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

The FDA has received 118 reports of diarrhea in cats after Eprinomectin + Esafoxolaner + Praziquantel. That is 3.6% of all reports for this medicine, compared with 5.1% across reports for all cat medicines.

118Reports
13%Marked serious
28%Recovered
8.5%Died or euthanised
1 daysTypical onset
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How soon it started

Same day
49 43%
1–2 days
39 34%
3–7 days
14 12%
1–4 weeks
10 8.8%
Over a month
2 1.8%

How the animals did

Recovered
33 28%
Still unwell when reported
12 10%
Died
5 4.2%
Euthanised
5 4.2%
Not known
63 53%

Problems reported at the same time

64 54%
54 46%
16 14%
11 9.3%
10 8.5%
8 6.8%

Age of the animals

Under 1 year
33
1–3 years
31
4–7 years
14
8–11 years
17
12+ years
19

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 diarrhea in cats?
118 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).

Diarrhea with similar medicines

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