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

The FDA has received 30 reports of hyperphosphataemia in cats after Eprinomectin + Esafoxolaner + Praziquantel. That is 0.9% of all reports for this medicine, compared with 1.0% across reports for all cat medicines.

30Reports
83%Marked serious
10%Recovered
33%Died or euthanised
2 daysTypical onset
SponsoredWorried about your pet? Ask a veterinarian online, 24/7

How soon it started

Same day
5 18%
1–2 days
11 39%
3–7 days
7 25%
1–4 weeks
4 14%
Over a month
1 3.6%

How the animals did

Recovered
3 10%
Still unwell when reported
6 20%
Died
6 20%
Euthanised
4 13%
Not known
11 37%

Problems reported at the same time

Age of the animals

Under 1 year
16
1–3 years
3
4–7 years
2
8–11 years
5
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 hyperphosphataemia in cats?
30 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).

Hyperphosphataemia with similar medicines

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