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

495 reports to the FDA describe itching in dogs given Afoxolaner + Moxidectin + Pyrantel. That is 5.3% of all reports for this medicine, compared with 4.3% across reports for all dog medicines.

495Reports

6.5%Marked serious

31%Recovered

1.6%Died or euthanised

Same dayTypical onset

How soon it started

Same day

238 51%

1–2 days

123 26%

3–7 days

42 9.0%

1–4 weeks

47 10%

Over a month

15 3.2%

How the animals did

Recovered

153 31%

Still unwell when reported

65 13%

Died

4 0.8%

Euthanised

4 0.8%

Not known

269 54%

Problems reported at the same time

68 14%

56 11%

53 11%

43 8.7%

42 8.5%

37 7.5%

Restlessness or agitation

31 6.3%

Skin rash or irritation

30 6.1%

Age of the animals

Under 1 year

1–3 years

159

4–7 years

158

8–11 years

12+ years

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 itching in dogs?: 495 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).

Itching with similar medicines

Itching after Fluralaner (Bravecto) 2,940 reports · 4.3% of its reports
Itching after Afoxolaner (NexGard) 6,468 reports · 11% of its reports
Itching after Sarolaner (Simparica) 1,104 reports · 6.6% of its reports
Itching after Lotilaner (Credelio) 627 reports · 6.3% of its reports
Itching after Lotilaner + Moxidectin + Praziquantel + Pyrantel (Credelio Quattro) 177 reports · 5.7% of its reports

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