Pale mucous membrane after Ivermectin + Pyrantel (Heartgard Plus) in dogs

282 reports to the FDA describe pale mucous membrane in dogs given Ivermectin + Pyrantel. That is 0.2% of all reports for this medicine, compared with 0.7% across reports for all dog medicines, so it is reported less often than average with this medicine.

282Reports

66%Marked serious

27%Recovered

23%Died or euthanised

10 daysTypical onset

How soon it started

Same day

34 23%

1–2 days

24 17%

3–7 days

9 6.2%

1–4 weeks

27 19%

Over a month

51 35%

How the animals did

Recovered

68 24%

Recovered with lasting effects

7 2.5%

Still unwell when reported

40 14%

Died

42 15%

Euthanised

22 7.8%

Not known

103 37%

Problems reported at the same time

148 52%

116 41%

86 30%

85 30%

77 27%

62 22%

61 22%

60 21%

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 pale mucous membrane in dogs?: 282 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 10 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).

Pale mucous membrane with similar medicines

Pale mucous membrane after Milbemycin Oxime + Spinosad (Trifexis) 352 reports · 0.3% of its reports
Pale mucous membrane after Moxidectin (ProHeart 6) 1,957 reports · 3.9% of its reports
Pale mucous membrane after Milbemycin Oxime + Praziquantel (Interceptor Plus) 140 reports · 0.4% of its reports
Pale mucous membrane after Milbemycin Oxime (Interceptor) 137 reports · 0.5% of its reports
Pale mucous membrane after Selamectin (Revolution) 97 reports · 0.3% of its reports
Pale mucous membrane after Ivermectin (Heartgard) 66 reports · 0.5% of its reports
Pale mucous membrane after Ivermectin + Praziquantel + Pyrantel (Iverhart Max) 84 reports · 1.0% of its reports

All reported side effects of Ivermectin + Pyrantel in dogs · Medicines most reported with pale mucous membrane