Lateral recumbency after Milbemycin Oxime + Spinosad (Trifexis) in dogs

178 reports to the FDA describe lateral recumbency 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.

178Reports

80%Marked serious

41%Recovered

37%Died or euthanised

2 daysTypical onset

How soon it started

Same day

45 33%

1–2 days

23 17%

3–7 days

4 3.0%

1–4 weeks

19 14%

Over a month

44 33%

How the animals did

Recovered

59 33%

Recovered with lasting effects

14 7.9%

Still unwell when reported

20 11%

Died

27 15%

Euthanised

38 21%

Not known

20 11%

Problems reported at the same time

78 44%

75 42%

66 37%

55 31%

50 28%

48 27%

44 25%

40 22%

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 lateral recumbency in dogs?: 178 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 2 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).

Lateral recumbency with similar medicines

Lateral recumbency after Ivermectin + Pyrantel (Heartgard Plus) 186 reports · 0.1% of its reports
Lateral recumbency after Moxidectin (ProHeart 6) 358 reports · 0.7% of its reports
Lateral recumbency after Milbemycin Oxime + Praziquantel (Interceptor Plus) 33 reports · 0.1% of its reports
Lateral recumbency after Selamectin (Revolution) 21 reports · 0.1% of its reports
Lateral recumbency after Ivermectin (Heartgard) 46 reports · 0.4% of its reports

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