Liver problems after Afoxolaner + Moxidectin + Pyrantel (NexGard PLUS) in dogs
The FDA has received 172 reports of liver problems in dogs after Afoxolaner + Moxidectin + Pyrantel. That is 1.9% of all reports for this medicine, compared with 4.6% across reports for all dog medicines, so it is reported less often than average with this medicine.
How soon it started
How the animals did
Problems reported at the same time
Age of the animals
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 liver problems in dogs?
- 172 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 2 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).
Liver problems with similar medicines
- Liver problems after Fluralaner (Bravecto) 1,685 reports · 2.5% of its reports
- Liver problems after Afoxolaner (NexGard) 1,408 reports · 2.5% of its reports
- Liver problems after Sarolaner (Simparica) 397 reports · 2.4% of its reports
- Liver problems after Lotilaner (Credelio) 220 reports · 2.2% of its reports
- Liver problems after Lotilaner + Moxidectin + Praziquantel + Pyrantel (Credelio Quattro) 76 reports · 2.5% of its reports
All reported side effects of Afoxolaner + Moxidectin + Pyrantel in dogs · Medicines most reported with liver problems