Dermatosis after Milbemycin Oxime + Spinosad (Trifexis) in dogs

193 reports to the FDA describe dermatosis in dogs given Milbemycin Oxime + Spinosad. That is 0.1% of all reports for this medicine, compared with 0.0% across reports for all dog medicines, so it is reported unusually often with this medicine.

193Reports
14%Marked serious
11%Recovered
0.0%Died or euthanised
43 daysTypical onset
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How soon it started

Same day
10 8.6%
1–2 days
4 3.4%
3–7 days
6 5.2%
1–4 weeks
35 30%
Over a month
61 53%

How the animals did

Recovered
16 8.3%
Recovered with lasting effects
6 3.1%
Still unwell when reported
92 48%
Not known
79 41%

Problems reported at the same time

31 16%
20 10%
19 9.8%
Skin scraping abnormal
12 6.2%

Age of the animals

Under 1 year
98
1–3 years
48
4–7 years
19
8–11 years
8
12+ years
3

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 dermatosis in dogs?
193 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 43 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).

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