Cough after Imidacloprid + Moxidectin (Advantage Multi) in dogs

The FDA has received 222 reports of cough in dogs after Imidacloprid + Moxidectin. That is 1.7% of all reports for this medicine, compared with 0.8% across reports for all dog medicines, so it is reported unusually often with this medicine.

222Reports

73%Marked serious

33%Recovered

7.7%Died or euthanised

2 daysTypical onset

How soon it started

Same day

55 38%

1–2 days

23 16%

3–7 days

10 6.9%

1–4 weeks

37 26%

Over a month

20 14%

How the animals did

Recovered

73 33%

Still unwell when reported

13 5.9%

Died

10 4.5%

Euthanised

7 3.2%

Not known

119 54%

Problems reported at the same time

Vomiting

53 24%

Lethargy

49 22%

Didn't prevent heartworm

49 22%

34 15%

30 14%

21 9.5%

19 8.6%

19 8.6%

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 cough in dogs?: 222 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).

Cough with similar medicines

Cough after Spinosad (Comfortis) 299 reports · 0.5% of its reports
Cough after Lufenuron + Milbemycin Oxime (Sentinel) 166 reports · 0.6% of its reports
Cough after Nitenpyram (Capstar) 46 reports · 0.4% of its reports
Cough after Lufenuron + Milbemycin Oxime + Praziquantel (Sentinel Spectrum) 48 reports · 0.5% of its reports
Cough after Fipronil + S-methoprene (Frontline Plus) 22 reports · 0.7% of its reports
Cough after Flumethrin + Imidacloprid (Seresto) 24 reports · 1.1% of its reports

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