Brand: ULTRA-MOX ™

Company: ELANCO (BAYER)


FORMULATION: «oral paste» in pre-charged syringes containing 30 g

ACTIVE INGREDIENT(S):

CHEMICAL CLASS of the active ingredient(s):


INDICATIONS

HORSES


PARASITES CONTROLLED* (spectrum of activity)

* Country-specific differences may apply: read the product label.

  • Roundworms:
    • Ascarids: Parascaris equorum (mature and immature).
    • Small strongyles: Cyathostomum spp, Gyalocephalus spp, Cylicostephanus spp, Cylicocyclus spp (mature and immature) adult and developing stages (DL), late encysted stages (DL), late encysted stages (LL3/LL4) and inhibited stages of small strongyles.
    • Large Strongyles: Strongylus vulgaris (mature and arterial larval stages), Strongylus edentatus (mature and tissue stages), Strongylus equinus (mature), Triodontophorus spp (mature).
    • Large mouth stomach worms: Habronema spp. Also skin lesions caused by the cutaneous larvae of Habronema and Draschia spp. (summer sores).
    • Hairworms: Trichostrongylus axei (mature).
    • Intestinal Threadworms: Strongyloides westeri (mature).
    • Pinworms: Oxyuris equi (adult and immature).
    • Lungworms: Dictyocaulus arnfieldi (mature and immature).
  • Tapeworms: Anoplocephala perfoliata (mature and immature) (scoleces and segments).
  • Bots: Gasterophilus spp (oral and gastric stages).

RECOMMENDED DOSE*

*Can be slightly different in some countries: read the product label!

  • 1 g of product per 20 kg bodyweight (one 30 g syringe will treat a 600 kg horse): equivalent to 0.4 mg moxidectin per kg bodyweight (= 400 mcg/kg), 10 mg oxfendazole per kg bodyweight and 2.5 mg praziquantel per kg bodyweight.
  • Read the product label for further details on dosing

SAFETY

  • LD50 (acute oral) in rats: >5000 mg/kg (estimate calculated according to the WHO based on the moxidectin LD50)
  • Estimated hazard class according to the WHO: not applicable for veterinary medicines

Suspected poisoning? Read the articles on moxidectin safety, oxfendazole safety and/or praziquantel safety in this site.

Withholding periods (=withdrawal times) for meat & milk (country-specific differences may apply: read the product label)

  • Meat: New Zealand: 63 days

WARNING !!!: Never use on humans, dogs or cats

You may be interested in the following articles in this site dealing with the general safety of veterinary products:


RESISTANCE PREVENTION

Risk of resistance? YES

  • Small strongyles (cyathostomes). Tolerance of small strongyles to macrocyclic lactones (e.g. ivermectin, moxidectin), manifested as a low but significant worm egg output after treatment (determined after fecal egg counts) is not yet widespread, but has been already reported in Europe (e.g. in the UK, Germany, Italy), the USA, Brazil and New Zealand. Resistance of small strongyles to benzimidazoles (incl. oxfendazole) is widespread and frequent in Australia, USA, UK and Europe, Argentina, Chile, Uruguay, and also in New Zealand. 
  • Parascaris equorum. Cases of resistance to macrocyclic lactones (e.g. ivermectin, moxidectin) and to benzimidazoles have been reported as well (e.g. in the USA,Australia and New Zealand).

This means that if this product does not achieve the expected efficacy against the mentioned parasites, it may be due to resistance and not to incorrect use, which is usually the most frequent cause of product failure.

It is generally accepted that the use of mixtures of active ingredients with different modes of action against a given parasite can delay the appearance of resistance. But only if the concerned parasites are susceptible to all the actives in the mixture. If not, the mixture is likely to promote multi-resistant parasites, because the selection pressure against all actives remains in place. Mixtures such as this one may provide peace-of mind to those users that do not know the resistance status of worms in their property: at least one of the actives will work... This may be the case for a while. But the risk that some worm species become resistant to all components after a few years using the same or comparable mixtures is considerable. If it is not too late, a better alternative is to determine the resistance status in the property and to rotate among products (not mixtures) against which the worms have not yet developed resistance, stopping the use of those chemical classes that have already shown resistance problems.

Alternative chemical classes/active ingredients to prevent resistance of gastrointestinal roundworms through product rotation:

These alternative products may not be available in all countries, or may not be available as oral pastes or gels.

Learn more about resistance and how it develops.


MARKETING

Are the active ingredients of this product ORIGINAL* or GENERICS**?

  • GENERICS

*Meaning that they are still patent protected and generics are not yet available
**Meaning that they have lost patent protection and may be acquired from manufacturers of generic active ingredients other than the holder of the original patent.

COUNTRIES where this product is marketed: New Zealand
GENERIC BRANDS available? YES, but maybe not with the same composition

Click here to learn more about GENERIC vs. ORIGINAL drugs.


COMMENTS

ULTRA-MOX is a classic oral paste for horses from BAYER (now ELANCO) containing three active ingredients: moxidectin, oxfendazole and praziquantel. Moxidectin is effective against roundworms and bots, oxfendazole against roundworms (with another mode of action than moxidectin) and tapeworms, praziquantel against tapeworms.

Moxidectin is a macrocyclic lactone introduced in the market in the early 1990s (by AMERICAN CYANAMID → PFIZER → ZOETIS). It is moderately used in livestock and pets. It is effective against most species of roundworms that affect horses and against bots (Gasterophilus spp), but not against tapeworms. It is moderately used in livestock, horses and pets, not in agricuture.

Moxidectin and other macrocyclic lactones have about two weeks residual effect on horses because they are stored in body fat and progressively released. This, together with the time that worms need to develop inside the horse after infection (pre-patent period) allows to space the treatment intervals to 10 to 12 weeks in year-round control programs in many regions. For other active ingredients that have no residual effect such as fenbendazolemebendazole, or pyrantel the treatment interval is usually 4 to 6 weeks.

Whereas in ruminants moxidectin administered at 400 mcg/kg controls a series of external parasites as well (mites, lice, etc.), such an indication is not approved in most countries in horses: external parasites have to be controlled with ectoparasiticides (e.g. pour-ons, sprays, etc.).

Oxfendazole is a veteran benzimidazole introduced in the 1970s (by WELLCOME, SYNTEX) that is moderately used in livestock and horses, rather scarcely in pets. It is a broad-spectrum anthelmintic effective against roundworms in the gut and the lungs, but not against those in the skin. It is also ineffective against gastric bots (Gasterophilus spp) or whatever external parasites. At the recommended dose it is also ineffective against horse tapeworms (Anoplocephala spp). It is scarcely used in livestock, horses and pets. It is not used in agriculture.

Praziquantel is a veteran anthelmintic introduced in the 1970s (by BAYER). It is highly effective against tapeworms (in horses mainly Anoplocephala spp) but has no efficacy whatsoever against roundworms. It is the anthelmintic most vastly used against tapeworms in horses and pets, used in hundreds of brands. It is hardly used in livestock. It is not used in agriculture.

Oxfendazole and praziquantel have no residual effect, i.e. they kill the parasites after administration but do not protect against reinfestation.

Many horse owners complain about the price of the oral pastes & gels for horses (with ivermectin or other macrocyclic lactones), compared with the much cheaper injectables for livestock with the same active ingredients, used at the same dose (200 mcg/kg). This is why off-label use of livestock ivermectin injectables in horses is very common worldwide, particularly in working horses of cattle and sheep ranches. The reason why injectables are mostly not approved for use on horses is apparently that, shortly after introduction, it was noticed that horses were more prone to develop severe clostridial infections at the injection site (due to contamination of the needles) and other undesired side effects than cattle or sheep. In addition, the pharmacokinetic behavior of ivermectin on horses is different than in ruminants. For these reasons oral pastes were developed for horses that do not show such side effects. However, in numerous countries (e.g. in Latin America) some ivermectin injectables for livestock are also approved for use on horses.

For an overview and a list of the most used oral paste & gel brands click here.


DISCLAIMER

This article IS NOT A PRODUCT LABEL. It offers complementary information that may be useful to veterinary professionals and users that are not familiar with veterinary antiparasitics. 

Information offered in this article has been extracted from publications issued by manufacturers, government agencies (e.g. EMEA, FDA, USDA, etc.) or in the scientific literature. No guarantee is given on its accuracy, integrity, sufficiency, actuality and opportunity, and any liability is denied. Read the site's DISCLAIMER.

In case of doubt contact the manufacturer or a veterinary professional.