FDA Approves Loading Dose for EPM Treatment

The FDA approved a loading dose for Marquis, which is also the first FDA-approved EPM treatment.
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It’s another day at the barn, but you notice your horse stumbling and not walking like he normally does. He also seems mildly depressed. Are these subtle signs of a neurological disease? Could it be equine protozoal myeloencephalitis (EPM)?

This common neurologic disease in horses caused by Sarcocystis neurona, a parasite that invades the brain and spinal cord. When undetected or untreated, EPM can cause serious damage to the horse’s central nervous system and can be fatal in some cases. Opossums are definitive hosts for this parasite and horses become infected with EPM through contact with opossum feces by grazing or by eating contaminated feed.

When it’s time for veterinarians and horse owners to take action against EPM, one option is a product called Marquis (15% w/w ponazuril), the first U.S. Food and Drug Administration (FDA)-approved treatment for EPM.

Recently, the FDA recently approved giving a loading dose (a larger dose on the first day) of the product to begin the treatment. A loading dose allows the drug’s concentrations to approach a steady state—when the rate of input is equal to the rate of elimination—in 1 to 2 days, as opposed to eight days using the originally approved dosage regimen

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