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

The FDA has received 185 reports of overdose in dogs after Ivermectin + Praziquantel + Pyrantel. That is 2.2% of all reports for this medicine, compared with 1.3% across reports for all dog medicines, so it is reported unusually often with this medicine.

185Reports

8.6%Marked serious

43%Recovered

1.1%Died or euthanised

Same dayTypical onset

How soon it started

Same day

92 72%

1–2 days

5 3.9%

3–7 days

4 3.1%

1–4 weeks

13 10%

Over a month

13 10%

How the animals did

Recovered

76 41%

Recovered with lasting effects

4 2.2%

Still unwell when reported

1 0.5%

Died

1 0.5%

Euthanised

1 0.5%

Not known

102 55%

Problems reported at the same time

Vomiting

100 54%

Accidental exposure

51 28%

Incorrect dose administered

40 22%

Lethargy

37 20%

Didn't prevent heartworm

26 14%

Diarrhea

23 12%

Didn't stop worms

22 12%

Didn't work as expected

18 9.7%

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 overdose in dogs?: 185 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).

Overdose with similar medicines

Overdose after Ivermectin + Pyrantel (Heartgard Plus) 1,647 reports · 1.1% of its reports
Overdose after Milbemycin Oxime + Spinosad (Trifexis) 2,052 reports · 1.6% of its reports
Overdose after Moxidectin (ProHeart 6) 366 reports · 0.7% of its reports
Overdose after Milbemycin Oxime + Praziquantel (Interceptor Plus) 266 reports · 0.8% of its reports
Overdose after Milbemycin Oxime (Interceptor) 131 reports · 0.4% of its reports
Overdose after Selamectin (Revolution) 160 reports · 0.5% of its reports
Overdose after Ivermectin (Heartgard) 134 reports · 1.1% of its reports
Overdose after Moxidectin + Pyrantel + Sarolaner (Simparica Trio) 31 reports · 2.7% of its reports

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