Inappropriate urination after Imidacloprid + Moxidectin (Advantage Multi) in cats

The FDA has received 37 reports of inappropriate urination in cats after Imidacloprid + Moxidectin. That is 0.5% of all reports for this medicine, compared with 0.7% across reports for all cat medicines, so it is reported less often than average with this medicine.

37Reports
95%Marked serious
41%Recovered
30%Died or euthanised
1 daysTypical onset
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How soon it started

Same day
11 32%
1–2 days
7 21%
3–7 days
5 15%
1–4 weeks
4 12%
Over a month
7 21%

How the animals did

Recovered
15 41%
Still unwell when reported
1 2.7%
Died
8 22%
Euthanised
3 8.1%
Not known
10 27%

Problems reported at the same time

Age of the animals

Under 1 year
11
1–3 years
12
4–7 years
7
8–11 years
0
12+ years
6

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 inappropriate urination in cats?
37 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).

Inappropriate urination with similar medicines

All reported side effects of Imidacloprid + Moxidectin in cats · Medicines most reported with inappropriate urination