Liver problems after Eprinomectin + Esafoxolaner + Praziquantel (NexGard Combo) in cats

82 reports to the FDA describe liver problems in cats given Eprinomectin + Esafoxolaner + Praziquantel. That is 2.5% of all reports for this medicine, compared with 2.8% across reports for all cat medicines.

82Reports
65%Marked serious
20%Recovered
30%Died or euthanised
1 daysTypical onset
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How soon it started

Same day
25 32%
1–2 days
32 41%
3–7 days
9 12%
1–4 weeks
11 14%
Over a month
1 1.3%

How the animals did

Recovered
16 20%
Still unwell when reported
17 21%
Died
10 12%
Euthanised
15 18%
Not known
24 29%

Problems reported at the same time

Age of the animals

Under 1 year
23
1–3 years
17
4–7 years
17
8–11 years
13
12+ years
11

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 liver problems in cats?
82 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).

Liver problems with similar medicines

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