Medications to keep on hand Every day I help at least one person with a fish disease problem, and many times that person doesn’t have any medication(s) on hand to begin treatment. Delaying treatment can literally mean the difference between life & death for a fish. So with that in mind, I’ve come up with a list of useful medications to keep on hand. Be aware not all LFS keep these medications in stock. Therefore it would be wise to keep at least some of these medications in your “fish medicine cabinet.” Anti-parasitic: Chloroquine phosphate (treats Ich, Velvet, Brooklynella & Uronema) - Prescription required from a vet, which can then be filled at a local pharmacy. If you buy it online, on ebay, from China, etc. - Who knows what you’re really getting? Copper (treats Ich & Velvet) - The following brands are available, with therapeutic ranges listed and compatible test kits: Cupramine (0.35 - 0.5 ppm) - Seachem or Salifert copper test kit Coppersafe (1.5 - 2.0 ppm) - API copper test kit Copper Power (2.5 ppm) - API copper test kit Acriflavine (treats Velvet, Brooklynella & Uronema) - Use in a bath solution to provide temporary relief of velvet. Can also be used as a bath or QT treatment for brook & uronema. Acriflavine-MS & Ruby Reef Rally both contains acriflavine. Formalin (treats Velvet, Brooklynella & Uronema - alternative treatment for Flukes & Black Ich) - Use in a bath solution to provide temporary relief of velvet. Can also be used as a bath or QT treatment for brook, uronema, flukes & black ich. Formalin is found in the following products: Formalin-MS, Quick Cure, Aquarium Solutions Ich-X, Kordon Rid-Ich Plus. Anti-bacterial/antibiotics: A broad spectrum antibiotic that treats both gram-positive and gram-negative bacterial diseases is recommended. Seachem Kanaplex, Furan-2, Nitrofuracin Green Powder and Triple Sulfa Powder are all good options to have on hand. Erythromycin & Minocycline can also be used but are becoming more difficult to find. To achieve the widest possible spectrum of treatment when battling a particularly nasty bacterial infection, combine the following: Kanaplex, Furan-2, and metronidazole (exs. Seachem MetroPlex, Metro-MS). Dewormers: Praziquantel (ex. Prazipro) for gill flukes. API General Cure (contains both praziquantel & metronidazole). Metronidazole (exs. Seachem MetroPlex, Metro-MS) can be used to treat stubborn intestinal worms prazi does not treat. Formalin can be used to treat prazi-resistant strains of flukes and black ich. Multi-purpose medications: Metronidazole (treats Brooklynella, Uronema, internal parasites/intestinal worms, some anti-bacterial activity) - Use Seachem MetroPlex or Metro-MS. API General Cure contains both praziquantel & metronidazole. Malachite Green/Methylene Blue (treats ammonia burn, cuts, injuries). Medications that are “reef safe”: Prazipro - may kill tube worms/feather dusters and bristle worms. If you have lots of tiny feather dusters and/or bristle worms in your tank (usually down in the sump), the resulting die-off can lead to an ammonia spike. Kanaplex, erythromycin, metronidazole and powder praziquantel can all be soaked in fish food. Use a binder, such as Seachem Focus, to prevent the medication from leaching out into the water column. Fish Vitamins & misc.: Soak fish food in vitamin supplements such as Selcon, Zoecon and Vita-chem or even Omega 3 & 6 fish oil. This will boost a fish’s natural immune system and is particularly useful for clearing viruses such as Lymphocystis. Soak fish food in garlic to stimulate appetite. Useful for new fish that refuse to eat. Always keep an ammonia reducer, such as Amquel or Prime, on hand. You never know when you might need it. A reducer can be useful for immediately neutralizing ammonia in the DT, QT (so long as no medications are present, especially copper), or when drip acclimating a new fish that has been in transit a while and ammonia has built up.