Didn't work as expected after Lotilaner + Moxidectin + Praziquantel + Pyrantel (Credelio Quattro) in dogs

The FDA has received 292 reports of didn't work as expected in dogs after Lotilaner + Moxidectin + Praziquantel + Pyrantel. That is 9.5% of all reports for this medicine, compared with 13% across reports for all dog medicines.

292Reports

6.5%Marked serious

0.3%Recovered

1.0%Died or euthanised

149 daysTypical onset

How soon it started

Same day

6 3.0%

1–2 days

5 2.5%

3–7 days

1 0.5%

1–4 weeks

22 11%

Over a month

167 83%

How the animals did

Recovered

1 0.3%

Still unwell when reported

29 9.9%

Died

1 0.3%

Euthanised

2 0.7%

Not known

259 89%

Problems reported at the same time

23 7.9%

20 6.8%

18 6.2%

18 6.2%

15 5.1%

14 4.8%

12 4.1%

11 3.8%

Age of the animals

Under 1 year

1–3 years

113

4–7 years

8–11 years

12+ years

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 work as expected in dogs?: 292 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 149 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 work as expected with similar medicines

Didn't work as expected after Fluralaner (Bravecto) 5,946 reports · 8.6% of its reports
Didn't work as expected after Afoxolaner (NexGard) 8,625 reports · 15% of its reports
Didn't work as expected after Sarolaner (Simparica) 1,487 reports · 8.9% of its reports
Didn't work as expected after Lotilaner (Credelio) 1,497 reports · 15% of its reports
Didn't work as expected after Afoxolaner + Moxidectin + Pyrantel (NexGard PLUS) 1,527 reports · 16% of its reports

All reported side effects of Lotilaner + Moxidectin + Praziquantel + Pyrantel in dogs · Medicines most reported with didn't work as expected