Levamisole was introduced in the 1960s as a veterinary anthelmintic. Since then, its massive use in livestock has led to resistance in numerous species of gastrointestinal roundworms of cattle, sheep, and goats.

The most relevant resistant species are:

See below for DETAILS.

There are reports on other parasites that have developed resistance to levamisole as well, but so far, such cases remain restricted to limited regions and/or do not represent a global threat for domestic animals yet, and thus are not particularly analyzed in this article. Recommended measures to handle these cases are more or less the same as for the most critical ones: Rotation to chemical classes with different modes of action that remain effective and/or Integrated Pest Management. The following case can be mentioned:

  • Pigs: Oesophagostomum dentatum. Resistance of O. dentatum to levamisole was reported in Germany in 1990s. However, since then it has not become a generalized problem in most other countries.

Multiresistance is spreading. In a FAO survey in 2004 it was found that simultaneous resistance to benzimidazoles and levamisole was present in 73% of the sheep properties investigated in Brazil, 60% in Australia, and 8% in New Zealand. In 2010 one sheep property was reported in Brazil where gastrointestinal roundworms were simultaneously resistant to 7 different chemical classes (levamisole, benzimidazoles, macrocyclic lactones, nitroxinil, disophenol, trichlorfon and closantel). In 2021 a study in cattle farms in Brazil reported multiresistance of gastrointestinal roundworms to 4 different chemical classes of anthelmintics in 95% of the twenty farms investigated: macrocyclic lactones, levamisole, benzimidazoles, and closantel

Levamisole is only effective against roundworms (in the digestive system and elsewhere). It is ineffective against tapeworms or flukes.

Levamisole is available mainly for both oral and injectable administration to livestock (ruminants, pigs, swine, poultry): in contrast with benzimidazoles it is soluble in water. A few pour-ons alre also available for ruminants in some countries. There are hundreds of generic levamisole products in most countries.

For oral administration to livestock it is used mainly in drenches and feed or water additives, often in combination with other compounds. For dogs and cats it is available mainly in tablets or pills, but use in pets is scarce. It is not used in horses.

Parasites with resistance to levamisole

  • Gastrointestinal roundworms in catte, sheep and goats

    • OCCURRENCE. Resistance of these gastrointestinal roundworms (mainly Haemonchus spp, Cooperia spp, Nematodirus spp, Trichostrongylus spp, Teladorsagia spp, Oesophagostomum spp, Chabertia spp.) to levamisole has been reported worldwide, it is quite frequent in all types of livestock operations, and can be rather high. The problem is more extended in sheep and goats, than in cattle. Prevalence studies during a FAO survey run in the 2000s in numerous countries in sheep properties found that more or less strong resistance of gastrointestinal roundworms to levamisole was present in 84% of the properties investigated in Brazil, 82% in Uruguay, 80% in Australia, 71% in Paraguay, 50% in France, 35% in Spain, 25% in Argentina, and 24% in New Zealand. Since than the problem has certainly not improved but worsened.
    • OUTLOOK. Problems will worsen everywhere. Resistance will continue to spread and to strengthen, because little is done in most regions to reduce their use and to encourage non-chemical control and prevention. In fact, it is the biggest and most threatening resistance problem in livestock parasites. Also because such parasites are often multiresistant, i.e. they can be simultaneously resistant to nematicides of other chemical classes e.g. macrocyclic lactones, benzimidazoles, etc.
    • RECOMMENDED MEASURES. The most recommended measure is to switch to Integrated Pest Management (IPM) and/or to implement whatever preventative measures that reduce the use of any chemicals. Where alternative chemicals of another chemical classes are still working against these worms, rotation is usually a good option, i.e. to stop using levamisole and to use other products with actives of those still effective chemical classes during several years.
    • ALTERNATIVE PARASITICIDES for ROTATION. There are various chemical classes that control gastrointestinal roundworms too, and rotation with those chemical classes that still work can make sense. However, those worm species that have developed resistance to levamisole are often also resistant to these other chemical classes. Other chemicals or chemical classes that control gastrointestinal worms of livestock to some extent are the following:

Where available, follow national or regional recommendations for delaying resistance development or for handling already confirmed cases.

To evaluate resistance problems it must also be considered that innovation in the field of livestock parasiticides has strongly decreased in the last decades.

This means that the likelihood that new chemical classes with new modes of action against resistant parasites become available is quite slim. The reason is that, in the last decades, almost all animal health companies have focused their R&D investments in the much more profitable business of pet parasiticides. As a consequence, regarding resistance management in livestock and horses, almost nothing really new (i.e. with a new mode of action) has been introduced in the last decades: all new products (mostly new formulations or mixtures) have been basically "more of the same".

If you want to learn more about resistance, read one of the following articles in this site:

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