Disorientation after Imidacloprid + Moxidectin (Advantage Multi) in dogs

The FDA has received 182 reports of disorientation in dogs after Imidacloprid + Moxidectin. That is 1.4% of all reports for this medicine, compared with 1.0% across reports for all dog medicines.

182Reports

66%Marked serious

43%Recovered

7.1%Died or euthanised

Same dayTypical onset

How soon it started

Same day

66 53%

1–2 days

30 24%

3–7 days

9 7.3%

1–4 weeks

17 14%

Over a month

2 1.6%

How the animals did

Recovered

79 43%

Still unwell when reported

8 4.4%

Died

4 2.2%

Euthanised

9 4.9%

Not known

82 45%

Problems reported at the same time

72 40%

64 35%

61 34%

44 24%

41 23%

40 22%

Restlessness or agitation

31 17%

Drooling

22 12%

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 disorientation in dogs?: 182 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).

Disorientation with similar medicines

Disorientation after Spinosad (Comfortis) 497 reports · 0.9% of its reports
Disorientation after Lufenuron + Milbemycin Oxime (Sentinel) 154 reports · 0.6% of its reports
Disorientation after Nitenpyram (Capstar) 183 reports · 1.7% of its reports
Disorientation after Lufenuron + Milbemycin Oxime + Praziquantel (Sentinel Spectrum) 67 reports · 0.7% of its reports
Disorientation after Fipronil + S-methoprene (Frontline Plus) 34 reports · 1.2% of its reports
Disorientation after Imidacloprid 23 reports · 1.2% of its reports
Disorientation after Fipronil 24 reports · 1.7% of its reports

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