Tremors after Imidacloprid + Moxidectin (Advantage Multi) in dogs

The FDA has received 837 reports of tremors in dogs after Imidacloprid + Moxidectin. That is 6.4% of all reports for this medicine, compared with 3.4% across reports for all dog medicines, so it is reported unusually often with this medicine.

837Reports

62%Marked serious

41%Recovered

5.0%Died or euthanised

Same dayTypical onset

How soon it started

Same day

339 57%

1–2 days

143 24%

3–7 days

39 6.5%

1–4 weeks

42 7.0%

Over a month

33 5.5%

How the animals did

Recovered

338 40%

Recovered with lasting effects

7 0.8%

Still unwell when reported

49 5.9%

Died

21 2.5%

Euthanised

21 2.5%

Not known

401 48%

Problems reported at the same time

223 27%

219 26%

193 23%

144 17%

135 16%

103 12%

91 11%

Restlessness or agitation

87 10%

Age of the animals

Under 1 year

168

1–3 years

253

4–7 years

211

8–11 years

120

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 tremors in dogs?: 837 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).

Tremors with similar medicines

Tremors after Spinosad (Comfortis) 2,268 reports · 4.0% of its reports
Tremors after Lufenuron + Milbemycin Oxime (Sentinel) 590 reports · 2.3% of its reports
Tremors after Nitenpyram (Capstar) 402 reports · 3.7% of its reports
Tremors after Lufenuron + Milbemycin Oxime + Praziquantel (Sentinel Spectrum) 213 reports · 2.1% of its reports
Tremors after Fipronil + S-methoprene (Frontline Plus) 141 reports · 4.8% of its reports
Tremors after Flumethrin + Imidacloprid (Seresto) 66 reports · 2.9% of its reports
Tremors after Imidacloprid 58 reports · 3.0% of its reports
Tremors after Fipronil 65 reports · 4.6% of its reports
Tremors after Lufenuron 33 reports · 3.2% of its reports
Tremors after Imidacloprid + Permethrin + Pyriproxyfen 35 reports · 4.7% of its reports

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