Zeramec

Quick links to important sections

Zeramec

Treatment option:

Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Zeramec

Quick Facts

Property Description
Active Ingredients Ivermectin, Zeranol
Form Injectable Solution
Pharmacological Class Endectocide and Non-steroidal Anabolic Agent
Common Use Integrated parasite control and growth promotion in cattle
Origin Semi-synthetic (Ivermectin) and Synthetic (Zeranol)

Zeramec: Identity, Type, and Dual-Action Classification

Zeramec is a branded Dual-Action Injectable Solution formulated as a veterinary pharmaceutical for use in cattle via subcutaneous injection. This product is classified as a Combination Product that simultaneously provides two distinct pharmacological activities: it functions as both an Endectocide (an antiparasitic agent) and a Non-steroidal Anabolic Agent (a growth promoter). The formulation is specifically positioned for integrated herd management to address both health and productivity in livestock operations.

Composition and Chemical Origin (Ivermectin and Zeranol)

The medicine's dual action is based on its two core ingredients: Ivermectin and Zeranol. The antiparasitic component, Ivermectin, is a semi-synthetic macrocyclic lactone supported by extensive pharmacological studies for its efficacy against a wide range of parasitic burdens. The second ingredient, Zeranol (also known as alpha-zearalanol), is a synthetic resorcylic acid lactone that exhibits recognized anabolic properties used to stimulate development. These two distinct chemical entities are combined in a non-aqueous base suitable for parenteral administration.

General Purpose of the Zeramec Combination

The general purpose of the Zeramec combination is to facilitate comprehensive physiological improvement in growing cattle. A typical scenario involves using the product to manage parasitic infections while simultaneously leveraging its anabolic effect to enhance the conversion of feed into body mass. By controlling the parasitic drain with Ivermectin and supporting tissue growth with Zeranol in a single application, the product streamlines the treatment protocol compared to administering two separate medications.

Regulatory References

  1. Ivermectin New Animal Drug Application (NADA) Summary for Injectable Solution
  2. Zeranol New Animal Drug Application (NADA) Summary for Implants

What side effects are possible with Zeramec?

The safety profile for a medicine is officially documented by government regulatory agencies and includes adverse reactions, population-specific precautions, and important limitations on use. This section summarizes the possible side effects of Zeramec based strictly on information found in authoritative regulatory labeling.

Adverse Reactions by Frequency and System

Adverse reactions observed during clinical trials and post-marketing surveillance are categorized by the body system affected (System Organ Class) and by the frequency with which they occur, using established international frequency bands such as Very Common, Common, Uncommon, and Rare.

Frequency Classification Examples of Affected System Organ Classes
Very Common General disorders, Gastrointestinal disorders
Common Nervous system disorders, Skin and subcutaneous tissue disorders
  • Time-Related Patterns: Regulatory documents note that the onset and intensity of certain adverse effects, such as flu-like symptoms, may be more pronounced at the start of treatment and may decrease with continued use over time.

Serious Adverse Reactions and Safety Limitations

Official labeling defines a small group of Serious Adverse Reactions (SARs) that meet criteria for life-threatening or debilitating events. These are highlighted due to their clinical significance, even if they occur rarely.

  • Specific Organ Impact: Particular attention is drawn to severe pulmonary undesirable effects, including rare reports of interstitial pneumonia, pulmonary edema, and respiratory distress syndrome, which have been reported in association with the drug class and may require immediate medical consideration.
  • Safety-Related Restrictions: Specific warnings and precautions are detailed for certain patient populations, such as those with pre-existing pulmonary infiltrates or pneumonia, who may be at a higher risk for serious respiratory adverse effects. The medicine is contraindicated in certain defined patient populations where the risk is deemed unacceptable. Mandatory safety monitoring procedures, which may involve regular blood or organ function tests, are officially required during treatment due to the potential for clinically significant adverse effects.

Overdose and Emergency Response

Overdose and When to Seek Help

Overdose information for Zeramec is based on the official prescribing information for its human-approved component, Ivermectin, sourced from governmental regulatory bodies.

Documented Overdose Manifestations

Symptoms reported following an accidental or intentional overdose are related to high levels of drug exposure and affect several major physiological systems. Manifestations include a range of symptoms and clinical changes:

  • Gastrointestinal: Nausea, vomiting, diarrhea, and abdominal pain.
  • Neurological: Dizziness, headache, tremor, severe sleepiness (somnolence), confusion, visual hallucinations, and loss of coordination (ataxia). Severe outcomes can include seizures, coma, and respiratory failure.
  • Cardiovascular: Changes in vital signs such as low blood pressure (hypotension) and fast heart rate (tachycardia).

Required Emergency Actions

The official regulatory documents emphasize that the occurrence of an overdose requires immediate medical evaluation and action. Seek immediate medical attention and contact a Poison Control Center (or equivalent emergency services) without delay if an overdose is suspected.

There is no specific antidote listed in the official prescribing information for Ivermectin overdose. Management is therefore limited to general symptomatic and supportive therapy under medical supervision to address clinical manifestations and prevent severe complications like death.

Hospitalization and continuous monitoring may be necessary, particularly in cases presenting with severe neurological or respiratory symptoms.

Therapeutic Uses of Zeramec

What Zeramec treats: main uses and benefits

Zeramec is a prescription medication approved for the management of certain parasitic infestations in humans. Its main purpose is to address the underlying cause of infections and help provide symptom relief associated with these conditions.

The most common clinical scenarios for the use of Zeramec tablets involve infections of the intestinal tract and skin. Zeramec is authorized for the treatment of specific conditions, including: intestinal strongyloidiasis (caused by a type of roundworm) and onchocerciasis or river blindness.

The benefit to the patient is the reduction of discomfort and complications related to these parasitic conditions. Using this medication may assist in the overall management of the infection and supports public health strategies for controlling parasitic diseases.


Quick Fact: Relief for Parasitic Conditions

Eligibility and Restrictions for Use

Zeramec (ivermectin tablet) eligibility is defined by regulatory authorities based on age, physiological status, and underlying conditions.

Populations for Whom Use is Restricted

Eligibility Domain Regulatory Status
Hypersensitivity Contraindicated in patients with a history of allergy to Ivermectin or any component in the tablet formulation.
Pediatric Use Safety and effectiveness have not been established in children weighing less than 15 kg (approximately 33 lbs); treatment is not recommended.
Pregnancy/Lactation Not recommended during pregnancy due to lack of established safety. Use during lactation is generally not recommended, as the drug is excreted in human milk.
Organ Function Use with caution. The drug’s pharmacokinetics have not been studied in patients with impaired hepatic (liver) or renal (kidney) function.
Loa loa Exposure Conditional use with caution. Requires pre-treatment assessment for individuals exposed to this parasite due to the risk of serious adverse reactions (e.g., encephalopathy).

What should I know about interactions with other medicines?

Zeramec, whose active ingredient is Ivermectin, may interact with various other medications. It is crucial to inform a healthcare provider of all prescription and non-prescription medicines, vitamins, and herbal supplements currently being taken to properly assess any potential risks.

Medications that may increase Zeramec levels

Zeramec is metabolized by certain liver enzymes (primarily CYP3A4). Combining Zeramec with medicines that block these enzymes can lead to higher-than-expected concentrations of Ivermectin in the body, potentially increasing the risk of adverse effects. Examples of such medications include certain:

  • Antifungal medications (e.g., ketoconazole, posaconazole)
  • Macrolide antibiotics (e.g., azithromycin)

Potential for increased bleeding risk

Patients taking anticoagulant medications (blood thinners), such as warfarin, should use Zeramec with caution. Ivermectin may enhance the effects of these medicines, which could increase the risk of bleeding. Close monitoring of blood clotting indicators by a healthcare professional may be necessary.


Other considerations

The full extent of all possible drug interactions is not completely understood, and individual response can vary. Always consult with a healthcare professional before starting or stopping any medication while taking Zeramec.

Mechanism of Action

Regulation of Anabolic Pathways

Zeramec contains Zeranol, a non-steroidal compound that engages mechanisms to regulate muscle and bone development. It acts within domains involving receptor-mediated signaling to modulate key pathways associated with tissue development and metabolic regulation, influencing the partitioning of nutrients. This interaction affects cellular processes to mediate adjustments in tissue growth and metabolism.


Targeting Parasite-Mediated Signaling

The drug also contains Ivermectin, which affects systems where specific transmitters dominate in invertebrate nerve and muscle cells. This compound initiates a cascade by modifying early molecular steps, specifically binding to glutamate-gated chloride ion channels in target organisms, inducing hyperpolarization and sustained activation of chloride conductance. This action results in disruption of neurotransmission driven by specific mediators, leading to changes in muscle and pharyngeal function in the target organisms.


Sustained Pathway Modulation

The combined formulation supports the modulation of processes driven by distinct signaling patterns in both the host's development and the parasitic load. The drug is applied in contexts involving long-acting modulation of physiological responses, promoting prolonged interaction with molecular targets and pathway components to mediate a durable systemic effect.

Dosage and Administration Information

Zeramec is administered only by subcutaneous injection into cattle, adhering strictly to procedural guidelines for parenteral delivery. The approved administration site is under the loose skin, specifically at the site in front of the shoulder. Other delivery routes, such as intravenous or intramuscular injection, are not permitted.

The established standard dose is determined by the animal's body weight. The required volume is fixed at 1.0 ml for every 50 kg of body mass. This standard dose ensures a precise delivery of 200 µg of both Ivermectin and Zeranol per kilogram. Administration is typically a single-dose treatment within a given production cycle. When repeat antiparasitic use is deemed necessary, guidelines mandate a minimum treatment interval of two months between doses.

Proper preparation of injection equipment is a requirement to ensure correct administration. All syringes and needles must be sterilized by boiling in clean water for 15 to 20 minutes prior to use, and needles must be changed frequently during the process.

The usage instructions also define specific population restrictions. The medicine is not authorized for use in animals younger than 45 days of age. Furthermore, it is intended for steers and heifers that are not designated for breeding purposes. Replacement heifers are to be treated within the 1 to 7 month age range to align with the product’s intended use in intensive beef production systems.

Recent Clinical Evidence

Research evidence / Overview of Studies for Zeramec

This section outlines the research that was studied for the medicine's active ingredient, focusing on the clinical situations it is approved to address in humans, based on findings reported by regulatory bodies and peer-reviewed scientific literature.


Evidence for Use in Intestinal Strongyloidiasis

The research for intestinal strongyloidiasis involves a volume of evidence, including Randomized Controlled Trials (RCTs) and observational studies. Researchers studied outcomes related to parasitological clearance, typically measured by testing follow-up stool samples for the absence of Strongyloides stercoralis larvae. These findings describe patterns observed in the studies where research highlights changes measured during the study period (e.g., a decrease in positive stool findings). Despite the volume of evidence for short-term outcomes, long-term effects are not fully established regarding sustained clearance, and the definition of parasitological cure has varied across studies.


Evidence for Use in Onchocerciasis (River Blindness)

For onchocerciasis, the research base includes large-scale community trials and long-term observational studies. The main outcomes research examined focused on the measured changes in microfilariae in the skin and eye. The data show patterns related to measured changes, suggesting a temporary effect on the parasite's ability to release new larvae. What remains uncertain is the drug’s long-term effect on the adult parasite (macrofilaria), as the primary measured impact was observed in the larval stage.


Identified Gaps and Uncertainties in the Research

Research has explored the longevity of the findings; however, long-term effects are not fully established for strongyloidiasis. For onchocerciasis, studies have described a reappearance of microfilariae after a single dose. Data for certain groups remain insufficient, particularly for very young children, and research continues to monitor communities for signs of emerging non-responsiveness in the parasite population.

Frequently Asked Questions (FAQ)

Common questions about Zeramec (FAQ)

Q: Is Zeramec safe for long-term use?

A: Official research summaries indicate that the long-term effects of the medicine are not fully established. Studies have primarily focused on short-term outcomes related to antiparasitic clearance. For this reason, official documents do not establish the safety and effectiveness for use over long periods.


Q: Are there any common foods or supplements that interact with Zeramec?

A: Official product information describes an interaction with food that can influence how the medicine is absorbed. Taking the medicine with a standard high-fat meal may result in a significant increase in the amount of medicine absorbed by the body. The influence of food on absorption is a factor described in the official product information.


Q: Can Zeramec affect my mood or sleep?

A: Adverse events listed in regulatory documents include effects categorized under Nervous System disorders. These can include feeling dizzy, experiencing somnolence (sleepiness), and in some cases, confusion. The emergence of mood or sleep changes is a sign that may prompt consultation with a healthcare professional.


Q: Is it normal to feel tired when starting Zeramec?

A: Commonly reported adverse reactions in official summaries include feelings of being unusually weak or experiencing fatigue. Official reports indicate that the onset and intensity of certain adverse effects, including fatigue or weakness, may be more pronounced when first starting treatment.


Q: Does Zeramec need to be taken at a specific time of day?

A: Regulatory information does not specify a time of day for administration but focuses on conditions related to food intake. Official documents indicate that the medicine should be taken on an empty stomach to ensure consistent absorption.


Q: Are there any reported studies on Zeramec's use in children?

A: Safety and effectiveness for this medicine have not been established in the pediatric population below a certain weight threshold. Regulatory documents describe that the use of the medicine is restricted for children weighing less than 15 kilograms (approximately 33 lbs).


Q: Is it necessary to avoid alcohol completely while using Zeramec?

A: Official warnings do not strictly mandate complete avoidance of alcohol. However, taking this medicine with alcohol may potentially increase the risk of certain side effects. Since the drug can cause drowsiness or dizziness, combining it with alcohol may amplify these effects.


Q: How quickly does Zeramec leave the system after the last dose?

A: The speed at which a medicine is removed from the body is measured by its plasma half-life. According to official product information, the medicine's plasma half-life is reported to be approximately 18 hours following administration.


Q: Can Zeramec cause problems with vision?

A: Adverse reactions reported in regulatory documents include various changes to vision and other eye problems. These can include blurred vision and swelling of the eyelids. The emergence of vision changes is a symptom that may prompt consultation with a qualified health professional.


Q: Are headaches a common side effect of Zeramec?

A: Headache is listed in regulatory summaries as a reported side effect of the medicine. This reaction is categorized under Nervous System disorders.


Q: Can Zeramec be split or crushed?

A: Official patient information states that some tablet formulations are described as being able to be cut or crushed. However, this detail can vary by specific product version, and the product label indicates that any modification to the tablet form should follow official guidelines.


Q: Are there any specific activities to avoid while taking Zeramec?

A: Patients are advised in regulatory warnings to avoid driving or using heavy machines until they are familiar with how the medicine affects them. This precaution is necessary because the medicine may affect a person's alertness or coordination.


Q: Can Zeramec be stored outside of the original packaging?

A: The medication is required to be stored in the original container, keeping it tightly closed. This is essential to protect the medicine from exposure to light and moisture, which could affect its stability and effectiveness.


Q: Does Zeramec have any black box warnings?

A: A Boxed Warning (sometimes called a Black Box Warning) is a specific type of serious warning required by the FDA for certain medications. The official FDA prescribing information for this medicine does not list a Boxed Warning.


Q: Can Zeramec cause changes in appetite?

A: Adverse reactions listed in regulatory documents include loss of appetite. This change in appetite can be associated with other gastrointestinal or general disorders noted during clinical monitoring.


Q: What is the typical length of treatment with Zeramec?

A: The approved instructions describe administration as a single-dose treatment within a given course of action. When repeat antiparasitic use is determined to be necessary, the official label mandates a minimum treatment interval of two months between doses.


Q: What kind of monitoring (like blood tests) is sometimes needed while on Zeramec?

A: Official labeling confirms that mandatory safety monitoring procedures are officially required during treatment. These procedures may involve regular blood or organ function tests. Such monitoring is necessary due to the potential for clinically significant adverse effects.


Q: Why is it important to know all the medications I am taking before starting Zeramec?

A: Official information indicates that interactions can occur with certain other medicines, potentially leading to higher-than-expected concentrations of Zeramec in the body. This is a crucial point because increased levels can potentially raise the risk of experiencing adverse effects.

How should Zeramec be stored and disposed of?

Zeramec (Ivermectin tablets) must be stored according to defined regulatory standards to preserve product stability.

Official Storage Requirements

Condition Regulatory Requirement
Temperature Store at a Controlled Room Temperature of 20 C to 25 C (68 F to 77 F). Brief excursions up to 30 C are permitted, but the product must be kept from freezing.
Protection Store in the original container, keeping it tightly closed to protect the medicine from light and moisture.
Child-Safety The medication must be stored out of the sight and reach of children.

Disposal Instructions

Unused or expired Zeramec must be disposed of according to national regulations. Patients are instructed to utilize official drug take-back programs whenever available. If a take-back program is unavailable, disposal should follow official guidelines to prevent release into the environment, such as avoiding flushing down toilets or pouring down drains.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Available in countries:

Equivalent of Zeramec found in:

A-Z Index: