Otitis externa after Milbemycin Oxime + Praziquantel (Interceptor Plus) in dogs

The FDA has received 64 reports of otitis externa in dogs after Milbemycin Oxime + Praziquantel. That is 0.2% of all reports for this medicine, compared with 0.2% across reports for all dog medicines.

64Reports

16%Marked serious

11%Recovered

1.6%Died or euthanised

57 daysTypical onset

How soon it started

Same day

4 11%

1–2 days

2 5.7%

3–7 days

2 5.7%

1–4 weeks

4 11%

Over a month

23 66%

How the animals did

Recovered

6 9.4%

Recovered with lasting effects

1 1.6%

Still unwell when reported

26 41%

Died

1 1.6%

Not known

30 47%

Problems reported at the same time

Didn't prevent heartworm

22 34%

Itching

13 20%

Skin rash or irritation

12 19%

Didn't stop worms

7 11%

Didn't work as expected

7 11%

Vomiting

7 11%

Swelling

6 9.4%

Diarrhea

5 7.8%

Age of the animals

Under 1 year

1–3 years

4–7 years

8–11 years

12+ years

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 otitis externa in dogs?: 64 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 57 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).

Otitis externa with similar medicines

Otitis externa after Ivermectin + Pyrantel (Heartgard Plus) 68 reports · 0.0% of its reports
Otitis externa after Milbemycin Oxime + Spinosad (Trifexis) 201 reports · 0.2% of its reports
Otitis externa after Moxidectin (ProHeart 6) 61 reports · 0.1% of its reports
Otitis externa after Milbemycin Oxime (Interceptor) 32 reports · 0.1% of its reports
Otitis externa after Selamectin (Revolution) 50 reports · 0.2% of its reports
Otitis externa after Ivermectin (Heartgard) 21 reports · 0.2% of its reports

All reported side effects of Milbemycin Oxime + Praziquantel in dogs · Medicines most reported with otitis externa