Cough after Ivermectin + Pyrantel (Heartgard Plus) in dogs

The FDA has received 727 reports of cough in dogs after Ivermectin + Pyrantel. That is 0.5% of all reports for this medicine, compared with 0.8% across reports for all dog medicines, so it is reported less often than average with this medicine.

727Reports
58%Marked serious
21%Recovered
11%Died or euthanised
24 daysTypical onset
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How soon it started

Same day
72 22%
1–2 days
33 10%
3–7 days
24 7.4%
1–4 weeks
55 17%
Over a month
141 43%

How the animals did

Recovered
94 13%
Recovered with lasting effects
58 8.0%
Still unwell when reported
106 15%
Died
58 8.0%
Euthanised
20 2.8%
Not known
391 54%

Problems reported at the same time

Age of the animals

Under 1 year
53
1–3 years
235
4–7 years
191
8–11 years
163
12+ years
67

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 cough in dogs?
727 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 24 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).

Cough with similar medicines

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