Diarrhea after Ivermectin + Praziquantel in horses

The FDA has received 122 reports of diarrhea in horses after Ivermectin + Praziquantel. That is 4.6% of all reports for this medicine, compared with 4.9% across reports for all horse medicines.

122Reports
11%Marked serious
8.2%Recovered
11%Died or euthanised
Same dayTypical onset
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How soon it started

Same day
11 61%
1–2 days
6 33%
3–7 days
0 0.0%
1–4 weeks
0 0.0%
Over a month
1 5.6%

How the animals did

Recovered
10 8.2%
Still unwell when reported
1 0.8%
Died
11 9.0%
Euthanised
2 1.6%
Not known
98 80%

Problems reported at the same time

21 17%
13 11%
8 6.6%
Dehydration
8 6.6%
7 5.7%

Age of the animals

Under 1 year
9
1–3 years
6
4–7 years
10
8–11 years
15
12+ years
56

About this medicine

Ivermectin prevents heartworm disease (monthly). Praziquantel treats tapeworms.

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 Ivermectin + Praziquantel cause diarrhea in horses?
122 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 the same 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).

Diarrhea with similar medicines

All reported side effects of Ivermectin + Praziquantel in horses · Medicines most reported with diarrhea