Cardiac disorder after Ivermectin + Pyrantel (Heartgard Plus) in dogs

The FDA has received 10,035 reports of cardiac disorder in dogs after Ivermectin + Pyrantel. That is 6.8% of all reports for this medicine, compared with 1.1% across reports for all dog medicines, so it is reported unusually often with this medicine.

10,035Reports
100%Marked serious
66%Recovered
0.9%Died or euthanised
294 daysTypical onset
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How soon it started

Same day
36 2.6%
1–2 days
4 0.3%
3–7 days
4 0.3%
1–4 weeks
23 1.6%
Over a month
1,330 95%

How the animals did

Recovered
158 1.6%
Recovered with lasting effects
6,428 64%
Still unwell when reported
286 2.9%
Died
64 0.6%
Euthanised
31 0.3%
Not known
3,068 31%

Problems reported at the same time

Age of the animals

Under 1 year
66
1–3 years
4,589
4–7 years
3,221
8–11 years
1,653
12+ years
352

About this medicine

Ivermectin prevents heartworm disease (monthly). Pyrantel treats roundworms and hookworms.

Products with this combination include Heartgard Plus, Tri-Heart Plus, Iverhart Plus. 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 + Pyrantel cause cardiac disorder in dogs?
10,035 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 294 days 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).

Cardiac disorder with similar medicines

All reported side effects of Ivermectin + Pyrantel in dogs · Medicines most reported with cardiac disorder