Lethargy after Lotilaner + Moxidectin + Praziquantel + Pyrantel (Credelio Quattro) in dogs

The FDA has received 396 reports of lethargy in dogs after Lotilaner + Moxidectin + Praziquantel + Pyrantel. That is 13% of all reports for this medicine, compared with 11% across reports for all dog medicines.

396Reports

16%Marked serious

40%Recovered

4.8%Died or euthanised

1 daysTypical onset

How soon it started

Same day

144 41%

1–2 days

68 19%

3–7 days

17 4.8%

1–4 weeks

29 8.3%

Over a month

93 26%

How the animals did

Recovered

157 40%

Still unwell when reported

142 36%

Died

11 2.8%

Euthanised

8 2.0%

Not known

78 20%

Problems reported at the same time

181 46%

157 40%

141 36%

53 13%

35 8.8%

34 8.6%

33 8.3%

25 6.3%

Age of the animals

Under 1 year

1–3 years

113

4–7 years

102

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 lethargy in dogs?: 396 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 1 day 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).

Lethargy with similar medicines

Lethargy after Fluralaner (Bravecto) 6,278 reports · 9.1% of its reports
Lethargy after Afoxolaner (NexGard) 6,825 reports · 12% of its reports
Lethargy after Sarolaner (Simparica) 1,852 reports · 11% of its reports
Lethargy after Lotilaner (Credelio) 1,033 reports · 10% of its reports
Lethargy after Afoxolaner + Moxidectin + Pyrantel (NexGard PLUS) 747 reports · 8.1% of its reports

All reported side effects of Lotilaner + Moxidectin + Praziquantel + Pyrantel in dogs · Medicines most reported with lethargy