Inappropriate urination after Imidacloprid + Moxidectin (Advantage Multi) in dogs

The FDA has received 76 reports of inappropriate urination in dogs after Imidacloprid + Moxidectin. That is 0.6% of all reports for this medicine, compared with 0.5% across reports for all dog medicines.

76Reports

87%Marked serious

45%Recovered

7.9%Died or euthanised

1 daysTypical onset

How soon it started

Same day

24 36%

1–2 days

20 30%

3–7 days

5 7.5%

1–4 weeks

11 16%

Over a month

7 10%

How the animals did

Recovered

34 45%

Still unwell when reported

2 2.6%

Died

1 1.3%

Euthanised

5 6.6%

Not known

34 45%

Problems reported at the same time

24 32%

20 26%

20 26%

15 20%

15 20%

13 17%

10 13%

8 11%

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 inappropriate urination in dogs?: 76 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 1 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).

Inappropriate urination with similar medicines

Inappropriate urination after Spinosad (Comfortis) 140 reports · 0.2% of its reports
Inappropriate urination after Lufenuron + Milbemycin Oxime (Sentinel) 59 reports · 0.2% of its reports
Inappropriate urination after Nitenpyram (Capstar) 28 reports · 0.3% of its reports
Inappropriate urination after Lufenuron + Milbemycin Oxime + Praziquantel (Sentinel Spectrum) 27 reports · 0.3% of its reports
Inappropriate urination after Fipronil + S-methoprene (Frontline Plus) 24 reports · 0.8% of its reports

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