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

The FDA has received 334 reports of itching in cats after Eprinomectin + Esafoxolaner + Praziquantel. That is 10% of all reports for this medicine, compared with 8.9% across reports for all cat medicines.

334Reports
13%Marked serious
24%Recovered
6.9%Died or euthanised
1 daysTypical onset
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How soon it started

Same day
154 47%
1–2 days
98 30%
3–7 days
33 10%
1–4 weeks
26 8.0%
Over a month
14 4.3%

How the animals did

Recovered
80 24%
Recovered with lasting effects
1 0.3%
Still unwell when reported
40 12%
Died
7 2.1%
Euthanised
16 4.8%
Not known
190 57%

Problems reported at the same time

Age of the animals

Under 1 year
60
1–3 years
107
4–7 years
68
8–11 years
36
12+ years
44

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 itching in cats?
334 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).

Itching with similar medicines

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