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Date: Sunday, August 14, 2022 9:29

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Release 2.74
Nexmectin 18.7 mg/g Oral Paste for Horses
Species: Horses and other equidae
Therapeutic indication: Pharmaceuticals: Endoparasiticides: Anthelmintics for horses
Active ingredient: Ivermectin
Product:Nexmectin 18.7 mg/g Oral Paste for Horses
Product index: Nexmectin 18.7 mg/g Oral Paste for Horses
Withdrawal notes: Horses: Meat & Offal: 34 days. Do not use in mares producing milk for human consumption
Qualitative and quantitative composition
Each g contains:
Active substance:
18.7 mg
Titanium dioxide (E171)
20 mg
For full list of excipients, see Pharmaceutical Particulars section.
Pharmaceutical form
Oral Paste. A white homogeneous paste.
Clinical particulars
Target Species
Indications for use, specifying the target species
Treatment of nematode or arthropod infection due to:
Large strongyles:
Strongylus vulgaris (adults and L4 stage larvae) [arterial])
Strongylus endentatus (adults and L4 stage larvae [tissue])
Strongylus equinus (adults)
Small strongyles (including benzimidazole resistant strains):
Cyathostomum spp. (adults and luminal L4 stage larvae)
Cylicocyclus spp. (adults and luminal L4 stage larvae)
Cylicodontophorus spp. (adultsa and luminal L4 stage larvae)
Cylicostephanus spp. (adults and luminal L4 stage larvae)
Gyalocephalus spp. (adults and luminal L4 stage larvae)
Parascaris equorum (luminal L5 larvae and adults)
Oxyuris equi (L4 stage larvae and adults)
Neck threadworms:
Onchocerca spp. (microfilariae)
Stomach bots:
Gasterophilus spp. (oral and gastric stages)
Do not use in cases of hypersensitivity to the active substance or to any of the excipients. Do not use in dogs or cats as severe adverse reactions may occur.
Special warnings for each target species
Some horses with heavy infections of Onchocerca spp. microfilariae have experienced oedema and pruritus following treatment, such reactions are assumed to be the result of death of large numbers of microflariae. These signs resolve within a few days but symptomatic treatment may be advisable.
Care should be taken to avoid the following practices because they increase the risk of development of resistance and could ultimately result in ineffective therapy:
Too frequent and repeated use of anthelmintics from the same class over an extended period of time.
Underdosing, which may be due to underestimation of body weight or misadministration of the product.
Suspected clinical cases of resistance to anthelmintics should be further investigated using appropriate tests (eg Faecal Egg Count Reduction Test). Where the results of the test(s) strongly suggest resistance to a particular anthelmintic, an anthelmintic belonging to another pharmacological class and having a different mode of action should be used.
Veterinary advice should be given on appropriate dosing programs and stock management to achieve adequate parasite control and reduce the likelihood of anthelmintic resistance developing. In the event that a product is suspected of being ineffective, the animal owner is advised to seek veterinary advice.
Resistance to ivermectin has been reported in Parascaris equorum. Therefore, the use of this product should be based on local farm epidemiological information about susceptibility of nematodes and recommendations on how to limit further selection for resistance to anthelmintics.
Special Precautions for Use
Special precautions for use in animals
Since ivermectin is highly bound to plasma proteins, special care should be taken in cases of sick animals or in nutritional conditions associated with low plasma protein levels.
Dogs and cats should not be allowed to ingest spilled gel or have access to used packaging due to the potential for adverse effects related to ivermectin toxicity.
The product has been formulated for use in horses only. Cats, dogs (especially Collies, Old English Sheepdogs and related breeds or crosses) and also turtles and tortoises may be adversely affected by the concentration of ivermectin in this product if they are allowed to ingest spilled paste or have access to used syringes.
Special precautions to be taken by the person administering the veterinary medicinal product to animals
Do not smoke, eat or drink while handling the product.
Wash hands after use.
This product may cause skin and eye irritation. Therefore, the user should avoid contact of the product with the skin and the eyes. In case of contact, rinse immediately and show the package leaflet or the label to the physician.
Adverse Reactions (frequency and seriousness)
None know.
Use during pregnancy, lactation
The product can be administered to mares at any stages of pregnancy or lactation. Do not use in mares producing milk for human consumption.
Interaction with other medicinal products and other forms of interaction
The effects of GABA agonists are increased by ivermectin.
Amounts to be administered and administration route
One syringe division of paste per 100 kg body weight (based on a recommended dosage of 200 μg ivermectin per kg body weight).
The syringe containing 6.42 g of paste delivers sufficient paste to treat 600 kg of bodyweight at the recommended dose rate.
The syringe containing 7.49 g of paste delivers sufficient paste to treat 700 kg of bodyweight at the recommended dose rate.
The paste is given by oral route.
To ensure administration of a correct dose, body weight should be determined as accurately as possible. The animal's mouth should be free from food to ensure swallowing. Turn the screw gauge on the syringe plunger to the body weight of the horse. The tip of the syringe barrel should be inserted at the interdental space (the gap between the front and back teeth) and the paste deposited on the base of the tongue. Advance the plunger as far as it will go, depositing the medication on the base of the tongue. Immediately elevate the horse's head for a few seconds to ensure swallowing.
Overdose (symptoms, emergency procedures, antidotes), if necessary
Mild transitory signs (slowed pupillary light response and depression) have been seen at a higher dose of 1.8 mg/kg (9 times the recommended dose level). Other signs seen at higher doses include mydriasis, ataxia, tremors, stupor, coma and death. The less severe signs have been transitory.
Although no antidote has been identified, symptomatic therapy may be beneficial.
Withdrawal period(s)
Meat and offal: 34 days
Do not use in mares producing milk for human consumption.
Pharmacological particulars
Pharmacotherapeutic Group
Endectocide, macrocyclic lactones
ATCVet code: QP54AA01
Pharmacodynamic Properties
Ivermectin is a member of the macrocyclic lactone class of endectocides. Compounds of the class bind selectively and with high affinity to glutamate-gated chloride ion channels which occur in invertebrate nerve and muscle cells. This leads to an increase in the the permeability of the cell membrane to chloride ions with hyperpolarization of the nerve or muscle cell, which results in paralysis and death of the parasite. Compounds of this class may also interact with other ligand-gated chloride channels, such as those gated by the neurotransmitter gamma-aminobutyric acid (GABA).
The margin of safety for compounds of this class is attributable to the fact that mammals do not have glutamate-gated chloride channels, the macrocyclic lactones have a low affinity for other mammalian ligand-gated chloride channels, and macrocyclic lactones do not readily cross the blood-brain barrier.
Pharmacokinetic Particulars
Following oral administration of the recommended dose to horses, a mean peak plasma concentration (Cmax) of 33 ng/ml was achieved within 24 hours.
Ivermectin is well absorbed into the systemic circulation following administration. Only about 2% of the drug is excreted in urine, faecal excretion being the major route of elimination.
Ivermectin passes readily into milk.
Pharmaceutical particulars
List of excipients
Hydrogenated Castor Oil
Titanium Dioxide (E171)
Propylene Glycol
Major Incompatibilities
Not applicable.
Shelf life
Shelf life of the veterinary medicinal product as packaged for sale: 3 years.
The product is for single use. After use, the syringe should be discarded.
Special precautions for storage
Do not store about 25°C
Nature and composition of immediate packaging
High density polyethylene dose graduated syringes in an outer cardboard box.
Pack size:
Box containing 1 syringe of 6,42g
Box containing 1 syringe of 7,49 g
Box containing 50 syringers of 7,49 g
Not all pack sizes may be marketed.
Special precautions for the disposal of unused veterinary medicinal product or waste materials derived from the use of such products
EXTREMELY DANGEROUS TO FISH AND AQUATIC LIFE. Do not contaminate surface waters or ditches with product or used container.
Any unused veterinary medicinal product or wast materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements
Marketing Authorisation Holder (if different from distributor)
Eco Animal Health Ltd, 78 Coombe Road, New Malden, Surrey, KT3 4QS
Marketing Authorisation Number
UK : 13277/4028
Significant changes
Date of the first authorisation or date of renewal
11 July 2019
Date of revision of the text
July 2019
Any other information
Legal category
Legal category: POM-VPS
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