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eSHa ndx vs. Prazipro: Which is Better for Internal Worms?

Internal worms (Nematodes and Cestodes) are the "silent" killers of the aquarium world. They often go unnoticed for months until a fish suddenly wastes away. When choosing a treatment, you'll often see two heavyweights recommended: eSHa ndx and Prazipro. While both treat "worms," they target completely different types.

Levamisole

Targets Roundworms

VS

Praziquantel

Targets tapeworms & Flukes

When to Choose eSHa ndx (Levamisole)

eSHa ndx contains **Levamisole Hydrochloride**, which is the gold standard for treating **Nematodes** (Roundworms). The most famous of these is the **Camallanus worm**—those tiny red worms you see sticking out of a fish's anus.

Watch the Fish: During treatment with ndx, fish may become temporarily sluggish or lose their appetite. This is normal as the worms lose their grip on the intestinal lining. Ensure the water is well-aerated during this time. You **must** vacuum your substrate 24 hours after dosing to remove the live (but immobile) worms before they recover and are eaten again. You can calculate your exact dose using our eSHa ndx calculator.

When to Choose Prazipro (Praziquantel)

Prazipro (and its European equivalent, eSHa gdex) contains Praziquantel. This targets **Cestodes** (Tapeworms) and **Trematodes** (Flukes). If your fish has a "concave" stomach despite eating, it may have tapeworms. If it's gasping or flicking, it likely has flukes. Check out our eSHa gdex calculator if you're in Europe.

Can They Be Used Together?

Technically, yes, Levamisole and Praziquantel can be used in the same timeframe, but it is very stressful for the fish. We recommend treating with one first (the one that matches the most likely symptoms), performing a large water change, and then treating with the second a week later.

Comparison at a Glance