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

The FDA has received 3,567 reports of vomiting in dogs after Ivermectin + Praziquantel + Pyrantel. That is 42% of all reports for this medicine, compared with 28% across reports for all dog medicines, so it is reported unusually often with this medicine.

3,567Reports

8.9%Marked serious

69%Recovered

1.3%Died or euthanised

Same dayTypical onset

How soon it started

Same day

2,305 81%

1–2 days

158 5.6%

3–7 days

40 1.4%

1–4 weeks

92 3.2%

Over a month

240 8.5%

How the animals did

Recovered

2,467 69%

Recovered with lasting effects

9 0.3%

Still unwell when reported

27 0.8%

Died

36 1.0%

Euthanised

9 0.3%

Not known

1,019 29%

Problems reported at the same time

568 16%

543 15%

190 5.3%

127 3.6%

113 3.2%

100 2.8%

86 2.4%

84 2.4%

Age of the animals

Under 1 year

298

1–3 years

1,324

4–7 years

1,006

8–11 years

499

12+ years

215

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 vomiting in dogs?: 3,567 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).

Vomiting with similar medicines

Vomiting after Ivermectin + Pyrantel (Heartgard Plus) 20,052 reports · 14% of its reports
Vomiting after Milbemycin Oxime + Spinosad (Trifexis) 75,323 reports · 58% of its reports
Vomiting after Moxidectin (ProHeart 6) 12,413 reports · 25% of its reports
Vomiting after Milbemycin Oxime + Praziquantel (Interceptor Plus) 7,113 reports · 23% of its reports
Vomiting after Milbemycin Oxime (Interceptor) 4,379 reports · 15% of its reports
Vomiting after Selamectin (Revolution) 3,074 reports · 10% of its reports
Vomiting after Ivermectin (Heartgard) 3,182 reports · 26% of its reports
Vomiting after Moxidectin + Pyrantel + Sarolaner (Simparica Trio) 197 reports · 17% of its reports
Vomiting after Ivermectin + Praziquantel 40 reports · 20% of its reports
Vomiting after Eprinomectin 20 reports · 19% of its reports

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