Pancreatitis after Ivermectin + Pyrantel (Heartgard Plus) in dogs

The FDA has received 192 reports of pancreatitis in dogs after Ivermectin + Pyrantel. That is 0.1% of all reports for this medicine, compared with 0.4% across reports for all dog medicines, so it is reported less often than average with this medicine.

192Reports

59%Marked serious

23%Recovered

13%Died or euthanised

5 daysTypical onset

How soon it started

Same day

29 29%

1–2 days

15 15%

3–7 days

8 8.0%

1–4 weeks

27 27%

Over a month

21 21%

How the animals did

Recovered

40 21%

Recovered with lasting effects

5 2.6%

Still unwell when reported

42 22%

Died

7 3.6%

Euthanised

17 8.9%

Not known

81 42%

Problems reported at the same time

104 54%

66 34%

51 27%

48 25%

33 17%

24 13%

19 9.9%

17 8.9%

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 pancreatitis in dogs?: 192 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 5 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).

Pancreatitis with similar medicines

Pancreatitis after Milbemycin Oxime + Spinosad (Trifexis) 358 reports · 0.3% of its reports
Pancreatitis after Moxidectin (ProHeart 6) 139 reports · 0.3% of its reports
Pancreatitis after Milbemycin Oxime + Praziquantel (Interceptor Plus) 74 reports · 0.2% of its reports
Pancreatitis after Milbemycin Oxime (Interceptor) 59 reports · 0.2% of its reports
Pancreatitis after Selamectin (Revolution) 43 reports · 0.1% of its reports
Pancreatitis after Ivermectin (Heartgard) 35 reports · 0.3% of its reports

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