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IMMITICIDE®(melarsomine dihydrochloride) Sterile Powder

INDICATIONS

IMMITICIDE® (melarsomine dihydrochloride) Sterile Powder is indicated for the treatment of stabilized Class 1, 2, and 3 heartworm disease caused by immature to mature adult infections of Dirofilaria immitis in dogs.

 

CONTRAINDICATIONS: IMMITICIDE is contraindicated in dogs with very severe (Class 4) heartworm disease. Patients in this category have Caval Syndrome (D. immitis present in the venae cavae and right atrium).

CLINICAL BENEFITS

  • Melarsomine dihydrochloride, the active ingredient in IMMITICIDE® (melarsomine dihydrochloride) Sterile Powder, is the only American Heartworm Society-recommended treatment for canine heartworm disease1

  •  Backed by scientific studies, antiparasitic IMMITICIDE has been approved and produced by a trusted company for over 25 years

  • Two dosing protocols, based on disease severity

  • Over 4 million doses sold2
DOSAGE & ADMINISTRATION

IMMITICIDE® (melarsomine dihydrochloride) Sterile Powder should be administered ONLY by deep intramuscular injection in the epaxial (lumbar) muscles in the third through fifth lumbar region. DO NOT ADMINISTER AT ANY OTHER SITE. Avoid superficial injection or leakage.

 

Use a 23-gauge, 1 inch needle for dogs equal to or less than 22 lbs (10 kg) in weight. Use a 22-gauge, 1 ½ inch needle for dogs greater than 22 lbs (10 kg).

 

Use alternating sides with each administration. If repeated administrations are warranted, avoid injecting at the same lumbar location. Record the location of the first injection(s) in the patient’s medical record for future reference.

 

Care must be taken to administer the proper dose. Accurately weigh the dog and calculate the volume to be injected based on the dose of 2.5 mg/kg (1.1 mg/lb). This is equivalent to 0.1 mL/kg (0.045 mL/lb).

 

It is vital to classify the severity of heartworm disease to apply the appropriate dosage regimen for IMMITICIDE Sterile Powder. IMMITICIDE should not be used in dogs with very severe (Class 4) heartworm disease. For complete dosing information according to heartworm disease class, please refer to the full prescribing information.

SAFETY

IMMITICIDE® (melarsomine dihydrochloride) Sterile Powder has a low margin of safety. Adverse reactions, primarily at the injection sites, were seen at the recommended dose in clinical trials.

 

HUMAN WARNINGS: Keep this and all medications out of the reach of children. Avoid human exposure. Wash hands thoroughly after use or wear gloves. Potentially irritating to eyes. Rinse eyes with copious amounts of water if exposed. Consult a physician in cases of accidental exposure by any route (dermal, oral, or by injection).

 

IMPORTANT SAFETY INFORMATION: IMMITICIDE Sterile Powder should not be used in dogs with very severe (Class 4) heartworm disease. IMMITICIDE Sterile Powder should be administered by deep intramuscular injection in the lumbar (epaxial) muscles (L3–L5) only. Do not use in any other muscle group. Do not use intravenously. Care should be taken to avoid superficial injection or leakage. Serious adverse reactions may occur in any dog with heartworm disease due to the killing of heartworms in the pulmonary arteries. Reactions may include thromboembolism, dyspnea, coughing, depression, right side heart failure, and death. Dogs should be cage rested following treatment due to possible thromboembolic disease. Post-injection site reactions (eg, pain, swelling) were the most commonly reported adverse events. See full prescribing information for dosing and administration directions prior to each use of IMMITICIDE Sterile Powder. For more information, please see full prescribing information.

IMPORTANT SAFETY INFORMATION:

IMMITICIDE® should not be used in dogs with very severe (Class 4) heartworm disease. IMMITICIDE Sterile Powder should be administered by deep intramuscular injection in the lumbar (epaxial) muscles (L3–L5) only. Do not use in any other muscle group. Do not use intravenously. Care should be taken to avoid superficial injection or leakage. Serious adverse reactions may occur in any dog with heartworm disease due to the killing of heartworms in the pulmonary arteries. Reactions may include thromboembolism, dyspnea, coughing, depression, right side heart failure, and death. Dogs should be cage rested following treatment due to possible thromboembolic disease. Post-injection site reactions (eg, pain, swelling) were the most commonly reported adverse events. See full prescribing information for dosing and administration directions prior to each use of IMMITICIDE. For more information, please see full prescribing information.  

The Original Melarsomine

IMMITICIDE® (melarsomine dihydrochloride) Sterile Powder contains the original melarsomine product recommended by both the American Animal Hospital Association (AAHA) and the American Heartworm Society (AHS) for heartworm disease treatment.1 IMMITICIDE has been trusted for over 25 years and is backed by numerous safety and efficacy studies. As a vet professional, you are now able to take control and order IMMITICIDE for your clinics without the need of a positive heartworm case.

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Significant reduction in heartworms—in cases from mild (Class 1) to severe (Class 3)3,4

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Efficacy of the 2-dose
protocol

Indicated for dogs with Class 1 or Class 2
heartworm disease*

Administered twice at 2.5 mg/kg, 24 hours apart

 

Bar graph showing 90.9% efficacy with 4 month old heartworms, and 90.7% efficacy for transplanted adult heartworms

 

Postmortem reduction in worm count (vs placebo treatment)

 

Study design: In placebo-controlled laboratory studies, IMMITICIDE® (melarsomine dihydrochloride) was administered at 2.5 mg/kg twice, 24 hours apart.

 

Efficacy of the 3-dose
protocol (alternate dosing regimen)

Indicated for dogs with Class 3 heartworm disease* 

Administered at 2.5 mg/kg once, followed 1 month later with 2.5 mg/kg administered twice, 24 hours apart

 
Bar graph showing 99% efficacy for transplanted adult heartworms

Postmortem reduction in worm count (vs placebo treatment)

 

Study design: To evaluate the effectiveness of the alternate dosing regimen, dogs were treated with 2.5 mg/kg once, followed 1 month later with 2.5 mg/kg administered twice, 24 hours apart.

 

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*See Prescribing Information for details about classifying the severity of heartworm disease.

Misconceptions of the Slow Kill Method

What is the slow kill method? For a few decades, the slow kill method has been used as an alternative option for treating heartworms. It involves long-term use of a monthly heartworm preventive plus an antibiotic called doxycycline. However, the American Heartworm Society (AHS) states that this treatment plan can cause more harm than good for the following reasons5:

 

  • Can Cause Lasting Damage
    As the name suggests, this treatment can take a very long time. During this time, adult heartworms will continue to cause severe damage to the pet’s heart, lungs, and other organs.

  • Strict Exercise Restrictions
    Since the timing of heartworm death is unpredictable, pets should be kept calm with strict exercise limitations during the entire time of treatment, which can take months or even years.

  • False Negatives
    Often when pets test negative for heartworms after being on the slow kill treatment, it is actually a false reading because the treatment did not eliminate all life stages that are still developing.

 

The cover of the treatment record folder offered by Boehringer Ingelheim

Treatment Record Keeping

Keeping accurate and understandable treatment records is important for you and your clients. This downloadable folder can help you document and keep each patient’s treatment information and recommendations organized and easily accessible.

Download Folder

Treatment Record Keeping

Keeping accurate and understandable treatment records is important for you and your clients. This downloadable folder can help you document and keep each patient’s treatment information and recommendations organized and easily accessible.

Download Folder
The cover of the treatment record folder offered by Boehringer Ingelheim

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Clinic Resources

Downloadable Content

IMMITICIDE® Sterile Powder Detailer

IMMITICIDE® Sterile Powder Treatment Record

American Heartworm Society’s Current Canine Guidelines for the
Prevention, Diagnosis, and Management of Heartworm
(Dirofilaria immitis) Infection in Dogs

Heartworm Disease Treatment Pet Owner Brochure
Supporting Websites

CAPC 2022 Heartworm Prevalence Map

American Heartworm Society Website

American Heartworm Society Treatment Dosage Calculator

Answering Pet Owner Questions

Here are some commonly asked questions by pet owners when it comes to treating their pet for heartworm disease.

Q: How long will my dog be in the hospital?

A: Let your pet owner know in most cases, dogs can come home following the procedure. However, their pet’s condition and your judgment will best determine when the pet may go home.

Q: How soon can my dog resume normal activities?

A: Remind your pet owner that their dog will need to rest to prevent complications resulting from stress on the heart and lungs before they can get back to normal activities. Emphasize the importance of following your recommendations and suggest weeks of rest.

Q: Are there any side effects from the treatment?

A: Let your pet owner know some of the things their dog may experience:

  • A temporary lack of appetite
  • An upset stomach
  • Drooling
  • Panting
  • Fever
  • Respiratory difficulty
  • Depression

Q: Can my dog get heartworm disease again?

A: As you know, having heartworms once DOES NOT make a dog immune to them. Encourage your pet owner to continue bringing in their dog for regular checkups as well as recommend a heartworm preventive medication.

Map of the prevalence in Heartworm disease in the United States, showing a higher prevalence in the south east portions of the country

Prevalence of Heartworm Disease

The data in this map serve as a strong representation of heartworm activity throughout the United States. Use this information to help educate your clients on the presence of a potentially deadly threat in your area.

Learn More

Prevalence of Heartworm Disease

The data in this map serve as a strong representation of heartworm activity throughout the United States. Use this information to help educate your clients on the presence of a potentially deadly threat in your area.

Learn More
Map of the prevalence in Heartworm disease in the United States, showing a higher prevalence in the south east portions of the country
A woman gives her dog a Heartgard Plus chew

Recommending Prevention

When it comes to helping prevent heartworm disease as well as treating and controlling 5 species of intestinal worms, recommend

HEARTGARD® Plus (ivermectin/pyrantel).* Learn more about the real-beef chew dogs prefer†, making monthly dosing easy and delicious.

Learn More

Recommending Prevention

When it comes to helping prevent heartworm disease as well as treating and controlling 5 species of intestinal worms, recommend

HEARTGARD® Plus (ivermectin/pyrantel).* Learn more about the real-beef chew dogs prefer†, making monthly dosing easy and delicious.

Learn More
A woman gives her dog a Heartgard Plus chew

‏

IMPORTANT SAFETY INFORMATION:

HEARTGARD® Plus (ivermectin/pyrantel) is for use in dogs only. All dogs should be tested for heartworm infection before starting a preventive program. Following the use of HEARTGARD Plus, digestive and neurologic side effects have been reported. For more information, please see full prescribing information.

References

*HEARTGARD Plus chews treat and control hookworms (Ancylostoma caninum, A. braziliense, and Uncinaria stenocephala) and roundworms (Toxocara canis and Toxascaris leonina).

 

†For dogs demonstrating a preference, they preferred HEARTGARD Plus chews over its competitors.

 

  1. American Heartworm Society. Summary of the current canine guidelines for the prevention, diagnosis, and management of heartworm (Dirofilaria immitis) infection in dogs. Accessed August 11, 2020. https://www.heartwormsociety.org/images/pdf/Canine-Guidelines-Summary.pdf

  2. Data on file at Boehringer Ingelheim.

  3. IMMITICIDE® (melarsomine dihydrochloride) Sterile Powder [Freedom of Information Summary; NADA 141-042].

  4. IMMITICIDE® (melarsomine dihydrochloride) Sterile Powder  [package insert]. Duluth, GA: Merial, Inc; 2017.

  5. American Heartworm Society. Quarterly Update Summer 2018. The AHS Protocol vs. “Slow Kill”. https://d3ft8sckhnqim2.cloudfront.net/images/bulletin/AHS-1807-Jul-18-Summer-Bulletin.pdf?1534890175
Trademarks

IMMITICIDE® is a registered trademark of Boehringer Ingelheim Animal Health France, used under license. HEARTGARD® and the Dog & Hand logo® are registered trademarks of Boehringer Ingelheim Animal Health USA Inc. ©2023 Boehringer Ingelheim Animal Health USA Inc., Duluth, GA. All rights reserved.

US-PET-0563-2020-V2