Pica after Ivermectin + Pyrantel (Heartgard Plus) in dogs

The FDA has received 267 reports of pica in dogs after Ivermectin + Pyrantel. That is 0.2% of all reports for this medicine, compared with 0.2% across reports for all dog medicines.

267Reports

49%Marked serious

38%Recovered

2.6%Died or euthanised

9 daysTypical onset

How soon it started

Same day

38 26%

1–2 days

25 17%

3–7 days

8 5.6%

1–4 weeks

29 20%

Over a month

44 31%

How the animals did

Recovered

101 38%

Recovered with lasting effects

1 0.4%

Still unwell when reported

20 7.5%

Died

3 1.1%

Euthanised

4 1.5%

Not known

138 52%

Problems reported at the same time

155 58%

55 21%

51 19%

45 17%

41 15%

Digestive tract disorder

29 11%

Didn't work as expected

24 9.0%

Behaviour change

22 8.2%

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 pica in dogs?: 267 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 9 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).

Pica with similar medicines

Pica after Milbemycin Oxime + Spinosad (Trifexis) 374 reports · 0.3% of its reports
Pica after Moxidectin (ProHeart 6) 29 reports · 0.1% of its reports
Pica after Milbemycin Oxime + Praziquantel (Interceptor Plus) 162 reports · 0.5% of its reports
Pica after Milbemycin Oxime (Interceptor) 46 reports · 0.2% of its reports
Pica after Selamectin (Revolution) 26 reports · 0.1% of its reports
Pica after Ivermectin (Heartgard) 34 reports · 0.3% of its reports

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