milbemycin oxime 12.5 mg + R-praziquantel 62.5 mg, tablet for dogs 20-50 kg
Assessed clinical scopeDog · Full labelled species-specific scope for susceptible intestinal cestodes and nematodes and prevention of Dirofilaria immitis infection, with combined use only when both active components are justified · By mouth
Care settingWeight-band tablet used after accurate weighing, parasite and heartworm-risk assessment, and review of the exact current package instruction
vetman score
6.1/10
Situational / acceptable
Evidence confidence: Low
Georgia: Expired · № 002535 · Verified on 15 Oct 2026
Direct but limited exact-form evidence prevents dismissal, yet both the expired Georgian certificate and the current-label mismatch materially weaken confidence; use only after confirming the current pack, dose table and legal status.
Regulatory and scientific credibility4.5/10
The Georgian register snapshot lists authorisation 002535 only through 19 October 2026, and no renewal has been verified as of assessment. The form was directly studied in 2019 but is absent from the current 2024 Russian national instruction, which now lists only four other presentations.
Clinical efficacy6.5/10
A manufacturer-linked 2019 controlled field report directly studied this strength and reported complete clearance in small groups, including microfilariae; however, it is not peer reviewed, sample sizes were small and the current national label no longer lists this presentation.
Safety and tolerability6.5/10
The established active ingredients have a generally predictable safety profile at labelled doses, but exact-brand safety evidence is mainly limited to small short-term groups. Microfilaraemic animals can react, MDR1-sensitive dogs require strict dosing, and renal, hepatic, age and weight restrictions apply.
Clinical practicality7.5/10
The large-dog tablet is convenient in principle, but the discrepancy between the registered presentation, the 2019 study and the current national instruction makes the current package dosing table essential before use.
Full-course cost-effectiveness-
Price was not assessed and is excluded from the overall score.
Important safety and use flags
- Use the fixed combination only when its cestode and nematode or heartworm-prevention components are jointly justified; avoid unnecessary exposure to either active substance.
- Before heartworm prevention in an endemic area, establish infection and microfilariae status. Do not interpret the small 2019 microfilaricidal study as support for adulticide treatment of established heartworm disease.
- Use caution with other macrocyclic lactones or P-glycoprotein substrates/inhibitors; susceptible animals may have a narrower safety margin.
- Control intermediate hosts for Dipylidium and follow local zoonosis procedures for Echinococcus; an anthelmintic dose alone does not prevent reinfection.
- This 12.5/62.5 mg presentation has an expired Georgian certificate and appears in the 2019 exact-brand report, but not in the current 2024 Russian national instruction. Confirm the physical pack, current leaflet, dose table and legal authorisation before prescribing.
Assessment sources+