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

The FDA has received 445 reports of vomiting in cats after Eprinomectin + Esafoxolaner + Praziquantel. That is 14% of all reports for this medicine, compared with 18% across reports for all cat medicines.

445Reports

17%Marked serious

39%Recovered

8.5%Died or euthanised

Same dayTypical onset

How soon it started

Same day

270 61%

1–2 days

107 24%

3–7 days

35 7.9%

1–4 weeks

19 4.3%

Over a month

11 2.5%

How the animals did

Recovered

172 39%

Still unwell when reported

43 9.7%

Died

17 3.8%

Euthanised

21 4.7%

Not known

192 43%

Problems reported at the same time

143 32%

132 30%

79 18%

64 14%

38 8.5%

35 7.9%

32 7.2%

32 7.2%

Age of the animals

Under 1 year

100

1–3 years

124

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 vomiting in cats?: 445 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).

Vomiting with similar medicines

Vomiting after Selamectin (Revolution) 2,379 reports · 11% of its reports
Vomiting after Ivermectin (Heartgard) 292 reports · 30% of its reports
Vomiting after Eprinomectin + Praziquantel 99 reports · 17% of its reports
Vomiting after Milbemycin Oxime (Interceptor) 69 reports · 17% of its reports
Vomiting after Milbemycin Oxime + Spinosad (Trifexis) 142 reports · 47% of its reports
Vomiting after Ivermectin + Pyrantel (Heartgard Plus) 31 reports · 47% of its reports

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