Three controlled, blinded and randomised multicentre field studies evaluated the efficacy and safety of a new formulation containing emodepside plus toltrazuril (Procox ® suspension for dogs) against naturally acquired parasite infections in dogs. In two studies dogs positive for gastrointestinal nematodes and/or Isospora spp. were treated with emodepside/ toltrazuril suspension (at least 0.45 mg emodepside plus 9 mg toltrazuril per kg body weight) or a reference product containing either milbemycin oxime plus praziquantel (Milbemax ® ) or sulfadimethoxine (Kokzidiol SD ® ) at recommended dose rates. The third study investigated efficacy against prepatent natural Isospora spp. infections in comparison to an untreated control group by enrolling Isosporanegative dogs that were at risk to develop a patent infection during the study.No suspected adverse drug reactions were observed in any of the 403 dogs enrolled in the three studies including 234 dogs treated with emodepside/toltrazuril suspension. In dogs treated with emodepside/ toltrazuril suspension against nematode infection faecal egg counts were reduced by 100 % (reference product: 99.7 %). Similarly, in the dogs that had been treated against patent Isospora spp. infection, faecal oocyst counts were reduced by 100 % (reference product: 99.0 %). In both studies, statistical analysis demonstrated non-inferiority and even superiority to the reference products (p ≤ 0.009). Dogs treated with emodepside/toltrazuril suspension during suspected prepatent Isospora spp. infection had 98.7 % lower faecal oocyst counts after treatment compared to untreated dogs (p < 0.0001). The studies demonstrated that emodepside/toltrazuril suspension is safe and highly efficacious against nematodes and Isospora spp. under field conditions. S22Procox ®

Three randomised, blinded and placebo-controlled laboratory studies were conducted to evaluate the efficacy of emodepside plus toltrazuril suspension (Procox(®) suspension for dogs) against Isospora canis and Isospora ohioensis-complex. Unweaned puppies were experimentally infected with sporulated oocysts of I. canis and/or I. ohioensis-complex. In each study, one group was treated during prepatency (2 or 4 days post infection) while dogs in the second group were treated individually after the onset of oocyst excretion of the respective coccidia species. The dogs were treated with the minimum therapeutic dose of 0.45 mg emodepside and 9 mg toltrazuril per kg body weight. Daily faecal oocyst counts from both groups were compared to placebotreated control groups to determine efficacy.Dogs treated during prepatent I. canis or I. ohioensis-complex infection showed significantly lower oocyst counts for up to 12 days compared to the control group. Oocyst counts were reduced by 90.2 - 100 % while the control groups continued to exhibit an adequate infection, except for one study where efficacy against prepatent I. canis infection faded 13 days after treatment. Following treatment of patent I. canis or I. ohioensis-complex infections, significantly lowered oocyst counts were observed for up to 9 days compared to the control group. Faecal oocyst counts were reduced by 91.5 - 100 %. In all three studies the number of days with diarrhoea was significantly lower when dogs were treated during prepatent Isospora spp. infection compared to the control groups. No adverse drug reactions were observed during the studies. In conclusion, the studies demonstrated that emodepside plus toltrazuril suspension is an efficient coccidiocide for dogs.

Two exploratory studies were performed to determine the optimum therapeutic dose of Procox(®) for the removal of experimental infection with mature adult Toxocara (T.) cati and Ancylostoma (A.) tubaeforme in kittens. Procox(®) is a new oral suspension containing a combination of the nematocidal and coccidiocidal active principles emodepside (0.1 %) and toltrazuril (2 %).In the first study, 18 eight-weeks-old kittens were inoculated with 450 L3 larvae of T. cati. 56 days after infection, the kittens were allocated to three treatment groups and were treated with 0.5 mg emodepside/kg body weight (group 1), 0.25 mg emodepside/kg body weight (group 2) and 0.1 mg emodepside/kg body weight (group 3), respectively. In the second study, 10 eight-weeks-old kittens were inoculated with 350 L3 larvae of A. tubaeforme. Four weeks after infection, the kittens were allocated to two treatment groups and were treated with 0.1 mg emodepside/kg body weight (group 1) or 0.25 mg emodepside/kg body weight (group 2). In both studies, all kittens received a reference treatment with Drontal(®) (230 mg pyrantel embonate and 20 mg praziquantel per tablet) at the recommended dose of one tablet/4 kg body weight 5 days after treatment with Procox(®). Anthelmintic efficacy was calculated by reduction in worm numbers expelled with the faeces following treatment with Procox(®) as compared with faecal worm numbers after reference treatment with Drontal(®), by thus avoiding necropsy of the animals.In the T. cati study, emodepside was at 99.9 %, 100 % and 96.5 % effective at a dosage of 0.5 mg, 0.25 mg and 0.1 mg per kg body weight, respectively. Against A. tubaeforme emodepside was at 95.7 % and 100 % effective at a dosage of 0.1 mg and 0.25 mg per kg body weight. No adverse events were seen during either study.It can be concluded that Procox(®) is efficacious for the control of mature adult T. cati and A. tubaeforme infections in cats at a single-dose rate of 0.25 mg emodepside/kg body weight.