Liver problems after Moxidectin + Pyrantel + Sarolaner (Simparica Trio) in dogs

63 reports to the FDA describe liver problems in dogs given Moxidectin + Pyrantel + Sarolaner. That is 5.4% of all reports for this medicine, compared with 4.6% across reports for all dog medicines.

63Reports

59%Marked serious

7.9%Recovered

21%Died or euthanised

75 daysTypical onset

How soon it started

Same day

7 16%

1–2 days

2 4.5%

3–7 days

2 4.5%

1–4 weeks

4 9.1%

Over a month

29 66%

How the animals did

Recovered

5 7.9%

Still unwell when reported

18 29%

Died

6 9.5%

Euthanised

7 11%

Not known

27 43%

Problems reported at the same time

23 37%

22 35%

22 35%

21 33%

14 22%

13 21%

Elevated gamma-glutamyl transferase (ggt)

11 17%

Blood problems

9 14%

Age of the animals

Under 1 year

1–3 years

4–7 years

8–11 years

12+ years

About this medicine

Moxidectin prevents heartworm disease (monthly topical, or a 6- or 12-month injection for dogs). Pyrantel treats roundworms and hookworms. Sarolaner kills fleas, ticks and some mites; monthly.

Products with this combination include Simparica Trio. 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 Moxidectin + Pyrantel + Sarolaner cause liver problems in dogs?: 63 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 75 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).

Liver problems with similar medicines

Liver problems after Ivermectin + Pyrantel (Heartgard Plus) 1,518 reports · 1.0% of its reports
Liver problems after Milbemycin Oxime + Spinosad (Trifexis) 2,221 reports · 1.7% of its reports
Liver problems after Moxidectin (ProHeart 6) 2,025 reports · 4.0% of its reports
Liver problems after Milbemycin Oxime + Praziquantel (Interceptor Plus) 534 reports · 1.7% of its reports
Liver problems after Milbemycin Oxime (Interceptor) 531 reports · 1.8% of its reports
Liver problems after Selamectin (Revolution) 560 reports · 1.9% of its reports
Liver problems after Ivermectin (Heartgard) 369 reports · 3.1% of its reports
Liver problems after Ivermectin + Praziquantel + Pyrantel (Iverhart Max) 149 reports · 1.7% of its reports

All reported side effects of Moxidectin + Pyrantel + Sarolaner in dogs · Medicines most reported with liver problems