Pinnal reddening after Milbemycin Oxime + Spinosad (Trifexis) in dogs

212 reports to the FDA describe pinnal reddening in dogs given Milbemycin Oxime + Spinosad. That is 0.2% of all reports for this medicine, compared with 0.1% across reports for all dog medicines, so it is reported unusually often with this medicine.

212Reports
26%Marked serious
65%Recovered
0.0%Died or euthanised
1 daysTypical onset
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How soon it started

Same day
86 48%
1–2 days
15 8.3%
3–7 days
12 6.6%
1–4 weeks
16 8.8%
Over a month
52 29%

How the animals did

Recovered
80 38%
Recovered with lasting effects
57 27%
Still unwell when reported
27 13%
Not known
48 23%

Problems reported at the same time

Age of the animals

Under 1 year
36
1–3 years
75
4–7 years
61
8–11 years
31
12+ years
5

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 pinnal reddening in dogs?
212 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).

Pinnal reddening with similar medicines

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