Loss of appetite after Afoxolaner + Moxidectin + Pyrantel (NexGard PLUS) in dogs

The FDA has received 505 reports of loss of appetite in dogs after Afoxolaner + Moxidectin + Pyrantel. That is 5.5% of all reports for this medicine, compared with 8.4% across reports for all dog medicines, so it is reported less often than average with this medicine.

505Reports
20%Marked serious
38%Recovered
7.7%Died or euthanised
1 daysTypical onset
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How soon it started

Same day
183 39%
1–2 days
180 38%
3–7 days
39 8.3%
1–4 weeks
32 6.8%
Over a month
37 7.9%

How the animals did

Recovered
192 38%
Still unwell when reported
84 17%
Died
17 3.4%
Euthanised
22 4.4%
Not known
190 38%

Problems reported at the same time

267 53%
238 47%
182 36%
60 12%
40 7.9%

Age of the animals

Under 1 year
82
1–3 years
177
4–7 years
114
8–11 years
83
12+ years
44

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 loss of appetite in dogs?
505 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).

Loss of appetite with similar medicines

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