Learning Your Medications for Bettas
Let’s know Medications for Bettas. Yet again because of PM’s I have posted this for you. You will find it covers most betta fish medications and is geared to bettas.

Before ANY treatment, check these parameters and ask yourself these questions:

Ammonia; this should be 0, if not this should be corrected by water changes
Nitrites; this also should be 0
Nitrates; this should be under 40-50 ppm for most betta fish,
kH, Calcium, and electrolytes; for many betta fish this should be 60-80 ppm
pH; often aquarists worry too much here (a steady KH maintains a stable pH) for bettas you will be at 6.0 – 7.0

LEASE NOTE, this is a basic betta Medications article only.
If you need expanded information about any of these medications or ones that are not even in this article, please just contact me at our aquaculture farm here in Thailand.

Now I would like to address the common anecdotal comments made by many people about the harmful side effects of betta fish medications. While almost every medication has some side effect which can harm or kill a fish, it is only over use or misuse can result in harm. Even in human treatments, what can cure can also harm so ask questions or research first.

A comment often stated all over the internet is the use of antibiotics will kill your nitrifying bacteria.

While this is true, it is ONLY true with new bio filters with many antibiotics (newly established aquariums). This only can happen with gram positive antibiotics or over use of others.

Although true nitrifying bacteria (Autotrophic bacteria) are gram negative, these bacteria are seriously impacted by gram positive rather than gram negative medications, possibly due to the bio films they produce (but the answer is not clear).

People need to understand the majority of aquarium infections are gram negative. So, the use of gram negative antibiotics such as Kanamycin (which is primarily gram negative) have a lower risk of a nitrifying bacteria die-off than when used properly/carefully in an established aquarium.

Some antibiotics are more mixed such as the Tetracycline families which are often equally divided such as Minocycline. However, Tetracycline Hydrochloride is primarily gram positive.

An example of medication overuse: Kanamycin Sulfate, this antibiotic can be very harmful on the Kidneys, HOWEVER this is one of the better kidney disease treatments available over the counter for fish. You just do not want to abuse or over use it.

Another example is Malachite Green. This has been shown in studies to be carcinogenic when used in large quantities.

Yet in studies using this chemical at established therapeutic levels, Malachite Green has not shown to pose this danger.

Here’s another of piece medication misinformation or what I consider jumping to stupid non-science orientated conclusions. In this area of two products by API; Melafix and Pimafix have recently fallen victim to well informed aquarists and forums making assumptions based on poor scientific method.

I recommend reading page four of this article specifically dealing with these treatments:

ORGANIC TREATMENTS, Melafix, TTO, Pimafix, Usnea.

Basically, I have read aquarists in forums stating Pimafix should not be used due to Clove Oil being in this product, however this is the same as stating a human should never use Tylenol as over use (especially with alcohol) can lead to liver failure.

If any problems have happened (I have never had an issue in 100’s of correct uses) it is not likely used properly with normal water changes between doses (which I recommend with all medications).

Melafix has been blamed for the death of Labyrinth/Pencil fish, which I am not doubting the sources (such as Fish Lore) are reputable, but since I and others have conducted tests with Melafix at double dose with Labyrinth fish with no ill effects, I think we have to look scientifically at what the trigger may be because it for sure is not this product.

Making False Assumptions when Medicating
This is similar to the section above, however here I’m referring to aquarium and pond keepers use of medications vs. the previous section dealing with anecdotal advice.

A good example is the use of Erythromycin or Melafix for treating Columnaris which is gram negative and then assuming your use of Erythromycin cured this ailment when laboratory tests prove this impossible.

What likely happened is some other part of your tank maintenance procedure took care of this opportunistic infection OR quite simply your fish did not even have Columnaris, rather Streptococcus or FNT Disease or other gram-positive diseases.

Changing water or otherwise improving water conditions can often allow a fish overcome an opportunistic infection (such as Aeromonas). This easily allows the aquarium keeper to assume that a treatment cured his/her fish.

My point is that this hobby is often driven by anecdotal assumptions and not aquaculture science I would like readers to avoid by thinking more scientifically.

A controlled study of medication use would include control groups, exact maintenance/water change procedures and more to keep different medication tests accurate.

Obviously the aquarium or pond keeper when confronted with sick fish does not have time or multiple aquariums/ponds to perform these tests.

However, with that being said, by changing water before treatments (even before each additional treatment), keeping water parameters where they should be for the fish kept, and knowing what each treatment method can and cannot effect, as well as proven/known effective treatments for bacterial & parasitic pathogens can allow an aquarist to know when an infection treatment is the best possible to utilize.

So please understand the importance of healthy water parameters and knowing what a medication can and cannot due rather than listening to or making your own anecdotal assumptions.

Contraindications (& Medication Mixing)
What are “Contraindication”?

Wikipedia: “In medicine, a contraindication is a condition or factor that serves as a reason to withhold a certain medical treatment

Some contraindications are absolute, meaning that there are no reasonable circumstances for undertaking a course of action

Other contraindications are relative, meaning that the patient is at higher risk of complications”

Knowing some of these contraindications will help determine whether it is advisable or at all safe to mix certain medications or chemical treatments. As well, the mix of medication and volume depends on the disease you are trying to treat and the inhabitants of your tank.

Here are some examples of medications that can or cannot be mixed:

Tetracycline, NEVER mix Tetracycline with any other medication. The reason for this is that it is a very harsh treatment and lowers the red blood cell count in your aquarium fish.

Potassium Permanganate can be mixed with salt ONLY and is used to aid in the treatment of external parasites such as Anchor Worms.

Triple Sulfa can be mixed with Paraguard as it aids with secondary infections and lowers the ricks of infections caused by the irritation of malachite green with certain sensitive fish such as Cory Catfish or Clown Loaches.

Paraguard, Furan 2, and Kanaplex can be mixed and this combination aids in the treatment of a wider spectrum of diseases.

These are the medications I find work well for internal infections/infestations when soaked in a fish food “slurry”;

Metronidazole, Neomycin, Kanamycin, Oxytetracycline, Piperazine, Praziquantel, and Levamisol.

Be careful of over use of Kanamycin in a fish food delivery; do not use for more than 7 days or kidney damage could result, otherwise up to 10 days for the other suggested medications.

For internal gut infections that often result in bloating or swim bladder infections, I have found the combination of Metronidazole with Neomycin to be most effective since one is effective against aerobic while the other is effective against anaerobic bacterium.

Please be aware that often swim bladder infections have an osmoregulation factor involved too so failure to address this such as poor mineral Cation levels can make successful treatment often impossible.

Here are some Gram-Negative Bacteria
Aeromonas (anaerobic)
Furunculosis; Aeromonas-salmonicida (anaerobic)
Flavobacterium (Columnaris) (aerobic)
Pseudomonas (aerobic)
Streptobacillus (anaerobic)
Salmonella (anaerobic)
Aerobic Chemolithotrophic Bacteria
Nitrifying bacteria

Nitrobacteraceae (aerobic)
Nitrobacter (aerobic)
Nitrococcus (aerobic)
Nitrospina (aerobic)
Nitrospira (aerobic)
Nitrosococcus (aerobic)
Nitrosolobus (aerobic)
Nitrosomonas (aerobic)

Anaerobic Chemotrophic Bacteria
Erythrobacter (anaerobic)
Cyanobacteria (Oxygenic Phototrophic)
Gram-positive bacteria do not always cause a disease in the host organism and have a very thick cell wall.

Gram positive infections are less common in fish (or aquaria in general). These are the bacteria that retain a crystal violet dye during the Gram stain process.

Here are some Gram-Positive Bacteria
Mycobacterium (aquatic tuberculosis)
Streptococcus (Pyogenic Hemolytic Streptococci, Oral Streptococci,Enterococci, Lactic Acid Streptococci, Anaerobic Streptococci)
Pseudonocardia (anaerobic)
Staphylococcus (aerobic)
Of the above bacteria noted, Flavobacterium (Columnaris), Vibrio, Aeromonas, & Pseudomonas cause the vast majority of diseases in aquariums/ponds AND these are gram negative. It should also be noted that Aeromonas and Vibrio are generally anaerobic, so keeping a well circulated/oxygenated aquarium or pond is important for their prevention and treatment.

Mycobacterium is an occasional problem that is gram positive.

I have cited much of the information for this section from this source:

Classification of Bacteria

How to Make a Percent-% Solution
Sometimes it is necessary to mix your own chemical solutions such as Methylene Blue, Malachite Green, Potassium Permanganate, etc.

Simply put– to make a 1% Malachite Green aqueous solution, use a 100 ml bottle. Then add 1 gram of Malachite Green to your bottle and bring the volume up to 100 ml.

As another example, to make a 2.30% Methylene Blue aqueous solution, use a 100 ml bottle, then add 2.3 grams of Methylene Blue to your bottle and bring the volume up to 100 ml.

See this equation:

% solution = (dry mass in grams / volume in ml) * 100

And now on to the good stuff!
TRIPLE SULFA (Sulfamerazine, Sulfamethazine, Sulfathiazole):

Sulfas are all antibacterials. These drugs produce are bacteriostatic, meaning they inhibit the growth of the bacteria but do not kill them.

Sulfa drugs arrest cell growth by inhibiting the synthesis of folic acid, a component required for growth by bacteria. Folic acid is a large molecule and is unable to enter bacterial cells, so the bacteria must synthesize the compound intracellularly. Animal cells are unable to synthesize folic acid and it must be provided in the diet. For this reason sulfa drugs are not toxic to animal cells.

USE: A broad spectrum antibacterial medication, fin and tail rot, mouth fungus and collapsed fins, columnaris, and hemorrhagic septicemia. Also useful for damaged fins caused by fin nipping. An old standby that is still useful and can be used in combination with Malachite Green or Acriflavin (do not combine with copper sulfate). Sulfas are more effective at higher pH levels.

DOSAGE: 250 mg per 10 gallons every 24 hours with a 25% water change before each treatment. Treat for a minimum of 10 days.

TETRACYCLINE HYDROCHLORIDE:

USE: Treatment of bacterial infections mostly gram-positive and some gram-negative infections such as fin and tail rot (split, ragged and deteriorating fin and/or tail), Popeye (protruding eyes, may be cloudy or hazy), gill disease (swollen, discolored gills, gasping for air and a decrease in activity) and secondary infections. It interferes with the production of proteins that the bacteria need to multiply and divide (bacteriostatic). Tetracycline Hydrochloride mode of action is as a protein synthesis inhibitor via an aminoacyl-tRNA binding mechanism to the 30S subunit. Mode of resistance is the loss of cell wall permeability. Note, Tetracycline can lower red blood cell count, because of this I would not use with injured fish.

DOSAGE: 250- 500 mg per 20 gallons of water. Every 24 hours with a 25% water change before each treatment. This product will not work in water with a ph above 7.5- NOT FOR MARINE USE!

QUININE SUFATE
USE: Resistant strains of Ich (especially on scale less fish). Protozoan, sliminess of the skin and Rams disease (whirling disease). Also good for resistant strains of Hexamita when combined with Metronidazole.

DOSAGE : 250 mg per 10 gallons of water. Once a day for 4-5 days. Do a 25% water change before each treatment.

OXYTETRACYCLINE HYDROCHLORIDE
USE: Gram-positive and gram-negative bacteria. Marine ulcer disease, cold water disease, bacterial hemorrhagic septicemia (Symptoms: Red streaks in body and fins, or redness in the body. Open sores or loss of scales) and mouth fungus.

DOSAGE: 250- 500 mg teaspoon per 20 gallons every 24 hours with a 50% water change before each treatment. This antibiotic is best used mixed in with food, especially if your ph is above 8.0..

NITROFURAZONE
USE: Bactericidal for some gram-positive and many gram-negative bacteria causing disease in fresh water and marine fishes. This antibacterial is effective for control of flexibacter/columnaris- (Symptoms: Fuzzy, thin, white coating on the body and fins. Looks like a fungus) -works well with Kanamycin for this, Aeromonas (Symptoms: fish have blisters forming on the skin that are full of a clear to yellowish fluid. The blisters may turn into large sores.), Vibrio and related species. Nitrofurazone is particularly useful for control of minor topical skin infections of marine fishes that have not become systemic. Effective against marine ulcer disease and protozoan. Also useful in treating furunculosis found in Koi.

Serious adverse events related to nitrofurans are very rare. Acquired resistance of bacteria to nitrofurans during therapy has been rare and has not appeared on a significant scale in over 50 years of use. Do not use in the presence of invertebrates.

Nitrofurazone is more effective at lower pH levels.

DOSAGE: 250- 500 mg per 20 gallons. Treat every 24 hours with a 50% water change before each treatment. Treat for 10 days.