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

The FDA has received 66 reports of swelling in dogs after Ivermectin + Praziquantel + Pyrantel. That is 0.8% of all reports for this medicine, compared with 2.8% across reports for all dog medicines, so it is reported less often than average with this medicine.

66Reports

53%Marked serious

47%Recovered

6.1%Died or euthanised

Same dayTypical onset

How soon it started

Same day

27 64%

1–2 days

5 12%

3–7 days

3 7.1%

1–4 weeks

2 4.8%

Over a month

5 12%

How the animals did

Recovered

30 45%

Recovered with lasting effects

1 1.5%

Still unwell when reported

2 3.0%

Died

2 3.0%

Euthanised

2 3.0%

Not known

29 44%

Problems reported at the same time

25 38%

20 30%

18 27%

16 24%

10 15%

Didn't prevent heartworm

10 15%

Breathing problems

9 14%

Abnormal radiograph finding

8 12%

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 swelling in dogs?: 66 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).

Swelling with similar medicines

Swelling after Ivermectin + Pyrantel (Heartgard Plus) 839 reports · 0.6% of its reports
Swelling after Milbemycin Oxime + Spinosad (Trifexis) 959 reports · 0.7% of its reports
Swelling after Moxidectin (ProHeart 6) 7,913 reports · 16% of its reports
Swelling after Milbemycin Oxime + Praziquantel (Interceptor Plus) 371 reports · 1.2% of its reports
Swelling after Milbemycin Oxime (Interceptor) 257 reports · 0.9% of its reports
Swelling after Selamectin (Revolution) 410 reports · 1.4% of its reports
Swelling after Ivermectin (Heartgard) 204 reports · 1.7% of its reports
Swelling after Moxidectin + Pyrantel + Sarolaner (Simparica Trio) 22 reports · 1.9% of its reports

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