Application site reaction after Eprinomectin + Esafoxolaner + Praziquantel (NexGard Combo) in cats

The FDA has received 416 reports of application site reaction in cats after Eprinomectin + Esafoxolaner + Praziquantel. That is 13% of all reports for this medicine, compared with 8.1% across reports for all cat medicines, so it is reported unusually often with this medicine.

416Reports
2.6%Marked serious
24%Recovered
1.7%Died or euthanised
1 daysTypical onset
SponsoredWorried about your pet? Ask a veterinarian online, 24/7

How soon it started

Same day
186 46%
1–2 days
138 34%
3–7 days
49 12%
1–4 weeks
25 6.2%
Over a month
7 1.7%

How the animals did

Recovered
97 23%
Recovered with lasting effects
1 0.2%
Still unwell when reported
47 11%
Died
3 0.7%
Euthanised
4 1.0%
Not known
264 63%

Problems reported at the same time

Age of the animals

Under 1 year
61
1–3 years
124
4–7 years
79
8–11 years
63
12+ years
45

About this medicine

Eprinomectin controls worms and prevents heartworm. Esafoxolaner kills fleas and ticks (spot-on for cats). Praziquantel treats tapeworms.

Products with this combination include NexGard Combo. The FDA hides brand names in its public data, so these reports cover every product with the same active ingredients.

Some herding breeds (for example Collies) carry the MDR1 gene variant and can be more sensitive to this drug class at high doses.

Questions owners ask

Can Eprinomectin + Esafoxolaner + Praziquantel cause application site reaction in cats?
416 reports link the two, but a report alone does not prove the medicine was the cause: other illnesses, other medicines or coincidence can be involved. Your vet can judge it for your animal.
How soon after a dose was it reported?
In half of the reports with dates, it started within 1 day of the first dose.
What should I do?
Don't give another dose until you've spoken to your vet, and keep the packaging so you can tell them the product and dose. Your vet can also report it to the FDA (or you can, through the manufacturer or FDA form 1932a).

Application site reaction with similar medicines

All reported side effects of Eprinomectin + Esafoxolaner + Praziquantel in cats · Medicines most reported with application site reaction