Medications and Treatments

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Disease Terminology and Treatment Drugs

  When it comes to curing a fish, there are only two methods available to us, either Chemotherapy or Environmental, both of which have their place, but never within our tanks.
  All treatments must be performed outside of the main tank within a Quarantine Tank. As long as there are hobbyist who insist on rushing home with their new purchases and putting them directly into the main tank, then there will always be disease and parasite problems.
  All large aquariums throughout the world all have strict quarantine procedures in place for a reason. It works!.
  Besides using a medication for a treatment, you should also provide pristine water conditions to reduce any stress on the fish as well as not giving the pathogen its suitable environment (organic laden).
  Keeping the tank’s temperature on the lower end (low to mid 70’s) will hinder the growth of most pathogens and may allow medications to be more effective. Also keeping the salinity lower (SG 1.018) helps with oxygenation as many antibiotics “work” better in lower salinities as well.
  Stress reduction is very important at this point as stress will increase the fish’s metabolic rate which increases the oxygen need, which further increases the metabolic rate, a very vicious circle.

  ALL TREATMENT PLANS MUST BE CARRIED THROUGH TO THE END OF THEIR SUGGESTED LENGTH OF TREATMENT, EVEN IF THE FISH IS LOOKING BETTER, CONTINUE TREATMENT. TO CUT THE TREATMENT SHORT ONLY INVITES THE CREATION OF MEDICINE RESISTANT PATHOGENS.

  A Note on Scaleless Fish – Any medication used in the treatment of parasites, such as formalin and copper must be used at half the recommended dosage, if you see the fish having problems during such treatments, a water change will be required to reduce the medication levels and another treatment plan should be considered.
  For Mandarins – Which are notably slimy fish that are not as susceptible to external parasite infestations as other fish may be. However, they are not immune, and are overly sensitive to copper compounds, other metal-based and formalin containing medications. They are best treated through environmental manipulation, such as hyposalinity.



  DIPS / BATHS – Overall article on how to and what to use per a given infection / infestation.

  HYPO SALINITY : The lowering of the water’s salinity down to 1.009 will reduce stress on fish and kill some types of parasites, most notably, Marine Ich. This treatment requires accurate salinity testing, which a refractometer will do. The usual hydrometers are not accurate enough to ensure proper salinity levels are achieved. I strongly urge using this treatment during all quarantine periods for new arrivals of fish.
  Test Kits – If you test your water for calcium or magnesium at hyposaline levels you will get a much lowered test result. Since test kits are affected by temperature and salinity levels the following formula will take hyposaline into consideration.  Temperature range 74-86f .
  For calcium tests –  Take your current readings of your SG and subtract it from a base of 1.025 if your temp is below 80 and 1.023 if your temp is above 80 and is a multiplier of 9.632 then add that number to your calcium test results that the kits gives you. Example –  1.023 -1.009 = .014×9.632 = 0.134848 round to135, Current reading is 230+135=365 
  For magnesium tests – Use a multiplier of 2.741 but subtract that number from your current test as it will read slightly higher than normal the fresher the water gets. 

  FORMALDEHYDE (Formalin – 3% formaldehyde) – A very effective treatment for parasites. Extreme care must be used when handling this chemical. Please take the time to make sure you fully understand its dangers and correct usage.
  DOSAGE: 1 teaspoon of a 3% solution per 10 gallons every other day for 10 days. Combines well with malachite green.

  Note: For those of you who live where Formalin is controlled or restricted, there is another product called ProForm C , which contains both malachyte green and formalin that should be available to you.

  COPPER BASED Medications – Another effective treatment for parasites, and as with all chemical treatments, care must be taken with its use, accurate dosing is very important and must be done outside of the main tank. A chelated copper is considered to be of a less hazard to the fish, but may not be as effective against the parasites. For unknown parasites, I would use this method since it will kill all external species of parasites, with the exception of Brooklynella, then formalin dips would be advised. I personally would recommend Cupramine be used.
  DOSAGE: Treat according to your solution to bring your copper level to .15 -.20 ppm. Sequestered Copper (often called chelated, but that is incorrect, chelated means inactivated) sulfate works best (citric acid help achieve this). Soluble copper salts work well in freshwater only. Do use with snails and other invertebrates, do not use in reef aquariums, and note; when uses as an algaecide, the copper is absorbed by the algae then released when it dies. Removal of sequestered copper can be difficult, only EDTA (Ethylene Diamine Tetra Acidic Acid) and water changes remove it, NOT carbon.

  FRESHWATER DIPS – While I do not feel that a freshwater dip is a cure, since not all parasites will be removed, and can be very stressful for the fish, but this procedure is helpful if the fish is heavily infested and needs some immediate relief, by reducing the number of attached parasites, it may help other treatment methods be more effective.

  ERYTHROMYCIN – Effective against most gram-positive and some gram negative bacteria and fungus.  It is also used to destroy cyanobacteria but does have its risks when used in a reef aquarium. 
  DOSAGE: 250- 500 mg per 20 gallons every 24 hours with a 25% water change before each treatment. Treat for 10 days. 

  METRONIDAZOLE – A very effective treatment for Internal Protozoal infections.
  DOSAGE: 250-500 mg per 20 gallons. Treat every 24 hours with a 25% water change before each treatment. Treat for 10 days.

  PIPERAZINE – Sold as Pipezine and is useful for the treatment of internal nematodes (roundworms).

  MALACHITE GREEN – Seems to be a dangerous compound to use but has been shown to be effective against a variety of problems, most commonly as a treatment for Fungal infections.
  DOSAGE: 1 teaspoon of a 0.038% solution per 10 gallons every other day for 10-14 days. Or 1 drop of .50% solution per gallon every other day for 10- 14 days. 25% water changes are recommended before each dose. Use half dose for scale-less and delicate fish such as Clown Loaches and Neon Tetras. Double dose for marine aquariums. Note; malachite green is more toxic at higher ph.

  NEOMYCIN SULFATE – An effective treatment for bacterial infections. NEVER mix with copper sulfate!
  DOSAGE: 250 mg per 10 gallons of water. Treat every 24 hours with a 25% water change before each treatment. Treat for 10 days. For tuberculosis, use for up to 30 days.

  METHYLENE BLUE – Commonly used as a “cure all” for bacterial infections.
  DOSAGE: 1 teaspoon of a zinc free 2.303% solution per 10 gallons every other day for 10 days with water changes before each treatment. BEST USED IN A QUARANTINE TANK. Methylene blue can destroy nitrifying bacteria and plants in the display aquarium. 

  MINOCYCLINE – Sold as Maracyn 2 , Very effective against bacterial infections, if used at double the recommended dosage. Side note: This medication is also administered to us humans since there is a bacterial infection that we can catch from our fish tanks! Human Infections

  NITROFURAZONE – Sold as Furacyn, Effective against bacterial infections.
  DOSAGE: 250- 500 mg per 20 gallons. Treat every 24 hours with a 50% water change before each treatment. Treat for 10 days. 

  KANAMYCN SULFATE – Sold as Kanacyn, Effective against bacterial infections.

  OCTOZIN – Useful for internal parasites.

  PRAZIQUANTEL – Sold as Prazipro and Droncit,Effective against Trematodes. While this is a very difficult problem to diagnose, it is important to note that with Trematodes, there are two distinct forms of concern for us, which involves their life cycles, there are digenetic trematodes which require two or more other life forms that they must pass through before ending up on our fish, since those other life forms are not present in our tanks, this problem will just die off on its own. The type of trematode that is of concern for us are the mono genetic types that have only one host needed (our fish). If this medication is administered via bath it will not be as effective on internal parasites as administering via food. Can be obtained on line: Nationalfishpharm.com or through a vet.

  ACRIFLAVINE – Effective against the parasite Amyloodinium.

  SULFASOXAZOLE – Effective against bacterial infections.

  TRIPLE SULFA (Sulfamerazine, Sulfamethazine, Sulfathiazole) – Treatment of gram-negative bacterial infections, fin and tail rot and mouth fungus.
  DOSAGE: 250 mg per 10 gallons every 24 hours with a 25% water change before each treatment. Treat for a minimum of 10 days.

  “Natural” Treatments:

  PIMAFIX – Effective against cotton like fungal infections as well as external and internal bacterial infections. There is debate on such medications amongst the hobby, some are against its use while other hobbyists have noted very good results with this product if used in conjunction with Melafix. A word of caution with its use, there has been observations that fish may experience oxygen deprivation / suffocation. As such, increased aeration should be used as well as monitoring the fish closely.

  GARLIC– In my corrected opinion, while garlic use is still somewhat of a controversial additive, it does perform as a mild anti-helminth (dewormer) and does have some anti-bacterial properties, but should be used with more conventional treatments.

  BETA GLUCAN – “Beta glucan works as a biological defense modifier. It activates the immune system by stimulating receptors on macrophages that cause them to react as if a fungus is attacking the body.” In other words, this is a great way to help the fish help itself, supplementing this product to the fish food will increase its own immune system and may just save you a few trips to the fish pharmacy.

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