Didn't work as expected after Eprinomectin + Esafoxolaner + Praziquantel (NexGard Combo) in cats

59 reports to the FDA describe didn't work as expected in cats given Eprinomectin + Esafoxolaner + Praziquantel. That is 1.8% of all reports for this medicine, compared with 8.7% across reports for all cat medicines, so it is reported less often than average with this medicine.

59Reports
24%Marked serious
6.8%Recovered
10%Died or euthanised
23 daysTypical onset
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How soon it started

Same day
2 3.9%
1–2 days
6 12%
3–7 days
1 2.0%
1–4 weeks
26 51%
Over a month
16 31%

How the animals did

Recovered
4 6.8%
Still unwell when reported
16 27%
Died
1 1.7%
Euthanised
5 8.5%
Not known
33 56%

Problems reported at the same time

6 10%
4 6.8%
3 5.1%
Sneezing
3 5.1%

Age of the animals

Under 1 year
28
1–3 years
11
4–7 years
5
8–11 years
3
12+ years
2

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 didn't work as expected in cats?
59 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 23 days 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).

Didn't work as expected with similar medicines

All reported side effects of Eprinomectin + Esafoxolaner + Praziquantel in cats · Medicines most reported with didn't work as expected