Incorrect route of drug administration after Eprinomectin + Esafoxolaner + Praziquantel (NexGard Combo) in cats

The FDA has received 83 reports of incorrect route of drug administration in cats after Eprinomectin + Esafoxolaner + Praziquantel. That is 2.6% of all reports for this medicine, compared with 0.3% across reports for all cat medicines, so it is reported unusually often with this medicine.

83Reports

3.6%Marked serious

27%Recovered

1.2%Died or euthanised

Same dayTypical onset

How soon it started

Same day

75 94%

1–2 days

3 3.8%

3–7 days

1 1.3%

1–4 weeks

1 1.3%

Over a month

0 0.0%

How the animals did

Recovered

22 27%

Still unwell when reported

1 1.2%

Euthanised

1 1.2%

Not known

59 71%

Problems reported at the same time

50 60%

38 46%

22 27%

14 17%

5 6.0%

Medication error

4 4.8%

Loss of appetite

4 4.8%

Hiding

3 3.6%

Age of the animals

Under 1 year

1–3 years

4–7 years

8–11 years

12+ years

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 incorrect route of drug administration in cats?: 83 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 the same 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).

Incorrect route of drug administration with similar medicines

Incorrect route of drug administration after Selamectin (Revolution) 53 reports · 0.2% of its reports
Incorrect route of drug administration after Eprinomectin + Praziquantel 40 reports · 6.8% of its reports

All reported side effects of Eprinomectin + Esafoxolaner + Praziquantel in cats · Medicines most reported with incorrect route of drug administration