Imidocarb Dipropionate
Antiprotozoal
View Brand Names (3)Dose and dosage
1.2 mg/kg IM; repeat in 10–14 days
For babesia and anaplasma mixed infection: 3 mg/kg IM; repeat in 10-14 days.
For treatment of equine piroplasmosis (Babesia caballi; Babesia equi):
a) 2.2 mg/kg IM will generally allow clinical signs to subside. To eliminate B. caballi inject 2 mg/kg IM once a day for 2 days. B. equi more difficult to eliminate; there has been some success reported when imidocarb is given at 4 mg/kg IM at 72 hour intervals for 4 doses.
For treatment of babesiosis:
a) 6.6 mg/kg IM or SC; repeat dose in 2 weeks
b) 5–6.6 mg/kg IM or SC; repeat in 14 days or 7.5 mg/kg IM or SC once.
A single dose of 6 mg/kg the day following a dose of diminazene at 3.5
mg/kg has also been shown to clear the infection.
For treatment of Ehrlichiosis:
Note: A study (Eddlestone, S. et al. 2005; Eddlestone, S.M. et al. 2006) demonstrated that imidocarb alone was not effective in clearing Ehrlichia canis from the blood of experimentally infected dogs.
a) In particularly severe cases, imidocarb at 5 mg/kg SC (in a single injection or two injections 15 days apart) with doxycycline at 10 mg/kg/day for 28 days (Sainz 2002)
For treatment of hepatozoonosis (H. canis):
b) 5 mg/kg IM or SC; every 14 days until parasitemia clears. Usually 1–2 injections are sufficient.
For treatment of Cytauxzoon felis:
a) 3–4 mg/kg IM; repeated 7 days after initial dose. Efficacy not proven. Cholinergic effects can be mitigated by pre-treating with atropine. Must also give supportive therapy (IV fluids, prophylactic heparin, nutritional/nursing care, analgesia, and potentially transfusion). This dose is from a prospective clinical trial to determine efficacy and adverse effects.
b) 5 mg/kg IM once and then 14 days later. (Greene et al. 2006) For treatment of feline hemoplasmosis (Haemobartonellosis; Mycoplasma haemofelis, Mycoplasma Haemominutum):
a) Doxycycline is preferred, but in cats intolerant of doxycycline the following alternatives may be effective: imidocarb can be used at 5 mg/kg IM, SC every 14 days until able to maintain a normal PCV. Other optional treatment includes enrofloxacin at 5 mg/kg PO daily or marbofloxacin at 2.75 mg/kg PO daily. (Lappin, M. 2002), (Lappin, M. 2006) For treatment of feline clinical ehrlichiosis or anaplasmosis:
a) As an alternative to doxycycline, imidocarb can be used at 5 mg/kg IM every 14 days for at least 2-4 treatments.
1.2 mg/kg IM; repeat in 10–14 days
Imidocarb is an aromatic diamidine. It inhibits nucleic acid metabolism in susceptible organisms and produces anticholinergic effects. It has antimicrobial activity against protozoal organisms, which accounts for its clinical use. It appears to particularly affect the erythrocyte stages of the parasite by inhibition of inositol entry into infected erythrocytes.
The manufacturer warns not use imidocarb in patients exposed to cholinesterase-inhibiting drugs, pesticides, or chemicals.
Allergic reactions may occur with beta-lactam antibiotics. With rapid infusion or in patients with renal insufficiency, neurotoxicity may occur. Neurotoxicity in animals has included tremors, nystagmus, and seizures. Nephrotoxicity is possible, but imipenem is combined with cilastatin to decrease renal metabolism. Vomiting and nausea are possible. IM injections can cause painful reactions
Dogs receiving a dosage of 9.9 mg/kg (1.5X labeled dose) showed signs of liver injury (slightly increased liver enzymes), pain and swelling at the injection site, and vomiting. Overdoses or chronic toxicity may present with cholinergic signs (vomiting, weakness, lethargy, salivation) or adverse changes in liver, kidney, lung, or intestinal function. Treatment with atropine may be useful to treat cholinergic signs associated with imidocarb.
The LD-50 in horses is reportedly 16 mg/kg.
Use cautiously in patients prone to seizures. Seizures may be more likely in
patients with renal failure.
Meat: 28 days.
Milk: 5 days.