Abnormal radiograph finding after Ivermectin + Praziquantel + Pyrantel (Iverhart Max) in dogs

The FDA has received 52 reports of abnormal radiograph finding in dogs after Ivermectin + Praziquantel + Pyrantel. That is 0.6% of all reports for this medicine, compared with 0.9% across reports for all dog medicines.

52Reports

46%Marked serious

13%Recovered

15%Died or euthanised

225 daysTypical onset

How soon it started

Same day

0 0.0%

1–2 days

4 17%

3–7 days

1 4.2%

1–4 weeks

4 17%

Over a month

15 63%

How the animals did

Recovered

6 12%

Recovered with lasting effects

1 1.9%

Still unwell when reported

5 9.6%

Died

4 7.7%

Euthanised

4 7.7%

Not known

32 62%

Problems reported at the same time

Didn't prevent heartworm

36 69%

Pulmonary disorder

19 37%

Didn't work as expected

12 23%

Lethargy

12 23%

Cardiac enlargement

11 21%

Liver problems

10 19%

Loss of appetite

9 17%

Breathing problems

9 17%

Age of the animals

Under 1 year

1–3 years

4–7 years

8–11 years

12+ years

About this medicine

Ivermectin prevents heartworm disease (monthly). Praziquantel treats tapeworms. Pyrantel treats roundworms and hookworms.

Products with this combination include Iverhart Max. The FDA hides brand names in its public data, so these reports cover every product with the same active ingredients.

Some herding breeds (for example Collies) carry the MDR1 gene variant and can be more sensitive to this drug class at high doses.

Questions owners ask

Can Ivermectin + Praziquantel + Pyrantel cause abnormal radiograph finding in dogs?: 52 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 225 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).

Abnormal radiograph finding with similar medicines

Abnormal radiograph finding after Ivermectin + Pyrantel (Heartgard Plus) 505 reports · 0.3% of its reports
Abnormal radiograph finding after Milbemycin Oxime + Spinosad (Trifexis) 630 reports · 0.5% of its reports
Abnormal radiograph finding after Moxidectin (ProHeart 6) 498 reports · 1.0% of its reports
Abnormal radiograph finding after Milbemycin Oxime + Praziquantel (Interceptor Plus) 164 reports · 0.5% of its reports
Abnormal radiograph finding after Milbemycin Oxime (Interceptor) 138 reports · 0.5% of its reports
Abnormal radiograph finding after Selamectin (Revolution) 149 reports · 0.5% of its reports
Abnormal radiograph finding after Ivermectin (Heartgard) 103 reports · 0.9% of its reports

All reported side effects of Ivermectin + Praziquantel + Pyrantel in dogs · Medicines most reported with abnormal radiograph finding