Liver problems after Lufenuron + Milbemycin Oxime + Praziquantel (Sentinel Spectrum) in dogs

The FDA has received 132 reports of liver problems in dogs after Lufenuron + Milbemycin Oxime + Praziquantel. That is 1.3% of all reports for this medicine, compared with 4.6% across reports for all dog medicines, so it is reported less often than average with this medicine.

132Reports

89%Marked serious

14%Recovered

13%Died or euthanised

6 daysTypical onset

How soon it started

Same day

15 22%

1–2 days

14 20%

3–7 days

8 12%

1–4 weeks

10 14%

Over a month

22 32%

How the animals did

Recovered

13 9.8%

Recovered with lasting effects

6 4.5%

Still unwell when reported

55 42%

Died

6 4.5%

Euthanised

11 8.3%

Not known

41 31%

Problems reported at the same time

54 41%

52 39%

45 34%

24 18%

19 14%

Didn't prevent heartworm

18 14%

Kidney problems

17 13%

Death

17 13%

Age of the animals

Under 1 year

1–3 years

4–7 years

8–11 years

12+ years

About this medicine

Lufenuron stops flea eggs from developing. Milbemycin Oxime prevents heartworm and controls some intestinal worms (monthly). Praziquantel treats tapeworms.

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

Questions owners ask

Can Lufenuron + Milbemycin Oxime + Praziquantel cause liver problems in dogs?: 132 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 6 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).

Liver problems with similar medicines

Liver problems after Spinosad (Comfortis) 955 reports · 1.7% of its reports
Liver problems after Lufenuron + Milbemycin Oxime (Sentinel) 414 reports · 1.6% of its reports
Liver problems after Imidacloprid + Moxidectin (Advantage Multi) 197 reports · 1.5% of its reports
Liver problems after Nitenpyram (Capstar) 87 reports · 0.8% of its reports
Liver problems after Fipronil + S-methoprene (Frontline Plus) 68 reports · 2.3% of its reports
Liver problems after Flumethrin + Imidacloprid (Seresto) 47 reports · 2.1% of its reports
Liver problems after Fipronil 53 reports · 3.8% of its reports
Liver problems after Lufenuron 53 reports · 5.2% of its reports
Liver problems after Imidacloprid + Permethrin + Pyriproxyfen 21 reports · 2.8% of its reports
Liver problems after Imidacloprid + Permethrin 24 reports · 5.1% of its reports

All reported side effects of Lufenuron + Milbemycin Oxime + Praziquantel in dogs · Medicines most reported with liver problems