Cough after Ivermectin + Praziquantel + Pyrantel (Iverhart Max) in dogs

The FDA has received 57 reports of cough in dogs after Ivermectin + Praziquantel + Pyrantel. That is 0.7% of all reports for this medicine, compared with 0.8% across reports for all dog medicines.

57Reports

40%Marked serious

26%Recovered

7.0%Died or euthanised

2 daysTypical onset

How soon it started

Same day

11 33%

1–2 days

7 21%

3–7 days

2 6.1%

1–4 weeks

1 3.0%

Over a month

12 36%

How the animals did

Recovered

14 25%

Recovered with lasting effects

1 1.8%

Still unwell when reported

3 5.3%

Died

4 7.0%

Not known

35 61%

Problems reported at the same time

Didn't prevent heartworm

29 51%

Vomiting

16 28%

Lethargy

14 25%

Breathing problems

9 16%

Didn't work as expected

8 14%

Itching

5 8.8%

Loss of appetite

5 8.8%

Abnormal radiograph finding

5 8.8%

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 cough in dogs?: 57 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 2 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).

Cough with similar medicines

Cough after Ivermectin + Pyrantel (Heartgard Plus) 727 reports · 0.5% of its reports
Cough after Milbemycin Oxime + Spinosad (Trifexis) 853 reports · 0.7% of its reports
Cough after Moxidectin (ProHeart 6) 434 reports · 0.9% of its reports
Cough after Milbemycin Oxime + Praziquantel (Interceptor Plus) 304 reports · 1.0% of its reports
Cough after Milbemycin Oxime (Interceptor) 193 reports · 0.6% of its reports
Cough after Selamectin (Revolution) 224 reports · 0.8% of its reports
Cough after Ivermectin (Heartgard) 117 reports · 1.0% of its reports
Cough after Moxidectin + Pyrantel + Sarolaner (Simparica Trio) 24 reports · 2.1% of its reports

All reported side effects of Ivermectin + Praziquantel + Pyrantel in dogs · Medicines most reported with cough