Anxiety after Afoxolaner + Moxidectin + Pyrantel (NexGard PLUS) in dogs

62 reports to the FDA describe anxiety in dogs given Afoxolaner + Moxidectin + Pyrantel. That is 0.7% of all reports for this medicine, compared with 0.5% across reports for all dog medicines.

62Reports
11%Marked serious
42%Recovered
0.0%Died or euthanised
Same dayTypical onset
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How soon it started

Same day
36 63%
1–2 days
13 23%
3–7 days
3 5.3%
1–4 weeks
4 7.0%
Over a month
1 1.8%

How the animals did

Recovered
26 42%
Still unwell when reported
3 4.8%
Not known
33 53%

Problems reported at the same time

Age of the animals

Under 1 year
3
1–3 years
18
4–7 years
21
8–11 years
17
12+ years
1

About this medicine

Afoxolaner kills fleas and ticks; given as a monthly chewable. Moxidectin prevents heartworm disease (monthly topical, or a 6- or 12-month injection for dogs). Pyrantel treats roundworms and hookworms.

Products with this combination include NexGard 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 Afoxolaner + Moxidectin + Pyrantel cause anxiety in dogs?
62 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).

Anxiety with similar medicines

All reported side effects of Afoxolaner + Moxidectin + Pyrantel in dogs · Medicines most reported with anxiety