Elevated symmetrical dimethylarginine (sdma) after Pyrantel + Sarolaner (Simparica Trio) in dogs

The FDA has received 61 reports of elevated symmetrical dimethylarginine (sdma) in dogs after Pyrantel + Sarolaner. That is 0.1% of all reports for this medicine, compared with 0.1% across reports for all dog medicines.

61Reports

82%Marked serious

8.2%Recovered

25%Died or euthanised

7 daysTypical onset

How soon it started

Same day

11 20%

1–2 days

11 20%

3–7 days

6 11%

1–4 weeks

7 13%

Over a month

19 35%

How the animals did

Recovered

4 6.6%

Recovered with lasting effects

1 1.6%

Still unwell when reported

38 62%

Died

3 4.9%

Euthanised

12 20%

Not known

3 4.9%

Problems reported at the same time

29 48%

23 38%

22 36%

21 34%

19 31%

16 26%

15 25%

15 25%

Age of the animals

Under 1 year

1–3 years

4–7 years

8–11 years

12+ years

About this medicine

Pyrantel treats roundworms and hookworms. Sarolaner kills fleas, ticks and some mites; monthly.

Products with this combination include Simparica Trio (which also contains moxidectin). The FDA hides brand names in its public data, so these reports cover every product with the same active ingredients.

Questions owners ask

Can Pyrantel + Sarolaner cause elevated symmetrical dimethylarginine (sdma) in dogs?: 61 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 7 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).

All reported side effects of Pyrantel + Sarolaner in dogs · Medicines most reported with elevated symmetrical dimethylarginine (sdma)