Levamisole is a broad spectrum anthelmintic effective against roundworms (both gastrointestinal and respiratory) but not against tapeworms or flukes. It is also completely ineffective against external parasites.
Worldwide it is used massively in livestock (mainly in drenches, feed additives, injectables and a few pour-ons) and only scarcely in pets (often in tablets, pills, etc. or oral suspensions). There are hundreds of generic brands worldwide, many as mixtures with other anthelmintics.
Levamisole is not used against agricultural or household pests
The table below indicates some usual dosing recommendations for levamisole issued by manufacturers or documented in the scientific literature. They may not be approved in some countries.
| Dosing recommendations for LEVAMISOLE |
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| DOGS | ||
| Delivery | Parasites | Dose (against levamisole-susceptible parasites) |
| Intramuscular | Roundworms | 5 mg/kg |
| Oral | Gastrointestinal roundworms | 5-16 mg/kg |
| Oral | Trichuris vulpis |
16 mg/kg |
| Oral | Respiratory roundworms | 7.5 mg/day x 2 days |
| Oral | Crenosoma vulpis | 8 mg/kg |
| Oral | Capillaria aerophila | 7-12 mg/kg/day, x 3-7 days |
| Oral | Filaroides osleri | 7.5-12 mg/kg/dayx 10-45 days |
| Oral | Dirofilaria immitis, microfilariae | 10 mg/kg/day x 6-12 days |
| Oral | Dirofilaria immitis, adults | 10 mg/kg 2x/day, x14 days |
| Oral | Angiostrongylus vasorum | 5-10 mg/kg/day x 2 days |
| Subcutaneous | Filaroides osleri | 7.5 mg/kg/day x 30 days |
| Subcutaneous | Roundworms | 5 mg/kg |
| CATS | ||
| Delivery | Parasites | Dose (against levamisole-susceptible parasites) |
| Intramuscular | Roundworms | 5 mg/kg |
| Oral | Roundworms | 7.5 mg/kg |
| Oral | Respiratory roundworms | 25 mg/kg/day every other day, 10-14 days |
| Oral | Aelurostrongylus abstrusus | 20-40 mg/kg/day every other day, 5-6 treatments |
| Oral | Capillaria aerophila | 5 mg/kg/day x5 days, rep 2x with 9 days interval |
| Oral | Dirofilaria immitis, microfilariae | 10 mg/kg/day x7 days |
| Subcutaneous | Gastrointestinal roundworms | 8 mg/kg |
| Subcutaneous | Capillaria aerophila | 4.4 mg/kg/day x2 days + 8.8 mg/kg 2 weeks later |
| Subcutaneous | Aelurostrongylus abstrusus | 7.5 mg/kg/day x2 days |
| CATTLE | ||
| Delivery | Parasites | Dose (against levamisole-susceptible parasites) |
| Topical | Roundworms | 10 mg/kg (pour-on) |
| Intramuscular | Roundworms | 5 mg/kg |
| Oral | Roundworms | 7.5 mg/kg |
| Oral | Dictyocaulus viviparus | 5-11 mg/kg |
| Oral | Thelazia spp | 5.4-11.9 mg/kg |
| Subcutaneous | Roundworms | 5 mg/kg |
| Subcutaneous | Dictyocaulus viviparus | 3.8-8 mg/kg |
| Subcutaneous | Ostertagia ostertagi | 7 mg/kg |
| SHEEP | ||
| Delivery | Parasites | Dose (against levamisole-susceptible parasites) |
| Intramuscular | Roundworms | 5 mg/kg |
| Oral | Roundworms | 7.5 mg/kg |
| Oral | Dictyocaulus spp | 8 mg/kg |
| Subcutaneous | Roundworms | 5 mg/kg |
| GOATS | ||
| Delivery | Parasites | Dose (against levamisole-susceptible parasites) |
| Intramuscular | Roundworms | 5 mg/kg |
| Oral | Roundworms | 7.5-12 mg/kg |
| Oral | Dictyocaulus spp | 8 mg/kg |
| Subcutaneous | Roundworms | 5 mg/kg |
| SWINE | ||
| Delivery | Parasites | Dose (against levamisole-susceptible parasites) |
| Intramuscular | Roundworms | 5 mg/kg |
| Oral | Roundworms | 7.5-10 mg/kg in feed or water |
| Subcutaneous | Metastrongylus apri | 5 mg/kg |
| Subcutaneous | Strongyloides ransomi | 5 mg/kg |
| HORSES | ||
| Delivery | Parasites | Dose (against levamisole-susceptible parasites) |
| Intramuscular | Dictyocaulus arnfieldi | 55 mg/kg, rep after 3-4 weeks |
| Oral | Roundworms | 7.5-15 mg/kg |
| Subcutaneous | Roundworms | 5-10 mg/kg |
| SOUTH AMERICAN CAMELIDS | ||
| Delivery | Parasites | Dose (against levamisole-susceptible parasites) |
| Oral | Roundworms | 5-8 mg/kg |
| Subcutaneous | Roundworms | 5-8 mg/kg |
| POULTRY | ||
| Delivery | Parasites | Dose (against levamisole-susceptible parasites) |
| Intramuscular | Gastrointestinal roundworms | 4-8 mg/kg, rep 10-14 days later |
| Oral | Gastrointestinal roundworms | 180-541 mg/l water x1-3 days, rep 10 days later |
| Oral | Ascarids | 10,8 mg/l water during several weeks |
| Oral | Heterakis spp | 40 mg/kg/day x 3 days |
| Oral | Capillaria spp | 40 mg/kg/day x 7 days |
| Subcutaneous | Gastrointestinal roundworms | 4-8 mg/kg, rep 10-14 days later |
| RABBITS | ||
| Delivery | Parasites | Dose (against levamisole-susceptible parasites) |
| Oral | Roundworms | 12.5-20 mg/kg |
| Subcutaneous | Roundworms | 8-20 mg/kg |
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Oral administration reaches higher concentrations in the digestive tract which improves efficacy against gastrointestinal roundworms. Against respiratory roundworms injectables ensure a better bioavailability and higher plasmatic concentrations.
In dogs, delivery with the food or immediately after reduces absorption, resulting in lower plasmatic levels and bioavailability. Fasting for 12 hours prior to treatment increases levamisole efficacy but also the risk of side effects.
Levamisole (by all delivery forms) has almost no residual effect, i.e. it kills the parasites during a few hours after treatment but offers no significant protection against re-infestation.
Unfortunately, resistance of gastrointestinal roundworms to levamisole in sheep, goats, cattle and horses is a major problem in numerous countries. Not so in pets, swine or poultry so far.
Dosing recommendations for antiparasitics depend on national regulations. National regulatory authorities determine whether a product is approved for a given indication, i.e. use on a particular host at a specific dose and against a specific parasite. Check the labels of the products available inyour country for specific information on approved indications. <
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