Drug dose omission after Ivermectin + Praziquantel + Pyrantel (Iverhart Max) in dogs

The FDA has received 87 reports of drug dose omission in dogs after Ivermectin + Praziquantel + Pyrantel. That is 1.0% of all reports for this medicine, compared with 0.4% across reports for all dog medicines, so it is reported unusually often with this medicine.

87Reports

14%Marked serious

9.2%Recovered

1.1%Died or euthanised

–Typical onset

How the animals did

Recovered

3 3.4%

Recovered with lasting effects

5 5.7%

Still unwell when reported

6 6.9%

Euthanised

1 1.1%

Not known

72 83%

Problems reported at the same time

Didn't prevent heartworm

82 94%

Drug dose administration interval too long

13 15%

Overdose

3 3.4%

Abnormal radiograph finding

3 3.4%

Cough

3 3.4%

Didn't work as expected

3 3.4%

Didn't stop fleas

3 3.4%

Underdose

3 3.4%

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 drug dose omission in dogs?: 87 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.
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).

Drug dose omission with similar medicines

Drug dose omission after Ivermectin + Pyrantel (Heartgard Plus) 503 reports · 0.3% of its reports
Drug dose omission after Milbemycin Oxime + Spinosad (Trifexis) 1,201 reports · 0.9% of its reports
Drug dose omission after Moxidectin (ProHeart 6) 53 reports · 0.1% of its reports
Drug dose omission after Milbemycin Oxime + Praziquantel (Interceptor Plus) 399 reports · 1.3% of its reports
Drug dose omission after Milbemycin Oxime (Interceptor) 109 reports · 0.4% of its reports
Drug dose omission after Selamectin (Revolution) 87 reports · 0.3% of its reports
Drug dose omission after Ivermectin (Heartgard) 72 reports · 0.6% of its reports

All reported side effects of Ivermectin + Praziquantel + Pyrantel in dogs · Medicines most reported with drug dose omission