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Veterinary Forum March 2007 (Vol 24, No 3)

FDA approves new topical antiparasitic

    ROCKVILLE, Md.— The FDA recently approved new topical solutions to control heartworm, fleas and intestinal nematodes in both dogs and cats.

    The new products, Advantage Multi for Dogs and Advantage Multi for Cats (Bayer Animal Health), combine imidacloprid and moxidectin to treat and control parasites. They are the next generation of the company's flagship brand, Advantage, according to Thomas Hopper, director of marketing for Bayer Animal Health.

    The products combine the effective flea control of Advantage with a preventative for heartworm and treatment and control of hookworms (adults, immature adults and fourth-stage larvae) and roundworms (Toxocara canis adults and fourth-stage larvae) in one convenient, monthly topical solution. Advantage Multi for Dogs also treats and controls whipworms, and Advantage Multi for Cats treats and controls ear mite infestations, according to Hopper.

    The Companion Animal Parasite Council (CAPC) recommends year-round flea control as well as treatment with heartworm preventatives that have broad-spectrum activity against parasites with zoonotic potential. The American Association of Feline Practitioners and the American Animal Hospital Association endorse these recommen­dations. Regardless, pet owners, on average, are not using these products year round. Instead, they are administering flea treatments only 8 months out of the year, heartworm treatment fewer than 10 months of the year and internal parasite treatment only 4 months a year, according to a recent national survey of 1,000 pet owners.

    However, Hopper told Veterinary Forum that 65% of pet owners would use the products more often if they were more convenient. Hopper added that cat owners are very concerned about feline heartworm — the rationale behind bringing the product, which has been used for several years in 35 countries, to the United States. More than 13 million doses of the products have been produced worldwide, he said.

    Joe Hostetler, DVM, at Bayer said that the products can be used in kittens and puppies once they have received their normal deworming medications. Bayer has produced kitten and puppy kits that contain only three doses of medication. Therefore, owners do not have to buy more than they need, as the products are dosed by weight and the first 3 months is a major growth period for young animals. Advantage Multi for Dogs can be used for puppies as young as 7 weeks of age that weigh at least 3 lb, and Multi for Cats can be used in kittens as young as 9 weeks of age that weigh at least 2 lb.

    The most common adverse events reported postapproval in foreign markets include gastrointestinal, dermatologic, immune and neurologic effects. Although Advantage Multi for Dogs topical solution has been shown to be safe when used as directed, a percentage of some herding breeds, such as collies and collie mixes, may have a mutation in the MDR1 gene that can result in abnormal absorption and distribution of the class of drugs known as avermectins, which can cause severe toxicity if orally ingested. Moxidectin is in the avermectin class. For this reason, the FDA has requested that Bayer include a warning regarding oral ingestion of the product.

    When adminstered topically as directed, Advantage Multi for Dogs has shown no abnormalities to avermectin in sensitive dogs at up to five times the prescribed dose, according to Hostetler. The warning says that dogs should not lick the application spot for 30 minutes. "As with all topical solutions, it should not be given orally," Hopper added.

    In addition, children should be kept from touching the wet spot until it dries, Hostetler said.

    Moxidectin was used in ProHeart 6, which was voluntarily pulled from the market by Fort Dodge Animal Health. Although Pro Heart 6 and the Bayer products contain moxidectin and are used against heartworm, the formulations are substantially different, according to Hopper. ProHeart 6 was an injectable product formulated with microsphere technology so that it could be dosed every 6 months. Advantage Multi is a topical product that is dosed monthly. Absorption of the products is different, he explained.

    Both Bayer products are available only through a veterinarian, he said.

    NEXT: Heart-Based Foreign Bodies: Removing an Embedded Serrated Knife