Diminazene Aceturate and Diminazene Diaceturate (Berenil)

Diminazene is an aromatic diamidine antiprotozoal used mainly in regions where babesiosis and animal trypanosomiasis are endemic. Diminazene aceturate and diminazene diaceturate are names used for the same salt in veterinary products, including Berenil. Its clinical applications vary with the protozoal species and include infections of livestock, dogs and horses.

Group

Diamidine antiprotozoal

Mechanism of Action

Diminazene binds AT-rich regions of protozoal DNA and interferes with nucleic-acid organization and replication. In trypanosomes, kinetoplast DNA is an important target, and disruption of mitochondrial DNA function contributes to parasite death. Additional nucleic-acid effects are proposed in other susceptible protozoa. The complete mechanism and relative importance of each target vary between parasite species.

Dose Rates

Dog

Use / stage	Dose	Route	Schedule	Instructions
Babesiosis	Reference only	IM		Source regimen: 3.5–5 mg/kg every 12 hours for two doses. Salt basis is not specified consistently; resolve it before using a diaceturate-strength calculator.
African trypanosomiasis	3.6–7 mg/kg	IM	Every 336 h	Repeat only as needed for relapse or reinfection; neurologic toxicity risk increases with cumulative exposure.

Cat

Use / stage	Dose	Route	Schedule	Instructions
Historical antiprotozoal regimens	Reference only	IM		Reported courses include 4 mg/kg daily for five doses; experimental T. evansi treatment used 3.5 mg/kg daily for five days. Cytauxzoon reports used 2 mg/kg for two injections within one week without parasite eradication. Toxicity and lack of consistent success make these unsuitable as routine feline regimens.
Cytauxzoonosis	2 mg/kg	IM	Every 168 h	Two doses one week apart. Historical treatment with poor success; monitor closely for toxicity.
Cytauxzoonosis	3–5 mg/kg	IM	Once	Historical alternative with poor treatment success; not evidence of reliable cure.

Cattle

Use / stage	Dose	Route	Schedule	Instructions
Babesiosis or trypanosomiasis	Reference only	IM		Source range 3.5–7 mg/kg; babesia studies also cite 3–5 mg/kg. Salt basis and repeat schedule are not fully specified.
Susceptible protozoal infection	3.5 mg/kg	IM	Once	Maximum 4 g/dose; Diminazene aceturate/diaceturate basis; response depends on organism susceptibility. The source mentions escalation up to 8 mg/kg but does not define organism-specific selection.

Horse

Use / stage	Dose	Route	Schedule	Instructions
Equine piroplasmosis	3.5–5 mg/kg	IM	Every 48 h	Up to 4 days; Diaceturate; two treatments only. Severe local reactions can occur.
Babesiosis	3–5 mg/kg	IM	Every 12 h	Up to 1 days; Diaceturate; two treatments only. A distinct study used 5 mg/kg twice 24 hours apart for B. caballi; do not merge schedules.
Susceptible protozoal infection	3.5 mg/kg	IM	Once	Maximum 4 g/dose; Diminazene aceturate/diaceturate basis; response depends on organism susceptibility. The source mentions escalation up to 8 mg/kg but does not define organism-specific selection.

Sheep

Use / stage	Dose	Route	Schedule	Instructions
Susceptible protozoal infection	3.5 mg/kg	IM	Once	Maximum 4 g/dose; Diminazene aceturate/diaceturate basis; response depends on organism susceptibility. The source mentions escalation up to 8 mg/kg but does not define organism-specific selection.

Goat

Use / stage	Dose	Route	Schedule	Instructions
Susceptible protozoal infection	3.5 mg/kg	IM	Once	Maximum 4 g/dose; Diminazene aceturate/diaceturate basis; response depends on organism susceptibility. The source mentions escalation up to 8 mg/kg but does not define organism-specific selection.

Indications

Treatment of susceptible bovine babesiosis, including infections caused by Babesia bovis or Babesia bigemina.
Treatment of susceptible animal trypanosomiasis in livestock, including selected Trypanosoma congolense, Trypanosoma vivax or Trypanosoma evansi infections.
Treatment of selected canine babesiosis, particularly susceptible large-Babesia infections such as Babesia canis.
Treatment of selected equine piroplasmosis caused by Babesia caballi or Theileria equi; response and parasite clearance vary with the organism and treatment regimen.

Contraindications

Not recommended in cats because of toxicity and inconsistent efficacy.
Camelids are highly susceptible to diminazene toxicity; avoid use when the preparation contraindicates camelids.

Interactions

No specific interactions identified in the supplied monograph.

Adverse effects

Painful injection and muscle injury
Salivation, nausea, vomiting and hepatic enzyme elevations in cats

Toxicity

Neurologic and systemic toxicity may be severe; avoid repeat dosing outside a defined regimen.

Preparations

Preparation	Form	Strength	Route
Prozomin injection Diminazene diaceturate 70 mg/mL plus phenazone 375 mg/mL. Deep IM; calculations use only the diminazene component.	Injection	diminazene diaceturate 70 mg / mL + phenazone 375 mg / mL	IM

Monitoring and Administration

Monitor neurologic status, CBC, hepatic function and injection sites. Narrow therapeutic margin limits empirical escalation.

Aceturate/diaceturate identity and dose basis must be confirmed for the actual preparation; do not convert using an assumed salt factor.

Monitor serial CBC, renal and hepatic indices and potassium during severe babesiosis. PCR at 60 and 90 days after therapy was proposed to assess B. gibsoni clearance; clinical recovery does not establish eradication.