Increased respiratory rate after Eprinomectin + Esafoxolaner + Praziquantel (NexGard Combo) in cats

23 reports to the FDA describe increased respiratory rate in cats given Eprinomectin + Esafoxolaner + Praziquantel. That is 0.7% 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.

23Reports
61%Marked serious
13%Recovered
35%Died or euthanised
Same dayTypical onset
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How soon it started

Same day
12 57%
1–2 days
5 24%
3–7 days
2 9.5%
1–4 weeks
1 4.8%
Over a month
1 4.8%

How the animals did

Recovered
3 13%
Still unwell when reported
2 8.7%
Died
5 22%
Euthanised
3 13%
Not known
10 43%

Problems reported at the same time

10 43%
8 35%
7 30%
Increased heart rate
5 22%

Age of the animals

Under 1 year
5
1–3 years
10
4–7 years
2
8–11 years
2
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 increased respiratory rate in cats?
23 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).

Increased respiratory rate with similar medicines

All reported side effects of Eprinomectin + Esafoxolaner + Praziquantel in cats · Medicines most reported with increased respiratory rate