Reduced responses after Milbemycin Oxime + Spinosad (Trifexis) in dogs

233 reports to the FDA describe reduced responses 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.

233Reports
48%Marked serious
74%Recovered
8.6%Died or euthanised
1 daysTypical onset
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How soon it started

Same day
90 45%
1–2 days
23 11%
3–7 days
7 3.5%
1–4 weeks
17 8.4%
Over a month
65 32%

How the animals did

Recovered
146 63%
Recovered with lasting effects
26 11%
Still unwell when reported
6 2.6%
Died
12 5.2%
Euthanised
8 3.4%
Not known
35 15%

Problems reported at the same time

Age of the animals

Under 1 year
48
1–3 years
105
4–7 years
42
8–11 years
21
12+ years
14

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 reduced responses in dogs?
233 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).

Reduced responses with similar medicines

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