Elevated amylase after Milbemycin Oxime + Spinosad (Trifexis) in dogs

129 reports to the FDA describe elevated amylase in dogs given Milbemycin Oxime + Spinosad. That is 0.1% of all reports for this medicine, compared with 0.3% across reports for all dog medicines, so it is reported less often than average with this medicine.

129Reports

81%Marked serious

30%Recovered

29%Died or euthanised

10 daysTypical onset

How soon it started

Same day

24 31%

1–2 days

12 15%

3–7 days

2 2.6%

1–4 weeks

13 17%

Over a month

27 35%

How the animals did

Recovered

18 14%

Recovered with lasting effects

21 16%

Still unwell when reported

27 21%

Died

15 12%

Euthanised

22 17%

Not known

26 20%

Problems reported at the same time

75 58%

74 57%

67 52%

66 51%

57 44%

49 38%

47 36%

47 36%

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). 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 elevated amylase in dogs?: 129 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 10 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 amylase with similar medicines

Elevated amylase after Ivermectin + Pyrantel (Heartgard Plus) 94 reports · 0.1% of its reports
Elevated amylase after Moxidectin (ProHeart 6) 149 reports · 0.3% of its reports
Elevated amylase after Milbemycin Oxime + Praziquantel (Interceptor Plus) 30 reports · 0.1% of its reports
Elevated amylase after Milbemycin Oxime (Interceptor) 33 reports · 0.1% of its reports
Elevated amylase after Selamectin (Revolution) 39 reports · 0.1% of its reports
Elevated amylase after Ivermectin (Heartgard) 26 reports · 0.2% of its reports

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