Regulatory product record
NEXGARD COMBO
Product identity, ingredients and source provenance from the regulatory catalogue. Linked clinical evidence has a separate review status.
Owner information handout
Plain-language medication information to review with the owner. Open the handout to print it or download a PDF.
Product identity
- Brand name
- NEXGARD COMBO
- DIN
- 02511231
- DPD drug code
- 100046
- Regulatory category
- APPROVED_VET_DRUG
- Market status
- MARKETED
- Route(s)
- TOPICAL
- Pharmaceutical form(s)
- SOLUTION
- Ingredients
- PRAZIQUANTEL (8.3 %), EPRINOMECTIN (0.4 %), ESAFOXOLANER (1.2 %)
- Species (DPD record)
- CATS
- Company
- BOEHRINGER INGELHEIM ANIMAL HEALTH CANADA INC. (DIN owner)
Source and provenance
- Source dataset
- health_canada_dpd_marketed
- Source snapshot date
- Not available in this source
- Source record key
- 100046
- Archive fingerprint (SHA-256)
- 85cc3ce208af3aa57018c3d14d83f90220c436baef7455384b6d48d9774e1c88
Linked clinical reference
Clinical entries are linked through the active molecule. Check their species, formulation, source and review status separately from this product record.
Clinical evidence
Pending clinical review (PROPOSED)Rule-based (RULE_BASED)— applies to the facts and dose entries in this species selection; individual source records retain their own status.
Indications3
Dipylidium caninum, Taenia pisiformis, Echinococcus granulosus (and E. multilocularis)
DogOn-label (ON_LABEL)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Indications table · Not applicable · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Dipylidium caninum, Taenia pisiformis, Echinococcus granulosus (and E. multilocularis) — FDA-approved (labeled)
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Indications table · Not applicable · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Dipylidium caninum, Taenia taeniaeformis
CatOn-label (ON_LABEL)1 source record · View provenance
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Indications table · Not applicable · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Dipylidium caninum, Taenia taeniaeformis — FDA-approved (labeled)
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Indications table · Not applicable · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
LONGRANGE, when administered at the recommended dose volume of 1 mL per 110 lb (50 kg) body weight, is effective in the treatment and control of the following internal and external parasites of cattle: Gastrointestinal Roundworms Lungworms Bunostomum phlebotomum 4 – Adults and L Dictyocaulus viviparus – Adults Cooperia oncophora 4 – Adults and L Cooperia punctata 4 – Adults and L Cooperia surnabada 4 – Adults and L Grubs Haemonchus placei – Adults Hypoderma bovis Oesophagostomum radiatum – Adults Ostertagia lyrata – Adults Mites Ostertagia ostertagi 4 4 – Adults, L, and inhibited L Sarcoptes scabiei bovis var. Trichostrongylus axei 4 – Adults and L Trichostrongylus colubriformis – Adults
Species not recordedOn-label (ON_LABEL)United States1 source record · View provenance
- Species not recorded · SPL section 34067-9 (INDICATIONS & USAGE SECTION) · United States · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Dose regimens7
This calculator performs arithmetic only on the sourced dosing field shown for each result — it does not verify the field's accuracy, does not select which field to use for a patient, and does not replace a veterinarian's order. Not for clinical use. Confirm every result against the primary source before dispensing.
Select a species above to calculate a dose.
Adverse effects551
Uncommon overall (oral use) — <5% (dog), <2% (cat)
DogCatNot applicable (NOT_APPLICABLE)2 source records · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Anorexia, vomiting, lethargy, diarrhea (oral) — Uncommon
DogNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pain at injection site, drowsiness, staggering gait (injectable) — More common than with oral form
DogNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Salivation, diarrhea, weakness, transient anorexia (injectable) — ~9.4% of cats in field trials
CatNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
These are counts of spontaneously reported events, not proven adverse effects, causal relationships, or incidence rates.
Bars compare report counts within each species; they do not show incidence.
More reportsFewer reportsDog
- Vomiting15,638 reports
- Lack of efficacy (endoparasite) - heartworm8,774 reports
- Diarrhoea5,549 reports
- Lack of efficacy (endoparasite) - hookworm4,096 reports
- Lethargy (see also Central nervous system depression in 'Neurological')4,087 reports
- INEFFECTIVE, HOOKS3,112 reports
- INEFFECTIVE, HEARTWORM LARVAE2,174 reports
- Other abnormal test result NOS2,051 reports
- Lack of efficacy (endoparasite) - tapeworm1,863 reports
- Emesis1,485 reports
- Lack of efficacy (endoparasite) - roundworm NOS1,473 reports
- Emesis (multiple)1,418 reports
Cat
- Hypersalivation1,636 reports
- Vomiting1,595 reports
- Application site alopecia1,497 reports
- Ataxia1,224 reports
- Lethargy (see also Central nervous system depression in 'Neurological')1,052 reports
- Lack of efficacy (endoparasite) - tapeworm906 reports
- Anorexia724 reports
- Behavioural disorder NOS694 reports
- Lethargy (see also Central nervous system depression in Neurological)642 reports
- Diarrhoea541 reports
- Application site hair loss514 reports
- Lethargy (see also Central nervous system depression in Neurological)490 reports
Monitoring1
Fecal exam to confirm efficacy; reinfection is common with D. caninum given ongoing flea exposure — counsel concurrent flea control
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Monitoring Parameters · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Contraindications1
Manufacturer: avoid in puppies <4 weeks or kittens <6 weeks (though praziquantel/febantel combo is approved for all ages); hypersensitivity
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Precautions4
None major beyond age restriction on monotherapy product
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Not effective against most nematodes (roundworms, hookworms) on its own — combination products (Drontal, etc.) exist specifically to broaden spectrum; confirm which product a client is using before assuming coverage.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Wide margin of safety — one of the best-tolerated anthelmintics in the antiparasitic library.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
D. caninum reinfection is essentially guaranteed without concurrent flea control, since fleas serve as the intermediate host — pair prescription with a flea-control conversation.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Interactions1
Grapefruit juice — ↑ praziquantel AUC 150–200% in dogs (avoid coadministration if practical)
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pharmacokinetics4
Bioavailability — Rapid, near-complete oral absorption but significant first-pass effect
DogNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Metabolism — Hepatic, CYP3A
DogNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Elimination — Primarily renal (metabolites)
DogNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Due to its unique formulation characteristics, when LONGRANGE is injected subcutaneously in the shoulder area of cattle, a polymeric PLGA matrix is formed. The biodegradable matrix solidifies in vivo to form an in situ forming gel, which allows a gradual release of eprinomectin from the formulation. The rate-limiting step is diffusion of the drug through the gel matrix. Because of its mechanism of release, absorption characteristics can be highly dependent upon the injection technique used and the corresponding surface to volume ratio of the gel. Clinical efficacy of avermectins and milbemycins is closely related to their pharmacokinetic behavior, and the time of parasite exposure to active drug concentrations is relevant to obtain optimal and persistent antiparasitic activity (Lanusse et al., 1997; Lifschitz et al., 1999; Lifschitz et al., 2004; Shoop et al., 1996). Lifschitz et al. (1999) indicated that plasma concentrations between 0.5 and 1 ng/mL would represent the minimal drug level required for optimal nematocidal activity, while others have suggested minimum levels of 1 to 2 ng/mL. Pharmacokinetic studies of LONGRANGE in cattle indicate that effective plasma levels remain for an extended period of time (at least 100 days). 1a Mean Eprinomectin BPlasma Concentration Versus Time Following a Single Subcutaneous Injection of LONGRANGE at a Dose Rate of 1 mg Eprinomectin per kg Body Weight in Beef Cattle
Species not recordedOn-label (ON_LABEL)United States1 source record · View provenance
- Species not recorded · SPL section 34090-1 (CLINICAL PHARMACOLOGY SECTION) · United States · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Pregnancy / lactation considerations1
Considered safe in pregnant dogs/cats and during lactation. Human FDA category B. Papich class A. Excreted in milk (~25% of maternal serum concentration) — unlikely to harm nursing offspring.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 992–994; Saunders Handbook of Veterinary Drugs (Papich), 4th ed., p. 663–664 — Pregnancy & Lactation · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Literature references42
References are linked to this drug. Species applicability is not recorded here, so the species filter does not narrow this list. Imported dates do not retain their original precision; confirm dates in the original citation.
- Efficacy of a topical combination of esafoxolaner, eprinomectin and praziquantel against Amblyomma maculatum infestations in cats.
Study summary not available in the imported record. Open the original citation to review the study.
- A case of sporadic cutaneous T-cell lymphosarcoma in a 3-year-old Holstein cow.
Study summary not available in the imported record. Open the original citation to review the study.
- Eprinomectin Inhibits Leishmania by Inducing Mitochondrial Dysfunction and Cell Cycle Arrest.
Study summary not available in the imported record. Open the original citation to review the study.
- Efficacy of NexGard® combo (esafoxolaner-eprinomectin-praziquantel) against natural Mammomonogamus ierei infection in cats.
Study summary not available in the imported record. Open the original citation to review the study.
- Efficacy of single and double doses of pour-on eprinomectin on small ruminant farms - Is it affected by Haemonchus contortus?
Study summary not available in the imported record. Open the original citation to review the study.
Sources: DailyMed, U.S. National Library of Medicine; PubMed, National Library of Medicine; openFDA, U.S. Food and Drug Administration; Plumb DC. Plumb's Veterinary Drug Handbook. 7th ed. PharmaVet Inc; 2011.