Elevated globulins after Eprinomectin + Esafoxolaner + Praziquantel (NexGard Combo) in cats

The FDA has received 39 reports of elevated globulins in cats after Eprinomectin + Esafoxolaner + Praziquantel. That is 1.2% of all reports for this medicine, compared with 0.5% across reports for all cat medicines, so it is reported unusually often with this medicine.

39Reports
59%Marked serious
15%Recovered
41%Died or euthanised
2 daysTypical onset
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How soon it started

Same day
9 25%
1–2 days
14 39%
3–7 days
6 17%
1–4 weeks
7 19%
Over a month
0 0.0%

How the animals did

Recovered
6 15%
Still unwell when reported
6 15%
Died
10 26%
Euthanised
6 15%
Not known
11 28%

Problems reported at the same time

23 59%
Hyperproteinaemia
17 44%
16 41%

Age of the animals

Under 1 year
8
1–3 years
11
4–7 years
8
8–11 years
6
12+ years
6

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 elevated globulins in cats?
39 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 2 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).

Elevated globulins with similar medicines

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