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Choose the species
One selection filters the source overview, clinical facts, reports and dose calculator. Literature references are not species-filtered.
Choose one species for its overview and dose calculator, or all species to browse the full evidence.
Source overview
Recorded excerpts for one species. Each dose remains a separate source entry; no regimen is selected.
Choose one species to view its source overview. All-species evidence remains available below.
View full clinical evidence and sources ↓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.
Indications2
Heartworm disease treatment — stabilized Class I–III (stage L5 immature to adult D. immitis)
DogOn-label (ON_LABEL)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Indications table · Not applicable · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Heartworm disease treatment — stabilized Class I–III (stage L5 immature to adult D. immitis) — Authorized (Immiticide label)
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Indications table · Not applicable · On-label (ON_LABEL) · Pending clinical review (PROPOSED) · Rule-based
NOT recommended — supportive/steroid management instead (worms few but reaction severe)
CatNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Indications table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: NOT recommended — supportive/steroid management instead (worms few but reaction severe) — Contraindicated de facto
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Indications table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Dose regimens3
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.
Choose one species above to view its dose calculator.
Adverse effects124
Injection-site reactions (pain, swelling, firm nodules — may persist indefinitely) — ~⅓ of dogs
DogNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pulmonary thromboembolism (dead-worm emboli, 7–30 day window) — The feared complication — coughing/gagging, fever, lung congestion, depression
DogNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Anorexia, vomiting, salivation, lethargy — Common label events
DogNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Side Effects / Adverse Effects table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Death (severe reactions, caval syndrome dogs) — Class IV risk
DogNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — 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
- INEFFECTIVE, HEARTWORM ADULTS4,219 reports
- Lack of efficacy (endoparasite) - heartworm2,742 reports
- Vomiting2,726 reports
- Injection site swelling2,273 reports
- Injection site pain1,458 reports
- Pain NOS1,280 reports
- Anorexia1,218 reports
- Diarrhoea1,182 reports
- Lethargy (see also Central nervous system depression in 'Neurological')1,126 reports
- INEFFECTIVE, HEARTWORM LARVAE1,123 reports
- Depression1,094 reports
- Fever993 reports
Cat
- Death5 reports
- Accidental exposure3 reports
- Aggression2 reports
- Agitation2 reports
- Ataxia2 reports
- Depression2 reports
- Respiratory distress2 reports
- Vocalisation2 reports
- Administration error NOS1 reports
- Cardiorespiratory arrest1 reports
- Diarrhoea1 reports
- Drug administration error1 reports
Monitoring1
Clinical: Class staging (antigen, radiographs) before; strict-rest compliance; respiratory signs daily through the embolic window; renal/hepatic values; injection sites
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Monitoring Parameters · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Contraindications1
Class IV disease (caval syndrome — worms in vena cava/right atrium → mechanical extraction first); cats; severe renal/hepatic/pulmonary disease; heartworm antigen use: confirm diagnosis
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Precautions4
Older dogs (>8 y) more susceptible; STRICT CAGE REST through the embolic weeks is part of the prescription
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
The one drug in the library dosed into the lumbar muscles only, never IV/SC — technique IS the safety profile (back-leak into subcutis = worst local reactions).
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Three-way exam trio: dogs only (cats = steroid support), Class IV excluded (caval = surgery), cage rest = medicine (exercise kills via emboli).
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Modern layering (AHS-era): doxycycline + macrocyclic lactone before/rearound melarsomine, staged 3-dose protocol for heavy worm burdens — the arsenical remains the only adulticide.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Interactions2
Doxycycline/Wolbachia pre-treatment — Modern protocol companion (kills heartworm endosymbiont, attenuates worms)
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Corticosteroids/antihistamines — Often pre-treated to blunt embolic reactions
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Drug Interactions table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pharmacokinetics2
PK — Peak ~11 min after IM; Vd 0.7 L/kg; t½ ~3 h
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Mechanism — Organic arsenical — selective toxicity to adult heartworm (vs old caparsolate: no hepatic necrosis)
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pregnancy / lactation considerations1
Weigh risk:benefit in pregnant/lactating/breeding dogs (label).
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 775–777 — Pregnancy & Lactation · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Literature references15
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.
- Treatment of heartworm (Dirofilaria immitis) disease in dogs in the USA: general findings and cost of disease.
Study summary not available in the imported record. Open the original citation to review the study.
- A systematic review and meta-analysis of non-arsenical adulticide protocols using moxidectin and doxycycline for the treatment of adult heartworm infection in dogs.
Study summary not available in the imported record. Open the original citation to review the study.
- Isolation and characterization of a novel glutamate-gated chloride channel subunit (GLC-2) from the canine heartworm Dirofilaria immitis.
Study summary not available in the imported record. Open the original citation to review the study.
- Assessing the efficacy of three trypanocidal drugs in controlling Trypanosoma evansi.
Study summary not available in the imported record. Open the original citation to review the study.
- Assembly-Driven Oxidative Degradation of Melarsomine Triggered by Cyanuric Acid.
Study summary not available in the imported record. Open the original citation to review the study.
Sources: PubMed, National Library of Medicine; openFDA, U.S. Food and Drug Administration; Plumb DC. Plumb's Veterinary Drug Handbook. 7th ed. PharmaVet Inc; 2011.
Owner information handout
Plain-language medication information to review with the owner. Open the handout to print it or download a PDF.