Loss of appetite after Eprinomectin + Esafoxolaner + Praziquantel (NexGard Combo) in cats

The FDA has received 461 reports of loss of appetite in cats after Eprinomectin + Esafoxolaner + Praziquantel. That is 14% of all reports for this medicine, compared with 14% across reports for all cat medicines.

461Reports

27%Marked serious

27%Recovered

16%Died or euthanised

1 daysTypical onset

How soon it started

Same day

176 39%

1–2 days

172 38%

3–7 days

51 11%

1–4 weeks

37 8.3%

Over a month

11 2.5%

How the animals did

Recovered

123 27%

Still unwell when reported

70 15%

Died

30 6.5%

Euthanised

44 9.5%

Not known

194 42%

Problems reported at the same time

263 57%

132 29%

68 15%

63 14%

62 13%

55 12%

54 12%

53 11%

Age of the animals

Under 1 year

1–3 years

127

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 loss of appetite in cats?: 461 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).

Loss of appetite with similar medicines

Loss of appetite after Selamectin (Revolution) 2,481 reports · 11% of its reports
Loss of appetite after Ivermectin (Heartgard) 109 reports · 11% of its reports
Loss of appetite after Eprinomectin + Praziquantel 62 reports · 11% of its reports
Loss of appetite after Milbemycin Oxime (Interceptor) 41 reports · 10% of its reports
Loss of appetite after Milbemycin Oxime + Spinosad (Trifexis) 27 reports · 9.0% of its reports

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