Medication Dosing Guide

[Humblefish]

I wanted to compile a quick reference of the most common aquarium medications we use, and provide dosing guidelines/ranges for each. Below you will find information pertaining to both aquarium brand medications and related generics. Generally speaking, using generics (I buy from here) is preferred because they are more pure and contain less fillers. However, you will need to use a small digital scale to accurately measure generic medications. Also keep in mind that some medications (especially antibiotics) will have ranges listed - lowest to highest tolerated therapeutic range. It's best to use the low range when treating species that are known to be sensitive to medications (e.g. anthias, dragonets, wrasses, scaleless fish, etc.) However, sometimes the only way to overcome a virulent infection (or similar) is to treat at maximum therapeutic.

** Antibiotics **
Ciprofloxacin: 1-2 hour bath treatment @ 250mg per gal. Repeat every 24 hours for 7 days. Methylene Blue can be added to increase efficacy.

Enrofloxacin: 9.5 - 19 mg/gal daily for 7 days; can be used both in a QT or as a 5 hour bath treatment.

Erythromycin (for eye infections): 12.5 - 25 mg/gal every 24 hours with a 25% water change before each treatment. Treat for 10-14 days.
Aquarium Brands: E.M. ERYTHROMYCIN (1 packet per 10 gallons) or Maracyn (1 packet per 10 gallons).

Kanamycin Sulfate: 25 - 37.5 mg/gal every 48 hours (24 hours for severe problems) with a 25% water change before each treatment. Treat for 10 - 14 days.
Aquarium Brands: Seachem Kanaplex (1 scoop per 5 gallons) or AAP Spectrogram 1 capsule per 10 gals (Kanamycin/Nitrofurazone synergistic combination, which can also be used with Metronidazole.)

Neomycin Sulfate: 25 mg/gal every 24 hours with a 25% water change before each treatment. Treat for 10 days. For fish tuberculosis, use for up to 30 days.
Aquarium Brands: Seachem Neoplex (1 measure per 2 gallons. Repeat this dose every 7 days to a maximum of 3 weeks.)

Nitrofuracin Green Powder: 1/4 teaspoon* per 20 gallons every 24 hours with a 25% water change before each treatment. Treat for 10 - 14 days.

* This works out to 1 gram per 20 gallons OR 50mg per gallon for in-tank treatment.

** NFG dosage is 100mg per gallon if doing just a 30 minute bath (thank you @Dierks).

Nitrofurazone: 10 - 25 mg/gal every 48 hours (24 hours for severe problems) with a 25-50% water change before each treatment. Treat for 10 - 14 days.
Aquarium Brands: API Furan-2 (1 packet per 10 gallons) or AAP Spectrogram 1 capsule per 10 gals (Kanamycin/Nitrofurazone synergistic combination, which can also be used with Metronidazole.)

Sulfa drugs (Sulfamerazine, Sulfamethazine, Sulfathiazole): 25 mg/gal every 48 hours (24 hours for severe issues) with a 25% water change before each treatment. Treat for a minimum of 10 days.
Aquarium Brands: API Triple Sulfa (1 packet per 10 gallons) or Seachem SulfaPlex (2-3 measures per 10 US gallons. Repeat this dose every 72 hours for a maximum of 3 weeks.)

** Copper Products ** (therapeutic level) and dosage required to achieve this
Copper Power (2.5 ppm): 1.48ml per gallon (or use this dosing calculator discovered by @HarleySt)

Copper sulfate pentahydrate (0.20 ppm): More info here

Cupramine (0.50 ppm): 4 drops (0.2ml) per gallon OR 1ml per 5 gallons

Cuprion (0.20 ppm): 1 drop per gallon

* Both Coppersafe and Kordon Copper Aid (2.0 ppm) can be used; however follow the directions on the label AND confirm reading via Hanna High Range Copper Colorimeter HI702. Actually, I would use the Hanna checker on all of the above as you may still need to dose a little extra in order to achieve full therapeutic.

** With copper never reach therapeutic all in one dosage! It's best to take at least 4-5 days (longer is ever better), dosing small amounts several times per day.

** Dewormers ** (External)
Fenbendazole: 12 hour bath treatment at 25 mg/L (95 mg/gallon)
** Bath must be repeated in about a week. Use this treatment calendar to determine when is the best time to do the SECOND bath: Marine Parasites

Hyposalinity: 15 ppt (1.011 SG) for 5 days eliminates juvenile and adult flukes + eggs.

Praziquantel: 9.5 mg/gal (not easily water soluble so mix in a cup using a few drops of vodka before dosing)
Aquarium Brands: API General Cure (1 packet or scoop per 10 gallons) or Prazipro (1 teaspoon or 5ml per 20 gallons)
** Must be dosed at least TWICE, usually a week apart. Use this treatment calendar to determine when is the best time to add the second dose: Marine Parasites

** Dewormers ** (Internal)
My recipe for food soaking deworming medications can be found below:

Using a shot glass:
1 Tbsp food (preferably pellets or frozen food)
1 scoop (~ 1/8 teaspoon) of medication (API General Cure or Fenbendazole** + Metroplex)
1 or 2 scoops Seachem Focus (this makes it reef safe + binds the medication to the food)
A pinch of Epsom salt to help expel dead worms/parasites
A few drops of saltwater or fish vitamins
Stir until a medicated food slurry has been achieved.
Feed after soaking for 30 mins.
Refrigerate or freeze any leftovers for future use.
You can feed this mix 1-2 times per day. Not recommend to exceed 2 feedings per day with medicated food.

** There have been some reports that Fenbendazole doesn't always bind well to food, even when using Seachem Focus. Fenbendazole also doesn't appear to be as "reef safe" as praziquantel, metronidazole - the two active ingredients found in General Cure. Therefore, caution must be taken when using it in a tank with corals.

** Misc. **
Acriflavine: Best to use Ruby Reef Rally @ 1 teaspoon per gallon in a 90 minute bath.

Chloroquine Phosphate: 40-60 mg/gal for 30 days (or 14 days and then transfer to a sterile observation tank at least 10 feet away)

DMSO: Aids in dissolving praziquantel, fenbendazole and other not easily water soluble medications. The following ratios were provided by @Dierks:

• 1 ml of DMSO is required to dissolve 10mg of Fenbendazole
• 1 ml of DMSO is required to dissolve 15mg of Metronidazole
• 1 ml of DMSO is required to dissolve 20 mg of Praziquantel

Formalin (37% formaldehyde):

• In-tank treatment: 1 milliliter (ml) per 10 gallons, or 2 drops per gallon daily in a bare aquarium.
• Bath treatment: 30-60 minutes @ 0.6 ml per gallon, or 12 drops per gallon.

Freshwater Dip: No longer than 5 minutes (more info)

Hydrogen Peroxide: 20 ml of 3% H2O2 per 1 gallon of saltwater for 30 minutes

Methylene Blue: Best to use an aquarium product such as Kordon or Fritz.

• 30 min bath (preferred): 1 teaspoon (5 ml) per 5 gallons.
• In a quarantine tank: 1 teaspoon (5 ml) per 10 gallons every other day for 10 days with water changes before each treatment.

Metronidazole: 12.5 - 25 mg/gal every 48 hours (24 hours for severe problems) with a 25% water change before each treatment. Treat for 10 days.
Aquarium Brands: Seachem MetroPlex (1-2 measures per 10 gallons. Repeat this dose every 48 hours for up to 3 weeks or until symptoms disappear.)

** You can use MS-222 Tricaine for both sedation and euthanasia: Tricaine-S

The spreadsheet for determining both dosages can be downloaded here: https://pentairaes.com/media/docs/treatment_calculator_excel_2010.xlsx

 

[scubabeth]

This is AWESOME, Bobby!! Thanks for compiling it all in one place! Maybe make this a sticky??

 

[Jessican]

I would suggest adding a caveat to food soaking fenbendazole - it doesn’t seem to bind very well, even with focus, and so doesn’t seem to be as reef safe as prazi or GC. I personally wouldn’t use it again in a tank with corals, I lost most of my softies to it.

 

[Salmo Si]

Excellent job!

It's been on my mind for ages to do something like this for the common meds we have over here. Maybe get round to it one day.....

 

[Humblefish]

I would suggest adding a caveat to food soaking fenbendazole - it doesn’t seem to bind very well, even with focus, and so doesn’t seem to be as reef safe as prazi or GC. I personally wouldn’t use it again in a tank with corals, I lost most of my softies to it.

Done!

Excellent job!

It's been on my mind for ages to do something like this for the common meds we have over here. Maybe get round to it one day.....

I considered doing a UK version (dosages in litres instead of gallons), except I realized you can't get most of those medications anyway.

 

[Wyster]

Done!



I considered doing a UK version (dosages in litres instead of gallons), except I realized you can't get most of those medications anyway.

Im lucky that I can, Good to have friends and Work Colleagues from the US

 

[Crashjack]

Have you tried mixing with Masstick? I suspect internal parasites in a fish and was interested in adding GC/Focus to Easy Masstick. I'm trying to avoid broadcast feeding as I lost two bta's, each after treating intestinal parasites. My hope was that the Masstick would have less of a chance of being consumed by my current bta, though the bta might have some exposure via clownfish poop.

 

[Crashjack]

Have you tried mixing with Masstick? I suspect internal parasites in a fish and was interested in adding GC/Focus to Easy Masstick. I'm trying to avoid broadcast feeding as I lost two bta's, each after treating intestinal parasites. My hope was that the Masstick would have less of a chance of being consumed by my current bta, though the bta might have some exposure via clownfish poop.

Just to update, I just got done last night with a 12-day feeding regimen using a GC/Focus Easy Masstick combo with good results. The fish that was in question was a Pintail fairy wrasse, which I added to my display about a month before treatment. The fish was received from one of this site's trusted quarantined fish businesses, and the only issues were behavioral... the fish didn't care much about feeding, it's coloration faded initially (did come back some prior to treatment), it mainly hovered in one of two spots near the surface, and it would remain hidden for extended periods of time. The fish would also show some improvement, then regress, then show improvement again, then regress again. I had seen very similar symptoms with two other fish, each on a different occasion, both of which likely had intestinal parasites as they also had the traditional "white stringy poop", and both were cured by a feeding regimen of GC/Focus laced food. Before shipping, the business owner told me that he had recently caught a fish bullying this fish, causing tail fin damage and prompting him to separate the fish (he also gave me a nice discount for the damaged tail). Therefore, a bacterial infection that either started during or was exacerbated by shipping, is also a possibility. Note: I don't blame the business owner for the fish's illness. He was very upfront about the tail injury, and the previous two fish I had with intestinal parasites were two I quarantined. I would much rather deal with a problem that is somewhat benign that I can also treat in the display, than one that threatens the health of all of my fish that I can't treat in the display.

Anyway, the fish has responded well to treatment as it now feeds aggressively, has good coloration, the tail is about healed (I didn't really see any improvement in the tail until treatment), and though it still spends a lot of time in one general area of the tank and near the surface, it moves around and does venture out. The other positive is that I see no signs of problems with my bta or any other corals. One thing I will add is that I might recommend using the regular Masstick instead of the "Easy Masstick" because mixing would be a whole lot easier. Even with the addition of Selcon, Garlic Guard, and Hikari pellets (small), I easily spent 45 minutes just stirring the stuff, and that was after spending quite a while tearing it into smaller chunks.

 

[Humblefish]

Thanks for that input @Crashjack

 

[erichuyn]

Quick check question about copperpower medication.
This doesn't precipitate out does it? So basicly if the dose in QT is correct and the water level stays correct with topping off the dose should stay the same?
Still need to watch out with a WC to get the dose in the WC water the same before changing then or would you still test the copper level daily?

 

[Big G]

Yes. The amount of copper will remain constant as long as there isn't anything in the tank absorbing it like rock. Just top off with RODI to maintain correct salinity.
And yes, when you take out water at a given level of copper in it; you replace with water dosed with copper at the same level.
Initially you may feel more comfortable testing frequently. Once you see steady levels checking less is fine.

 

[erichuyn]

One more then, a skimmer on a QT would likely have an effect on copper level since it takes out some saltwater. Or is that neglectable?

 

[Wyster]

My understanding is skimmers will remove copper although its very marginal, in essence you are removing water from the system if you skim wet. I do not run any Skimmers on my QT's for meds, Its better to try and avoid anything that may impact the levels of the meds , My observation tank has a small Tunze one, If you feel the need to run one then would suggest you test copper levels more frequently.

 

[Humblefish]

My understanding is skimmers will remove copper although its very marginal, in essence you are removing water from the system if you skim wet.

^^ This is exactly correct. A protein skimmer will not remove copper directly, but obviously by dumping the water in the collection cup and replacing with non-copper water you are diluting it slightly.

 

[thepacific]

@Humblefish A quick question..! Can i use prazipro and prime at the same time in a QT? I have finished the qt with copper+GC+metro and now in observation period. My clowns are scratching and I am guessing flukes. Not sure why GC dint work. Want to try with prazipro once now.

 

[Humblefish]

@Humblefish A quick question..! Can i use prazipro and prime at the same time in a QT? I have finished the qt with copper+GC+metro and now in observation period. My clowns are scratching and I am guessing flukes. Not sure why GC dint work. Want to try with prazipro once now.

Mixing Prazipro + Prime sometimes causes a catastrophic bacterial bloom.

If you've encountered so-called prazi resistant flukes, you may have to use fenbendazole: Fenbendazole

 

[Jposch]

@Humblefish here you say Chloroquine is 14 days, transfer, but on the Chloroquine thread it says 10 days. Also, any Fenbendazole + Chloroquine reactions known? Just wondering if I should stay around QT if I dose Fenbendazole into CP tank.

 

[Humblefish]

@Humblefish here you say Chloroquine is 14 days, transfer, but on the Chloroquine thread it says 10 days. Also, any Fenbendazole + Chloroquine reactions known? Just wondering if I should stay around QT if I dose Fenbendazole into CP tank.

So technically any parasites should have dropped off a fish after 7 days in reef temperatures (76F or higher). The presence of chloroquine or therapeutic copper in the water shields a fish from reinfection. Therefore, you can safely transfer the fish to another QT (all new equipment + water) after 10-14 days. 10 days is technically adequate; however 14 days allows more wiggle room for margin of error.

I've never mixed fenbendazole + chloroquine. @Dierks may have first-hand experience with doing that.

 

[Jposch]

So technically any parasites should have dropped off a fish after 7 days in reef temperatures (76F or higher). The presence of chloroquine or therapeutic copper in the water shields a fish from reinfection. Therefore, you can safely transfer the fish to another QT (all new equipment + water) after 10-14 days. 10 days is technically adequate; however 14 days allows more wiggle room for margin of error.

I've never mixed fenbendazole + chloroquine. @Dierks may have first-hand experience with doing that.

He does not. I guess I'll have to chance it, or better yet, I'll have to transfer them to Fenbendazole bath for 12hrs. And then move them to observation. But, I was reading that chloroquine stays present in high levels in humans for a long time, so may be a pointless endeavor. I'll have to find that article. Everything aquatics also sells Chloroquine. $40/25grams. Not the cheapest, but way more than most people need. I had to email them for a manual order because thier website is being modified and they don't have meds listed.

 

[Jposch]

Everything aquatic has all of the same pharmaceutical grade meds in smaller quantities tha NFP. I know not many need 100+ grams of everything. As of now, they are not listed on the website, but you can email and they are quick to respond and fill your order.