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

The FDA has received 79 reports of fever in cats after Eprinomectin + Esafoxolaner + Praziquantel. That is 2.4% of all reports for this medicine, compared with 3.2% across reports for all cat medicines.

79Reports
33%Marked serious
32%Recovered
13%Died or euthanised
1 daysTypical onset
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How soon it started

Same day
32 41%
1–2 days
24 31%
3–7 days
8 10%
1–4 weeks
13 17%
Over a month
1 1.3%

How the animals did

Recovered
25 32%
Still unwell when reported
17 22%
Died
5 6.3%
Euthanised
5 6.3%
Not known
27 34%

Problems reported at the same time

Age of the animals

Under 1 year
20
1–3 years
31
4–7 years
13
8–11 years
9
12+ years
4

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 fever in cats?
79 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).

Fever with similar medicines

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