Hypoproteinaemia after Afoxolaner (NexGard) in dogs

136 reports to the FDA describe hypoproteinaemia in dogs given Afoxolaner. That is 0.2% of all reports for this medicine, compared with 0.3% across reports for all dog medicines.

136Reports
71%Marked serious
17%Recovered
25%Died or euthanised
3 daysTypical onset
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How soon it started

Same day
33 28%
1–2 days
24 21%
3–7 days
10 8.5%
1–4 weeks
16 14%
Over a month
34 29%

How the animals did

Recovered
22 16%
Recovered with lasting effects
1 0.7%
Still unwell when reported
25 18%
Died
18 13%
Euthanised
16 12%
Not known
54 40%

Problems reported at the same time

Age of the animals

Under 1 year
40
1–3 years
32
4–7 years
24
8–11 years
25
12+ years
13

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 hypoproteinaemia in dogs?
136 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).

Hypoproteinaemia with similar medicines

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