Death after Eprinomectin + Esafoxolaner + Praziquantel (NexGard Combo) in cats

244 reports to the FDA describe death in cats given Eprinomectin + Esafoxolaner + Praziquantel. That is 7.5% of all reports for this medicine, compared with 8.9% across reports for all cat medicines.

244Reports
99%Marked serious
0.0%Recovered
100%Died or euthanised
1 daysTypical onset
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How soon it started

Same day
80 34%
1–2 days
96 41%
3–7 days
31 13%
1–4 weeks
21 9.0%
Over a month
6 2.6%

How the animals did

Died
116 48%
Euthanised
128 52%

Problems reported at the same time

Age of the animals

Under 1 year
76
1–3 years
58
4–7 years
38
8–11 years
23
12+ years
30

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 death in cats?
244 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).

Death with similar medicines

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