NexGard^® PLUS (afoxolaner, moxidectin, and pyrantel chewable tablets) is indicated for the prevention of heartworm disease caused by Dirofilaria immitis, as well as the treatment and control of adult hookworm (Ancylostoma caninum, Ancylostoma braziliense, and Uncinaria stenocephala) and roundworm (Toxocara canis and Toxascaris leonina) infections.

In addition, NexGard PLUS chews kill adult fleas and are indicated for the treatment and prevention of flea infestations caused by Ctenocephalides felis, and the treatment and control of Ixodes scapularis, Rhipicephalus sanguineus, Dermacentor variabilis, and Amblyomma americanum tick infestations. NexGard PLUS chews are safe to give to puppies at 8 weeks, weighing 4 pounds or more.

Heartworm Prevention: In 2 well-controlled laboratory studies, NexGard® PLUS (afoxolaner, moxidectin, and pyrantel chewable tablets) was 100% effective against induced D. immitis infections when administered for 6 consecutive months. In a well-controlled US field study consisting of 120 dogs administered NexGard PLUS chews and 124 dogs administered an active control, no dogs treated with NexGard PLUS chews tested positive for heartworm disease. All dogs treated with NexGard PLUS chews were negative for D. immitis antigen and blood microfilariae at study completion on Day 330.

Flea Treatment and Prevention: In a well-controlled laboratory study, NexGard PLUS chews demonstrated effectiveness against adult fleas.  The data from the study demonstrate that NexGard PLUS chews kill fleas before they can lay eggs, thus preventing subsequent flea infestations.

Tick Treatment and Control: In well-controlled laboratory studies, afoxolaner alone demonstrated effectiveness against Dermacentor variabilis, Ixodes scapularis, and Rhipicephalus sanguineus, 48 hours post-infestation, for 1 month. At 72 hours post-infestation, NexGard PLUS chews demonstrated effectiveness against Amblyomma americanum for 1 month.

Intestinal Nematode Treatment and Control: Elimination of adult roundworms (Toxocara canis and Toxascaris leonina) and hookworms (Ancylostoma caninum, Ancylostoma braziliense, and Uncinaria stenocephala) was demonstrated in well-controlled laboratory studies.

NexGard^® PLUS (afoxolaner, moxidectin, and pyrantel chewable tablets) is given orally once a month at the minimum dosage of 1.14 mg/lb (2.5 mg/kg) afoxolaner, 5.45 mcg/lb (12 mcg/kg) moxidectin, and 2.27 mg/lb (5.0 mg/kg) pyrantel (as pamoate salt). For heartworm disease prevention, give once monthly for at least 6 months after last exposure to mosquitoes.

NexGard PLUS chews can be administered with or without food. Care should be taken to ensure that the dog consumes the complete dose and that part of the dose is not lost or refused. If a dose is missed, administer a NexGard PLUS chew and resume a monthly dosing schedule.

Heartworm Prevention: NexGard PLUS chews should be administered at monthly intervals year-round or, at a minimum, administration should start within 1 month of the dog’s first seasonal exposure to mosquitoes and should continue at monthly intervals until at least 6 months after the dog’s last exposure. When replacing another monthly heartworm preventive product, the first dose of NexGard PLUS chews should be given within a month of the last dose of the former medication.

Flea Treatment and Prevention: NexGard PLUS chews should be administered year-round at monthly intervals or started at least 1 month before fleas become active. To minimize the likelihood of flea reinfestation, it is important to treat all animals within a household with an approved flea control product.

Tick Treatment and Control: NexGard PLUS chews should be administered year-round at monthly intervals or started at least 1 month before ticks become active.

Intestinal Nematode Treatment and Control: NexGard PLUS chews treat and control adult hookworms (Ancylostoma caninum, Ancylostoma braziliense, and Uncinaria stenocephala) and roundworms (Toxocara canis and Toxascaris leonina). For the treatment of adult hookworm and roundworm infections, NexGard PLUS chews should be administered as a single dose. Monthly use of NexGard PLUS chews will control any subsequent infections. Dogs may be exposed to and can become infected with hookworms and roundworms throughout the year, regardless of season or climate.

IMPORTANT SAFETY INFORMATION: NexGard^® PLUS (afoxolaner, moxidectin, and pyrantel chewable tablets) is for use in dogs only. The most frequently reported adverse reactions reported in clinical trials were diarrhea, vomiting, lethargy, and itching. NexGard PLUS contains afoxolaner, a member of the isoxazoline class, which has been associated with neurologic adverse reactions including tremors, ataxia, and seizures in dogs with or without a history of seizures. Use with caution in dogs with a history of seizures or neurological disorders. The safe use of NexGard PLUS has not been evaluated in breeding, pregnant, or lactating dogs. Dogs should be tested for existing heartworm infection prior to starting a heartworm disease preventive. For heartworm disease prevention, give once monthly for at least 6 months after last exposure to mosquitoes. 

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