Wobbliness (ataxia) after Ivermectin + Praziquantel in horses

The FDA has received 34 reports of wobbliness (ataxia) in horses after Ivermectin + Praziquantel. That is 1.3% of all reports for this medicine, compared with 4.9% across reports for all horse medicines, so it is reported less often than average with this medicine.

34Reports
24%Marked serious
12%Recovered
12%Died or euthanised
Same dayTypical onset
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How soon it started

Same day
8 80%
1–2 days
1 10%
3–7 days
0 0.0%
1–4 weeks
0 0.0%
Over a month
1 10%

How the animals did

Recovered
4 12%
Still unwell when reported
2 5.9%
Died
3 8.8%
Euthanised
1 2.9%
Not known
24 71%

Problems reported at the same time

12 35%
4 12%
3 8.8%
Neurological signs
3 8.8%

Age of the animals

Under 1 year
2
1–3 years
2
4–7 years
4
8–11 years
8
12+ years
16

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 wobbliness (ataxia) in horses?
34 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).

Wobbliness (ataxia) with similar medicines

All reported side effects of Ivermectin + Praziquantel in horses · Medicines most reported with wobbliness (ataxia)