What is ivermectin + pyrantel + praziquantel?
Ivermectin + pyrantel + praziquantel (brand names: Iverhart Max®, QuadriGuard®) is a combination of anti-parasitic medications used to prevent heartworm and control roundworm, hookworms and tapeworm in dogs.
How is ivermectin + pyrantel + praziquantel given?
- Ivermectin + pyrantel + praziquantel is given by mouth and is usually formulated as a flavored chewable tablet.
- If vomiting occurs when dosed on an empty stomach, give future doses with food or a treat. If vomiting continues, contact your veterinarian.
This medication should take effect within two hours; however, effects may not be noted outwardly, so laboratory tests may be needed to evaluate this medication’s effectiveness.
What if I miss giving my pet a scheduled dose?
If you miss a dose, give it as soon as you remember, and then wait the recommended time for the next dose, as prescribed by your veterinarian. Do not give the pet two doses at once or give extra doses. If you are using ivermectin + pyrantel + praziquantel as a heartworm preventive and more than 8 weeks have passed without giving this medication, contact your veterinarian for guidance.
Are there any potential side effects?
Ivermectin + pyrantel + praziquantel is generally well-tolerated at prescribed doses but some dogs may experience the following side effects:
- Decreased appetite
- Vomiting
- Diarrhea
- Burping
If any of these side effects persist longer than 24 hours, contact your veterinarian. Serious adverse reactions may also occur. If any of the following signs develop, stop giving ivermectin + pyrantel + praziquantel and contact your veterinarian immediately:
- Dilated pupils
- Unsteadiness when walking
- A dazed demeanor
Drug sensitivities can develop over time, with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment and notify your veterinarian if you have any concerns.
Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This moderate-acting medication should stop working within a few days, although effects can be longer in pets with liver or kidney disease.
Are there any risk factors for this medication?
DO NOT USE ivermectin + pyrantel + praziquantel in:
- Dogs younger than 8 weeks of age
- Dogs weighing less than 10 pounds
- Dogs that are sick, weak, or underweight
- Dogs that do not have a current negative heartworm test
- Dogs that are allergic to pyrantel, praziquantel, ivermectin or similar medications, such as selamectin and moxidectin
USE WITH CAUTION in:
- Pregnant and nursing dogs (ivermectin is considered safe in pregnant and nursing dogs, but the other drugs in this combination product have not been tested in pregnant and nursing dogs)
Some dog breeds are more sensitive to ivermectin than others (e.g., collies, sheepdogs, and collie- or sheepdog-cross breeds). This sensitivity is typically due to a genetic mutation (ABCB1, also known as MDR1) that makes them less able to tolerate high doses of certain medications. Doses used for heartworm prevention, such as those found in the combination of ivermectin + pyrantel + praziquantel, are safe to use in these breeds.
Are there any drug interactions I should be aware of?
Several medications should be used with caution when given with ivermectin + pyrantel + praziquantel, including:
- Albendazole
- Amlodipine
- Azole antifungals
- Cimetidine
- Cyclosporine (Atopica®)
- Dexamethasone
- Erythromycin
- Levamisole
- Phenobarbital
- Piperazine
Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any treatment.
Is any monitoring needed with this medication?
- For dogs with a potential ivermectin sensitivity, DNA screening may be done before receiving the medication. However, ivermectin + pyrantel + praziquantel can be used without testing because it has a low dose of ivermectin.
- Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.
- At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.
How do I store ivermectin + pyrantel + praziquantel?
- Store this medication at room temperature, in a dry place away from heat and direct sunlight. Exposure to heat or moisture may reduce its effectiveness.
- Ensure it is stored in a tightly closed container and secured inside a cabinet to prevent accidental ingestion.
- Keep the container out of reach of children and pets
What should I do in case of an emergency?
If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet’s weight and symptoms.
