Restlessness or agitation after Imidacloprid + Moxidectin (Advantage Multi) in dogs

The FDA has received 835 reports of restlessness or agitation in dogs after Imidacloprid + Moxidectin. That is 6.4% of all reports for this medicine, compared with 1.6% across reports for all dog medicines, so it is reported unusually often with this medicine.

835Reports

60%Marked serious

51%Recovered

2.0%Died or euthanised

Same dayTypical onset

How soon it started

Same day

451 76%

1–2 days

65 11%

3–7 days

21 3.5%

1–4 weeks

33 5.6%

Over a month

22 3.7%

How the animals did

Recovered

426 51%

Recovered with lasting effects

1 0.1%

Still unwell when reported

9 1.1%

Died

10 1.2%

Euthanised

7 0.8%

Not known

382 46%

Problems reported at the same time

269 32%

183 22%

146 17%

110 13%

88 11%

87 10%

83 9.9%

75 9.0%

Age of the animals

Under 1 year

191

1–3 years

289

4–7 years

190

8–11 years

103

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 restlessness or agitation in dogs?: 835 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).

Restlessness or agitation with similar medicines

Restlessness or agitation after Spinosad (Comfortis) 658 reports · 1.2% of its reports
Restlessness or agitation after Lufenuron + Milbemycin Oxime (Sentinel) 255 reports · 1.0% of its reports
Restlessness or agitation after Nitenpyram (Capstar) 596 reports · 5.5% of its reports
Restlessness or agitation after Lufenuron + Milbemycin Oxime + Praziquantel (Sentinel Spectrum) 73 reports · 0.7% of its reports
Restlessness or agitation after Fipronil + S-methoprene (Frontline Plus) 119 reports · 4.0% of its reports
Restlessness or agitation after Flumethrin + Imidacloprid (Seresto) 68 reports · 3.0% of its reports
Restlessness or agitation after Imidacloprid 44 reports · 2.3% of its reports
Restlessness or agitation after Fipronil 40 reports · 2.8% of its reports
Restlessness or agitation after Imidacloprid + Permethrin + Pyriproxyfen 56 reports · 7.6% of its reports
Restlessness or agitation after Cyphenothrin + Fipronil + S-methoprene 222 reports · 34% of its reports

All reported side effects of Imidacloprid + Moxidectin in dogs · Medicines most reported with restlessness or agitation