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

43 reports to the FDA describe lameness in dogs given Afoxolaner + Moxidectin + Pyrantel. That is 0.5% of all reports for this medicine, compared with 0.6% across reports for all dog medicines.

43Reports
28%Marked serious
19%Recovered
4.7%Died or euthanised
1 daysTypical onset
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How soon it started

Same day
10 27%
1–2 days
14 38%
3–7 days
1 2.7%
1–4 weeks
6 16%
Over a month
6 16%

How the animals did

Recovered
8 19%
Still unwell when reported
15 35%
Euthanised
2 4.7%
Not known
18 42%

Problems reported at the same time

Age of the animals

Under 1 year
6
1–3 years
17
4–7 years
11
8–11 years
7
12+ years
0

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 lameness in dogs?
43 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).

Lameness with similar medicines

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