Milprazon 12.5mg/125mg (Milbemycin Oxime + Praziquantel) for Dogs – Broad-Spectrum Wormer & Heartworm Prevention | 48 Tablets

What Is Milprazon 12.5mg/125mg?

Milprazon 12.5mg/125mg is a broad-spectrum oral wormer and heartworm preventive for dogs over 5kg, manufactured by KRKA. Each tablet contains:

• Milbemycin oxime 12.5mg — macrocyclic lactone effective against roundworms, hookworms, whipworms, and heartworm larvae
• Praziquantel 125mg — cestocide effective against all major tapeworm species including the fox tapeworm (Echinococcus multilocularis)

This box contains 48 tablets. Milprazon is the generic equivalent of Milbemax (Elanco) — the same active ingredients at the same doses, at a more competitive price. The 12.5mg/125mg formulation is the large dog tablet suitable for dogs from 5kg up to 75kg body weight.

This Product Is For: Dogs Over 5kg (up to 75kg)

The 12.5mg/125mg tablet is for medium, large, and giant breeds. A single tablet covers dogs from 5–25kg; two tablets for 25–50kg; three tablets for dogs 50–75kg. For puppies and dogs under 5kg, use the Milprazon 2.5mg/25mg small dog formulation.

Full Worm Coverage

How the Two Active Ingredients Work

Milbemycin Oxime — Nematode Paralysis via Chloride Channels

Milbemycin oxime belongs to the macrocyclic lactone antiparasitic class. It selectively kills nematodes and heartworm larvae by binding to glutamate-gated chloride ion channels in invertebrate nerve and muscle cells — channels absent in mammals, explaining its wide safety margin. Channel binding causes permanent paralysis and death of the parasite. At the monthly preventive dose, it kills L3 and L4 heartworm larvae in the tissues before they reach the heart and pulmonary arteries as adult worms. Unlike ivermectin, milbemycin oxime at the heartworm-prevention dose is also effective against roundworms, hookworms, and whipworms simultaneously.

Praziquantel — Tapeworm Membrane Disruption

Praziquantel acts by dramatically increasing tapeworm cell membrane permeability to calcium, flooding the worm’s muscle cells and causing intense spastic paralysis and rapid disintegration of the outer tegument (surface). The paralysed, disintegrating tapeworm loses its hold on the intestinal wall and is digested or expelled. Praziquantel works quickly — tapeworm death typically begins within hours. It covers all clinically relevant tapeworm species in dogs, including Echinococcus multilocularis — the fox tapeworm responsible for alveolar echinococcosis, a serious zoonotic disease. Hunting dogs, farm dogs, and any dog exposed to fox-contaminated environments should be treated regularly for Echinococcus prevention.

Dosage — 12.5mg/125mg Tablets for Large Dogs

⚠️ Must be given with food — food significantly improves absorption of milbemycin oxime and praziquantel. For heartworm prevention, the product label specifically states it should be administered with or after a small amount of food to ensure optimum efficacy.

48-Tablet Box Duration

The 48-tablet bulk pack represents exceptional value for large dogs needing routine quarterly worming, and is highly economical for monthly heartworm prevention in medium breeds.

How Often to Give Milprazon

• Heartworm prevention: Once monthly throughout the risk season (or year-round in endemic regions — southern Europe, Mediterranean countries, tropics). Start within 1 month of first mosquito exposure; continue for at least 1 month after last exposure.
• Routine intestinal worming: Every 1–3 months. Active, outdoor dogs — especially those that hunt, scavenge, or eat raw meat — should be wormed monthly.
• Echinococcus / fox tapeworm control: Every 4–6 weeks in hunting dogs, rural dogs, and dogs in fox-endemic areas.

⚠️ Heartworm Test Required Before Starting in Endemic Areas

If your dog lives in or has recently visited a heartworm-endemic area and has not previously had preventive treatment, consult your vet about testing for existing adult heartworm infection before starting Milprazon. Giving milbemycin oxime to a dog with high numbers of circulating microfilariae can trigger a serious hypersensitivity reaction: the sudden mass death of microfilariae releases large amounts of parasite proteins, causing vomiting, hypersalivation, laboured breathing, pale mucous membranes, and shock-like collapse. This reaction is not direct drug toxicity — it is caused by the dying microfilariae. Milprazon does NOT kill adult heartworms already established in the cardiovascular system.

⚠️ MDR1 / ABCB1 Mutation — Collie Breed Warning

Milbemycin oxime is a macrocyclic lactone. Collie-type herding breeds can carry the MDR1/ABCB1 mutation that reduces P-glycoprotein function, making them more sensitive to macrocyclic lactones at high doses. At the standard monthly heartworm prevention dose, Milprazon is safe for Collie breeds — milbemycin oxime has been shown nontoxic in rough-coated Collies at up to 20× the recommended dose in laboratory studies.

The risk increases if milbemycin oxime is combined with P-glycoprotein inhibitors. Always inform your vet if your Collie or herding-breed dog is taking:

• Cyclosporine (Cyclavance, Atopica)
• Azole antifungals (ketoconazole, itraconazole)
• Calcium channel blockers (diltiazem, verapamil)
• Amiodarone, carvedilol, spironolactone
• Erythromycin, clarithromycin

Breeds most frequently affected by the MDR1 mutation: Collie (70% frequency), Long-Haired Whippet (65%), Australian Shepherd (50%), McNab (30%), Shetland Sheepdog (15%), German Shepherd (10%), Border Collie, Old English Sheepdog. DNA testing via oral swab can confirm mutation status in any individual dog.

Minimum Age and Weight

• Dogs from 0.5kg body weight (use 2.5mg/25mg formulation for dogs under 5kg) and 2 weeks of age
• Safety in pregnant or lactating bitches has not been fully established; use on veterinary advice only

Side Effects

• Vomiting, diarrhoea, reduced appetite — rare; usually mild and transient; always give with food
• Neurological signs (ataxia, tremors, dilated pupils, hypersalivation) — very rare at label doses; elevated risk if combined with P-glycoprotein inhibitors in MDR1-affected breeds
• Shock-like hypersensitivity reaction — in dogs with high circulating microfilarial burden; see heartworm warning above

Storage

• Store at room temperature, below 25°C
• Keep in original blister packaging; protect from moisture and direct sunlight
• Keep out of reach of children and animals — the flavoured tablets may be attractive to dogs

Related products: Milprazon 2.5mg/25mg for Small Dogs & Puppies — 48 tablets | Milprazon Wormer for Cats — 2 tablets