It is very important to give it on an empty stomach because any contents in the stomach will decrease the drug uptake in the system. Anti-inflammatory drugs should be given during the first two weeks of treatment to help minimize further damage due to parasite death and the host's response. Horses that are severely affected are often given dexamethasone for one to three days after the beginning of their treatment. Longer use could suppress the immune system. Oral vitamin E is often supplemented to help the central nervous system heel.
Folic acid is supplemented to help prevent anemia and potential pregnancy problems.
Trying not to stress horses recovering from EPM is a major asset to the treatment plan. Severely affected horses should be kept in a well-bedded box stall until they can move around easily. A sudden change to the environment is something that must be avoided to minimize stress. Light exercise is appropriate as the horse gets better, since inactivity isn't healthy either. Alternative therapies such as message therapy, acupuncture, and chiropractic care all seem to help make sore horses feel better and are not discouraged.