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Milbemycin oxime + praziquantel is a veterinary pharmaceutical combination used primarily in dogs (and sometimes cats) for the prevention of heartworm disease and for the treatment and control of multiple gastrointestinal helminth infections, including adult hookworms, roundworms, whipworms, and tapeworms. Milbemycin oxime works as a macrocyclic lactone endectocide by binding to glutamate-gated chloride channels in nematodes and arthropods, leading to paralysis and death of susceptible parasites. Praziquantel is an isoquinoline-pyrazine anthelmintic, increasing the permeability of cell membranes to calcium, resulting in paralysis and death of tapeworms. This combination is formulated as a flavored chewable tablet for oral administration, typically given monthly. The combination is approved for use in dogs and puppies 6 weeks of age and older and weighing at least 2 lbs.
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