Elevated cholesterol (total) after Ivermectin + Pyrantel (Heartgard Plus) in dogs

96 reports to the FDA describe elevated cholesterol (total) in dogs given Ivermectin + Pyrantel. That is 0.1% of all reports for this medicine, compared with 0.3% across reports for all dog medicines, so it is reported less often than average with this medicine.

96Reports

56%Marked serious

14%Recovered

13%Died or euthanised

9 daysTypical onset

How soon it started

Same day

10 23%

1–2 days

4 9.3%

3–7 days

5 12%

1–4 weeks

8 19%

Over a month

16 37%

How the animals did

Recovered

11 11%

Recovered with lasting effects

2 2.1%

Still unwell when reported

28 29%

Died

6 6.3%

Euthanised

6 6.3%

Not known

43 45%

Problems reported at the same time

63 66%

33 34%

29 30%

26 27%

26 27%

Elevated gamma-glutamyl transferase (ggt)

18 19%

Leucocytosis

15 16%

Abnormal ultrasound finding

15 16%

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). 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 elevated cholesterol (total) in dogs?: 96 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 9 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).

Elevated cholesterol (total) with similar medicines

Elevated cholesterol (total) after Milbemycin Oxime + Spinosad (Trifexis) 81 reports · 0.1% of its reports
Elevated cholesterol (total) after Moxidectin (ProHeart 6) 87 reports · 0.2% of its reports
Elevated cholesterol (total) after Milbemycin Oxime + Praziquantel (Interceptor Plus) 53 reports · 0.2% of its reports
Elevated cholesterol (total) after Milbemycin Oxime (Interceptor) 31 reports · 0.1% of its reports
Elevated cholesterol (total) after Selamectin (Revolution) 36 reports · 0.1% of its reports
Elevated cholesterol (total) after Ivermectin (Heartgard) 24 reports · 0.2% of its reports

All reported side effects of Ivermectin + Pyrantel in dogs · Medicines most reported with elevated cholesterol (total)