Breathing problems after Milbemycin Oxime + Spinosad (Trifexis) in dogs

The FDA has received 2,380 reports of breathing problems in dogs after Milbemycin Oxime + Spinosad. That is 1.8% of all reports for this medicine, compared with 2.7% across reports for all dog medicines.

2,380Reports
49%Marked serious
53%Recovered
16%Died or euthanised
1 daysTypical onset
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How soon it started

Same day
841 47%
1–2 days
198 11%
3–7 days
47 2.6%
1–4 weeks
101 5.7%
Over a month
597 33%

How the animals did

Recovered
1,017 43%
Recovered with lasting effects
237 10.0%
Still unwell when reported
266 11%
Died
228 9.6%
Euthanised
144 6.1%
Not known
488 21%

Problems reported at the same time

Age of the animals

Under 1 year
231
1–3 years
706
4–7 years
648
8–11 years
499
12+ years
229

About this medicine

Milbemycin Oxime prevents heartworm and controls some intestinal worms (monthly). Spinosad kills fleas; monthly chewable.

Products with this combination include Trifexis. 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 + Spinosad cause breathing problems in dogs?
2,380 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).

Breathing problems with similar medicines

All reported side effects of Milbemycin Oxime + Spinosad in dogs · Medicines most reported with breathing problems