Elevated bile acids after Lufenuron + Milbemycin Oxime (Sentinel) in dogs

The FDA has received 32 reports of elevated bile acids in dogs after Lufenuron + Milbemycin Oxime. That is 0.1% of all reports for this medicine, compared with 0.1% across reports for all dog medicines.

32Reports

63%Marked serious

19%Recovered

16%Died or euthanised

42 daysTypical onset

How soon it started

Same day

5 29%

1–2 days

1 5.9%

3–7 days

0 0.0%

1–4 weeks

1 5.9%

Over a month

10 59%

How the animals did

Recovered

6 19%

Still unwell when reported

9 28%

Died

2 6.3%

Euthanised

3 9.4%

Not known

12 38%

Problems reported at the same time

25 78%

20 63%

17 53%

15 47%

6 19%

5 16%

5 16%

5 16%

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).

Products with this combination include Sentinel. 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 cause elevated bile acids in dogs?: 32 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 42 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).

Elevated bile acids with similar medicines

Elevated bile acids after Spinosad (Comfortis) 52 reports · 0.1% of its reports

All reported side effects of Lufenuron + Milbemycin Oxime in dogs · Medicines most reported with elevated bile acids