Didn't stop fleas after Lotilaner + Moxidectin + Praziquantel + Pyrantel (Credelio Quattro) in dogs

The FDA has received 84 reports of didn't stop fleas in dogs after Lotilaner + Moxidectin + Praziquantel + Pyrantel. That is 2.7% of all reports for this medicine, compared with 6.2% across reports for all dog medicines, so it is reported less often than average with this medicine.

84Reports
2.4%Marked serious
0.0%Recovered
1.2%Died or euthanised
44 daysTypical onset
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How soon it started

Same day
5 6.1%
1–2 days
7 8.5%
3–7 days
4 4.9%
1–4 weeks
17 21%
Over a month
49 60%

How the animals did

Still unwell when reported
15 18%
Died
1 1.2%
Not known
68 81%

Problems reported at the same time

19 23%
3 3.6%
3 3.6%
Not sleeping
3 3.6%
Increased heart rate
3 3.6%

Age of the animals

Under 1 year
7
1–3 years
18
4–7 years
29
8–11 years
10
12+ years
7

About this medicine

Lotilaner kills fleas and ticks; monthly chewable. Moxidectin prevents heartworm disease (monthly topical, or a 6- or 12-month injection for dogs). Praziquantel treats tapeworms. Pyrantel treats roundworms and hookworms.

Products with this combination include Credelio Quattro. The FDA hides brand names in its public data, so these reports cover every product with the same active ingredients.

In 2018 the FDA alerted owners and vets that isoxazoline products have been associated with neurologic reactions such as muscle tremors, wobbliness (ataxia) and seizures, including in animals with no history of them.

Questions owners ask

Can Lotilaner + Moxidectin + Praziquantel + Pyrantel cause didn't stop fleas in dogs?
84 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 44 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).

Didn't stop fleas with similar medicines

All reported side effects of Lotilaner + Moxidectin + Praziquantel + Pyrantel in dogs · Medicines most reported with didn't stop fleas