Hyperkalaemia after Afoxolaner (NexGard) in dogs

The FDA has received 78 reports of hyperkalaemia in dogs after Afoxolaner. That is 0.1% of all reports for this medicine, compared with 0.3% across reports for all dog medicines, so it is reported less often than average with this medicine.

78Reports
68%Marked serious
12%Recovered
32%Died or euthanised
3 daysTypical onset
SponsoredWorried about your pet? Ask a veterinarian online, 24/7

How soon it started

Same day
10 16%
1–2 days
20 33%
3–7 days
6 9.8%
1–4 weeks
7 11%
Over a month
18 30%

How the animals did

Recovered
9 12%
Still unwell when reported
14 18%
Died
15 19%
Euthanised
10 13%
Not known
30 38%

Problems reported at the same time

Age of the animals

Under 1 year
16
1–3 years
14
4–7 years
15
8–11 years
14
12+ years
19

About this medicine

Afoxolaner kills fleas and ticks; given as a monthly chewable.

Products with this ingredient include NexGard. 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 cause hyperkalaemia in dogs?
78 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 3 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).

Hyperkalaemia with similar medicines

All reported side effects of Afoxolaner in dogs · Medicines most reported with hyperkalaemia