If the Prazi is loosing effectiveness, I might get some Fluke Tabs which have trichlorfon and mebendazole as active ingredients. That is the next option I am considering. I wouldn't think that the flukes would be resistant to both Prazi and trichlorfon at the same time. I think if one doesn't work, the other probably will.
I have been doing 75% water changes every 4 days and retreating with 2x the recommended starting dose for Prazi. I removed everything from the tank except a thin layer of gravel and a couple plastic plants to give the fish some cover. I vacuum the gravel everytime I change the water and I scrub the glass frequently. I added some salt and turned up the heat slowly--trying to get it to about 86-88F to speed up the fluke life cycle so I can kill them faster. So, I have taken most precautions that I can plus adding more aeration. The water changing equipment is dried between uses which will kill any parasites they may have on them as well. Believe me, I have had this same go around before and I don't want it to get that far advanced this time so I am doing everything I can right away. Last time I used Prazi, it didn't seem to take effect as quickly as I hoped, but as soon as I cranked up the temp from about 78-79F to the upper 80s, I saw much greater improvement each day. After about 4 days, the fish that had been sitting motionless on the bottom were finally moving around and trying to eat. I was thrilled. This was after an attempted treatment with Trichlorfon (which they were resistant to).
The only thing that I was wondering about this time, is either I don't have the temp high enough (because it was hovering around 81-82 degrees over the last couple weeks while trying to treat it) or the prazi is not effective. I added another heater last night so I could slowly ramp it up to where I want it. In my opinion, Prazi doesn't lhave any strength after 3-4 days in the aquarium. So, that is as long as I go before a water change and redosing.
Cathy, how warm was your aquarium temp when you used the Prazi? I am using Prazi-pro form which I am not extremely fond of since it leaves a thick film on everything in the aquarium after a couple days. My dosage is about 5 mg/L (2x the recommended starting dose).