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

245 reports to the FDA describe tremors in dogs given Ivermectin + Praziquantel + Pyrantel. That is 2.9% of all reports for this medicine, compared with 3.4% across reports for all dog medicines.

245Reports

31%Marked serious

47%Recovered

2.9%Died or euthanised

Same dayTypical onset

How soon it started

Same day

126 70%

1–2 days

32 18%

3–7 days

6 3.3%

1–4 weeks

7 3.9%

Over a month

9 5.0%

How the animals did

Recovered

112 46%

Recovered with lasting effects

3 1.2%

Still unwell when reported

6 2.4%

Died

6 2.4%

Euthanised

1 0.4%

Not known

117 48%

Problems reported at the same time

127 52%

101 41%

48 20%

48 20%

32 13%

29 12%

22 9.0%

21 8.6%

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 tremors in dogs?: 245 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).

Tremors with similar medicines

Tremors after Ivermectin + Pyrantel (Heartgard Plus) 2,169 reports · 1.5% of its reports
Tremors after Milbemycin Oxime + Spinosad (Trifexis) 5,684 reports · 4.4% of its reports
Tremors after Moxidectin (ProHeart 6) 1,208 reports · 2.4% of its reports
Tremors after Milbemycin Oxime + Praziquantel (Interceptor Plus) 766 reports · 2.4% of its reports
Tremors after Milbemycin Oxime (Interceptor) 729 reports · 2.4% of its reports
Tremors after Selamectin (Revolution) 984 reports · 3.3% of its reports
Tremors after Ivermectin (Heartgard) 959 reports · 8.0% of its reports
Tremors after Moxidectin + Pyrantel + Sarolaner (Simparica Trio) 56 reports · 4.8% of its reports
Tremors after Ivermectin + Praziquantel 61 reports · 30% of its reports
Tremors after Moxidectin + Praziquantel 27 reports · 36% of its reports

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