Behaviour change after Eprinomectin + Esafoxolaner + Praziquantel (NexGard Combo) in cats

176 reports to the FDA describe behaviour change in cats given Eprinomectin + Esafoxolaner + Praziquantel. That is 5.4% of all reports for this medicine, compared with 5.4% across reports for all cat medicines.

176Reports
29%Marked serious
33%Recovered
11%Died or euthanised
Same dayTypical onset
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How soon it started

Same day
102 59%
1–2 days
48 28%
3–7 days
14 8.1%
1–4 weeks
7 4.1%
Over a month
1 0.6%

How the animals did

Recovered
58 33%
Still unwell when reported
18 10%
Died
5 2.8%
Euthanised
15 8.5%
Not known
80 45%

Problems reported at the same time

Age of the animals

Under 1 year
34
1–3 years
71
4–7 years
33
8–11 years
19
12+ years
13

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 behaviour change in cats?
176 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 the same 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).

Behaviour change with similar medicines

All reported side effects of Eprinomectin + Esafoxolaner + Praziquantel in cats · Medicines most reported with behaviour change