Choosing Treatment for Dogs With Generalised Demodicosis – Isoxazolines or Imidacloprid and Moxidectin?

  • Sarah Long Locum Veterinary Surgeon



Open Access Logo



PICO question

In dogs with generalised demodicosis, are isoxazolines as effective as a combined formulation of imidacloprid and moxidectin at reducing mite count and the severity of associated clinical signs?

Clinical bottom line

Five single-blinded, randomised, positive control trials, most under laboratory conditions, directly compared the use of isoxazolines against moxidectin/imidacloprid to treat canine generalised demodicosis. All of them showed comparable efficacy of isoxazolines. Three different isoxazolines were studied with two routes of administration (oral and topical) and four different dosing frequencies of moxidectin/imidacloprid. This made the papers more challenging to compare however, the evidence provided is sufficient to support their use. All of these trials were sponsored by the manufacturers of their respective isoxazoline products which may bias the study design and reporting of results. It is worth noting that sarolaner (Simparica™, Zoetis UK) was licensed in the UK for the treatment of canine demodicosis in January 2018 and that in the UK the Cascade should be followed when prescribing treatments. The licensed use of isoxazolines in other countries is beyond the scope of this article and the reader is urged to check local regulatory body advice before prescribing the below medications.

Open Access Peer Reviewed


Becskei, C., Cuppens, O., & Mahabir, S. P. (2018). Efficacy and safety of sarolaner against generalized demodicosis in dogs in European countries: A non-inferiority study. Veterinary Dermatology, 1–7.

Beugnet, F., Halos, L., Larsen, D., & de Vos, C. (2016). Efficacy of oral afoxolaner for the treatment of canine generalised demodicosis. Parasite, 23, 14.

Fourie, J. J., Liebenberg, J. E., Horak, I. G., Taenzler, J., Heckeroth, A. R., & Frénais, R. (2015). Efficacy of orally administered fluralaner (Bravecto®) or topically applied imidacloprid/moxidectin (Advocate®) against generalized demodicosis in dogs. Parasites and Vectors, 8(1), 1–8.

Fourie, J. J., Meyer, L., & Thomas, E. (2019). Efficacy of topically administered fluralaner or imidacloprid/moxidectin on dogs with generalised demodicosis. Parasites and Vectors.

Mueller, R. S., Bensignor, E., Ferrer, L., Holm, B., Lemarie, S., Paradis, M., & Shipstone, M. A. (2012). Treatment of demodicosis in dogs: 2011 clinical practice guidelines. Veterinary Dermatology, 23(2).

Perego, R., Spada, E., Foppa, C., & Proverbio, D. (2019). Critically appraised topic for the most effective and safe treatment for canine generalised demodicosis. BMC Veterinary Research.

Six, R. H., Becskei, C., Mazaleski, M. M., Fourie, J. J., Mahabir, S. P., Myers, M. R., & Slootmans, N. (2016). Efficacy of sarolaner, a novel oral isoxazoline, against two common mite infestations in dogs: Demodex spp. and Otodectes cynotis. Veterinary Parasitology, 222, 62–66.





Vol. 4 No. 2 (2019): The second issue of 2019

Section: Knowledge Summaries

Categories :  Small Animal  /  Dogs  /  Cats  /  Rabbits  /  Production Animal  /  Cattle  /  Sheep  /  Pig  /  Equine  /  Exotics  /