Didn't prevent heartworm after Imidacloprid + Moxidectin (Advantage Multi) in cats

The FDA has received 24 reports of didn't prevent heartworm in cats after Imidacloprid + Moxidectin. That is 0.3% of all reports for this medicine, compared with 0.3% across reports for all cat medicines.

24Reports
54%Marked serious
13%Recovered
13%Died or euthanised
–Typical onset
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How the animals did

Recovered
3 13%
Died
2 8.3%
Euthanised
1 4.2%
Not known
18 75%

Problems reported at the same time

6 25%
3 13%
Abnormal ultrasound finding
3 13%

Age of the animals

Under 1 year
3
1–3 years
11
4–7 years
2
8–11 years
6
12+ years
1

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 didn't prevent heartworm in cats?
24 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.
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).

All reported side effects of Imidacloprid + Moxidectin in cats · Medicines most reported with didn't prevent heartworm