Kidney problems after Imidacloprid + Moxidectin (Advantage Multi) in dogs

The FDA has received 106 reports of kidney problems in dogs after Imidacloprid + Moxidectin. That is 0.8% of all reports for this medicine, compared with 2.4% across reports for all dog medicines, so it is reported less often than average with this medicine.

106Reports

79%Marked serious

10%Recovered

39%Died or euthanised

7 daysTypical onset

How soon it started

Same day

12 20%

1–2 days

6 9.8%

3–7 days

16 26%

1–4 weeks

13 21%

Over a month

14 23%

How the animals did

Recovered

11 10%

Still unwell when reported

7 6.6%

Died

19 18%

Euthanised

22 21%

Not known

47 44%

Problems reported at the same time

40 38%

33 31%

33 31%

32 30%

25 24%

15 14%

13 12%

13 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 kidney problems in dogs?: 106 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 7 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).

Kidney problems with similar medicines

Kidney problems after Spinosad (Comfortis) 439 reports · 0.8% of its reports
Kidney problems after Lufenuron + Milbemycin Oxime (Sentinel) 162 reports · 0.6% of its reports
Kidney problems after Nitenpyram (Capstar) 55 reports · 0.5% of its reports
Kidney problems after Lufenuron + Milbemycin Oxime + Praziquantel (Sentinel Spectrum) 46 reports · 0.5% of its reports
Kidney problems after Fipronil + S-methoprene (Frontline Plus) 31 reports · 1.0% of its reports
Kidney problems after Flumethrin + Imidacloprid (Seresto) 27 reports · 1.2% of its reports
Kidney problems after Fipronil 30 reports · 2.1% of its reports
Kidney problems after Lufenuron 25 reports · 2.5% of its reports

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