Hyperglycaemia after Ivermectin + Pyrantel (Heartgard Plus) in dogs

The FDA has received 225 reports of hyperglycaemia in dogs after Ivermectin + Pyrantel. That is 0.2% of all reports for this medicine, compared with 0.5% across reports for all dog medicines, so it is reported less often than average with this medicine.

225Reports

68%Marked serious

23%Recovered

20%Died or euthanised

8 daysTypical onset

How soon it started

Same day

35 25%

1–2 days

25 18%

3–7 days

9 6.4%

1–4 weeks

26 18%

Over a month

46 33%

How the animals did

Recovered

43 19%

Recovered with lasting effects

8 3.6%

Still unwell when reported

41 18%

Died

28 12%

Euthanised

18 8.0%

Not known

87 39%

Problems reported at the same time

118 52%

102 45%

80 36%

63 28%

61 27%

47 21%

45 20%

44 20%

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 hyperglycaemia in dogs?: 225 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 8 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).

Hyperglycaemia with similar medicines

Hyperglycaemia after Milbemycin Oxime + Spinosad (Trifexis) 356 reports · 0.3% of its reports
Hyperglycaemia after Moxidectin (ProHeart 6) 208 reports · 0.4% of its reports
Hyperglycaemia after Milbemycin Oxime + Praziquantel (Interceptor Plus) 77 reports · 0.2% of its reports
Hyperglycaemia after Milbemycin Oxime (Interceptor) 51 reports · 0.2% of its reports
Hyperglycaemia after Selamectin (Revolution) 58 reports · 0.2% of its reports
Hyperglycaemia after Ivermectin (Heartgard) 77 reports · 0.6% of its reports
Hyperglycaemia after Ivermectin + Praziquantel + Pyrantel (Iverhart Max) 23 reports · 0.3% of its reports

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