Elevated lipase after Ivermectin + Pyrantel (Heartgard Plus) in dogs

The FDA has received 107 reports of elevated lipase in dogs after 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.

107Reports

65%Marked serious

10%Recovered

24%Died or euthanised

11 daysTypical onset

How soon it started

Same day

11 22%

1–2 days

7 14%

3–7 days

4 7.8%

1–4 weeks

10 20%

Over a month

19 37%

How the animals did

Recovered

10 9.3%

Recovered with lasting effects

1 0.9%

Still unwell when reported

21 20%

Died

10 9.3%

Euthanised

16 15%

Not known

49 46%

Problems reported at the same time

62 58%

62 58%

41 38%

37 35%

34 32%

28 26%

27 25%

27 25%

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 lipase in dogs?: 107 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 11 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 lipase with similar medicines

Elevated lipase after Milbemycin Oxime + Spinosad (Trifexis) 128 reports · 0.1% of its reports
Elevated lipase after Moxidectin (ProHeart 6) 108 reports · 0.2% of its reports
Elevated lipase after Milbemycin Oxime + Praziquantel (Interceptor Plus) 38 reports · 0.1% of its reports
Elevated lipase after Milbemycin Oxime (Interceptor) 48 reports · 0.2% of its reports
Elevated lipase after Selamectin (Revolution) 27 reports · 0.1% of its reports
Elevated lipase after Ivermectin (Heartgard) 28 reports · 0.2% of its reports

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