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

The FDA has received 26 reports of nausea in dogs after Ivermectin + Praziquantel + Pyrantel. That is 0.3% of all reports for this medicine, compared with 0.4% across reports for all dog medicines.

26Reports

15%Marked serious

54%Recovered

7.7%Died or euthanised

Same dayTypical onset

How soon it started

Same day

8 57%

1–2 days

3 21%

3–7 days

0 0.0%

1–4 weeks

1 7.1%

Over a month

2 14%

How the animals did

Recovered

13 50%

Recovered with lasting effects

1 3.8%

Euthanised

2 7.7%

Not known

10 38%

Problems reported at the same time

Vomiting

17 65%

Lethargy

12 46%

Tremors

4 15%

Excessive licking and/or grooming

4 15%

3 12%

3 12%

2 7.7%

2 7.7%

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 nausea in dogs?: 26 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).

Nausea with similar medicines

Nausea after Ivermectin + Pyrantel (Heartgard Plus) 233 reports · 0.2% of its reports
Nausea after Milbemycin Oxime + Spinosad (Trifexis) 876 reports · 0.7% of its reports
Nausea after Moxidectin (ProHeart 6) 146 reports · 0.3% of its reports
Nausea after Milbemycin Oxime + Praziquantel (Interceptor Plus) 126 reports · 0.4% of its reports
Nausea after Milbemycin Oxime (Interceptor) 65 reports · 0.2% of its reports
Nausea after Selamectin (Revolution) 56 reports · 0.2% of its reports
Nausea after Ivermectin (Heartgard) 55 reports · 0.5% of its reports

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