAMED®) Combination dewormers are not available in the US. Each drug in the combination must be administered separately, ideally in a separate syringe. Dewormers should not be mixed because they are not chemically-compatible. The most effective drug from each class should be given. A full dose of each drug should be administered, based on an accurate weight. Only oral (drench) formulations should be used. The withdrawal period of the drug with the longest withdrawal should be observed (usually Cydectin®)

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