Elevated gamma-glutamyl transferase (ggt) after Milbemycin Oxime + Praziquantel (Interceptor Plus) in dogs

53 reports to the FDA describe elevated gamma-glutamyl transferase (ggt) in dogs given Milbemycin Oxime + Praziquantel. That is 0.2% of all reports for this medicine, compared with 0.4% across reports for all dog medicines, so it is reported less often than average with this medicine.

53Reports
81%Marked serious
15%Recovered
19%Died or euthanised
21 daysTypical onset
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How soon it started

Same day
3 8.8%
1–2 days
3 8.8%
3–7 days
3 8.8%
1–4 weeks
10 29%
Over a month
15 44%

How the animals did

Recovered
8 15%
Still unwell when reported
26 49%
Died
4 7.5%
Euthanised
6 11%
Not known
9 17%

Problems reported at the same time

Liver problems
45 85%
Vomiting
26 49%
Loss of appetite
23 43%
Lethargy
20 38%
Neutrophilia
14 26%
Diarrhea
13 25%
Leucocytosis
11 21%
Elevated cholesterol (total)
10 19%

Age of the animals

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

About this medicine

Milbemycin Oxime prevents heartworm and controls some intestinal worms (monthly). Praziquantel treats tapeworms.

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

Some herding breeds (for example Collies) carry the MDR1 gene variant and can be more sensitive to this drug class at high doses.

Questions owners ask

Can Milbemycin Oxime + Praziquantel cause elevated gamma-glutamyl transferase (ggt) in dogs?
53 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 21 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 gamma-glutamyl transferase (ggt) with similar medicines

All reported side effects of Milbemycin Oxime + Praziquantel in dogs · Medicines most reported with elevated gamma-glutamyl transferase (ggt)