Anxiety after Imidacloprid + Moxidectin (Advantage Multi) in dogs

The FDA has received 103 reports of anxiety in dogs after Imidacloprid + Moxidectin. That is 0.8% of all reports for this medicine, compared with 0.5% across reports for all dog medicines, so it is reported unusually often with this medicine.

103Reports

76%Marked serious

56%Recovered

1.9%Died or euthanised

Same dayTypical onset

How soon it started

Same day

46 52%

1–2 days

15 17%

3–7 days

4 4.5%

1–4 weeks

10 11%

Over a month

13 15%

How the animals did

Recovered

58 56%

Still unwell when reported

3 2.9%

Euthanised

2 1.9%

Not known

40 39%

Problems reported at the same time

Behaviour change

37 36%

Breathing problems

25 24%

Restlessness or agitation

23 22%

21 20%

17 17%

15 15%

15 15%

13 13%

Age of the animals

Under 1 year

1–3 years

4–7 years

8–11 years

12+ years

About this medicine

Imidacloprid kills fleas (spot-on or collar). Moxidectin prevents heartworm disease (monthly topical, or a 6- or 12-month injection for dogs).

Products with this combination include Advantage Multi. The FDA hides brand names in its public data, so these reports cover every product with the same active ingredients.

Questions owners ask

Can Imidacloprid + Moxidectin cause anxiety in dogs?: 103 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 the same 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).

Anxiety with similar medicines

Anxiety after Spinosad (Comfortis) 141 reports · 0.2% of its reports
Anxiety after Lufenuron + Milbemycin Oxime (Sentinel) 113 reports · 0.4% of its reports
Anxiety after Nitenpyram (Capstar) 63 reports · 0.6% of its reports
Anxiety after Lufenuron + Milbemycin Oxime + Praziquantel (Sentinel Spectrum) 36 reports · 0.4% of its reports
Anxiety after Fipronil + S-methoprene (Frontline Plus) 36 reports · 1.2% of its reports
Anxiety after Flumethrin + Imidacloprid (Seresto) 23 reports · 1.0% of its reports
Anxiety after Fipronil 23 reports · 1.6% of its reports
Anxiety after Cyphenothrin + Fipronil + S-methoprene 39 reports · 6.0% of its reports

All reported side effects of Imidacloprid + Moxidectin in dogs · Medicines most reported with anxiety