Not sleeping after Ivermectin + Pyrantel (Heartgard Plus) in dogs

The FDA has received 70 reports of not sleeping in dogs after Ivermectin + Pyrantel. That is 0.0% of all reports for this medicine, compared with 0.1% across reports for all dog medicines, so it is reported less often than average with this medicine.

70Reports
74%Marked serious
31%Recovered
0.0%Died or euthanised
24 daysTypical onset
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How soon it started

Same day
10 24%
1–2 days
3 7.1%
3–7 days
4 9.5%
1–4 weeks
9 21%
Over a month
16 38%

How the animals did

Recovered
22 31%
Still unwell when reported
8 11%
Not known
40 57%

Problems reported at the same time

Age of the animals

Under 1 year
8
1–3 years
18
4–7 years
24
8–11 years
13
12+ years
7

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 not sleeping in dogs?
70 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).

Not sleeping with similar medicines

All reported side effects of Ivermectin + Pyrantel in dogs · Medicines most reported with not sleeping