Heart murmur after Imidacloprid + Moxidectin (Advantage Multi) in dogs

The FDA has received 30 reports of heart murmur in dogs after Imidacloprid + Moxidectin. That is 0.2% of all reports for this medicine, compared with 0.2% across reports for all dog medicines.

30Reports
90%Marked serious
10%Recovered
27%Died or euthanised
29 daysTypical onset
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How soon it started

Same day
6 25%
1–2 days
1 4.2%
3–7 days
2 8.3%
1–4 weeks
4 17%
Over a month
11 46%

How the animals did

Recovered
2 6.7%
Recovered with lasting effects
1 3.3%
Still unwell when reported
3 10%
Died
7 23%
Euthanised
1 3.3%
Not known
16 53%

Problems reported at the same time

Age of the animals

Under 1 year
0
1–3 years
8
4–7 years
6
8–11 years
10
12+ years
5

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 heart murmur in dogs?
30 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 29 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).

Heart murmur with similar medicines

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