Application site reaction after Imidacloprid + Moxidectin (Advantage Multi) in cats

The FDA has received 1,047 reports of application site reaction in cats after Imidacloprid + Moxidectin. That is 13% of all reports for this medicine, compared with 8.1% across reports for all cat medicines, so it is reported unusually often with this medicine.

1,047Reports

55%Marked serious

35%Recovered

1.1%Died or euthanised

1 daysTypical onset

How soon it started

Same day

255 37%

1–2 days

202 29%

3–7 days

120 17%

1–4 weeks

64 9.3%

Over a month

45 6.6%

How the animals did

Recovered

363 35%

Still unwell when reported

51 4.9%

Died

6 0.6%

Euthanised

5 0.5%

Not known

622 59%

Problems reported at the same time

583 56%

262 25%

236 23%

121 12%

118 11%

Skin rash or irritation

94 9.0%

Accidental exposure

85 8.1%

Lethargy

84 8.0%

Age of the animals

Under 1 year

129

1–3 years

351

4–7 years

250

8–11 years

165

12+ years

About this medicine

Imidacloprid kills fleas (spot-on or collar). Moxidectin prevents heartworm disease (monthly topical, or a 6- or 12-month injection for dogs).

Products with this combination include Advantage Multi. The FDA hides brand names in its public data, so these reports cover every product with the same active ingredients.

Questions owners ask

Can Imidacloprid + Moxidectin cause application site reaction in cats?: 1,047 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).

Application site reaction with similar medicines

Application site reaction after Spinosad (Comfortis) 25 reports · 0.2% of its reports
Application site reaction after Nitenpyram (Capstar) 41 reports · 0.5% of its reports
Application site reaction after Flumethrin + Imidacloprid (Seresto) 187 reports · 28% of its reports
Application site reaction after Imidacloprid + Pyriproxyfen 45 reports · 6.9% of its reports
Application site reaction after Fipronil + S-methoprene (Frontline Plus) 28 reports · 7.6% of its reports

All reported side effects of Imidacloprid + Moxidectin in cats · Medicines most reported with application site reaction