Didn't prevent heartworm after Sarolaner + Selamectin (Revolution Plus) in cats

83 reports to the FDA describe didn't prevent heartworm in cats given Sarolaner + Selamectin. That is 1.0% of all reports for this medicine, compared with 0.3% across reports for all cat medicines, so it is reported unusually often with this medicine.

83Reports
100%Marked serious
7.2%Recovered
1.2%Died or euthanised
190 daysTypical onset
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How soon it started

Same day
3 16%
1–2 days
0 0.0%
3–7 days
0 0.0%
1–4 weeks
1 5.3%
Over a month
15 79%

How the animals did

Recovered
6 7.2%
Still unwell when reported
68 82%
Died
1 1.2%
Not known
8 9.6%

Problems reported at the same time

2 2.4%
Drug dose omission
2 2.4%
1 1.2%
Pulmonary congestion
1 1.2%

Age of the animals

Under 1 year
0
1–3 years
20
4–7 years
25
8–11 years
15
12+ years
17

About this medicine

Sarolaner kills fleas, ticks and some mites; monthly. Selamectin prevents heartworm and treats fleas, ear mites and some worms (spot-on).

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

In 2018 the FDA alerted owners and vets that isoxazoline products have been associated with neurologic reactions such as muscle tremors, wobbliness (ataxia) and seizures, including in animals with no history of them.

Questions owners ask

Can Sarolaner + Selamectin cause didn't prevent heartworm in cats?
83 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 190 days 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).

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