Heartgard Plus for Dogs

Heartgard Plus should be administered orally at monthly intervals at the recommended minimum dose level of 6 mcg of ivermectin per kilogram (2.72 mcg/lb) and 5 mg of pyrantel (as pamoate salt) per kg (2.27 mg/lb) of body weight. The following table outlines the recommended dosing schedule for the prevention of canine heartworm disease and for the treatment and control of ascarids and hookworms:

Heartgard Plus Dosage Chart:

Heartgard Plus is recommended for dogs 6 weeks of age and older.

Quick Tips for Administering Heartgard Plus:

• Give Heartgard Plus Chewables once a month, ideally on the same day each month, year-round.
• Heartgard Plus Chewables are specifically for dogs.
• The chewables should be chewed by the dog, not swallowed whole.
• Chewables can be broken into pieces or crumbled and mixed with a small amount of food if needed.
• Observe your dog closely after dosing to ensure the entire chewable has been swallowed. If not fully consumed, administer another full recommended dose as soon as possible.
• Keep the chewable in its wrapper until you are ready to give it to your pet to protect it from light.

Administration Instructions:

Remove only one chewable at a time from the foil-backed blister card. Return the remaining chewables to its box to protect the product from light. Because most dogs find Heartgard Plus palatable, the product can be offered to the dog by hand. Alternatively, it may be added intact to a small amount of dog food. The chewable should be administered in a manner that encourages the dog to chew, rather than to swallow without chewing. Chewables may be broken into pieces and fed to dogs that normally swallow treats whole.

Ensure your dog consumes the complete dose. Observe your dog for a few minutes after administration to make sure none of the dose is lost or rejected. If it is suspected that any of the dose has been lost, redosing is recommended.

Heartgard Plus should be given at monthly intervals during the period of the year when mosquitoes (vectors), potentially carrying infective heartworm larvae, are active. The initial dose must be given within a month (30 days) after the dog's first exposure to mosquitoes. The final dose must be given within a month (30 days) after the dog's last exposure to mosquitoes.

When replacing another heartworm preventive product in a heartworm disease preventive program, the first dose of Heartgard Plus must be given within a month (30 days) of the last dose of the former medication.

If the interval between doses exceeds a month (30 days), the efficacy of ivermectin can be reduced. Therefore, for optimal performance, the chewable must be given once a month on or about the same day of the month. If treatment is delayed, whether by a few days or many, immediate treatment with Heartgard Plus and resumption of the recommended dosing regimen minimizes the opportunity for the development of adult heartworms.

Monthly treatment with Heartgard Plus also effectively treats and controls ascarids (T. canis, T. leonina)and hookworms (A. caninum, U. stenocephala, A. braziliense) . Clients should be advised of measures to be taken to prevent reinfection with intestinal parasites.

Federal (U.S.A.) law restricts this drug to use by or on the order of a licensed veterinarian.

Acceptability:

Clinical trials have shown that Heartgard Plus chewables are readily accepted by most dogs when offered orally.

Precautions:

All dogs should be tested for existing heartworm infection before starting treatment with Heartgard Plus which is not effective against adult D. immitis. Infected dogs must be treated to remove adult heartworms and microfilariae before initiating a program with Heartgard Plus.

While some microfilariae may be killed by the ivermectin in Heartgard Plus at the recommended dose level, Heartgard Plus is not effective for microfilariae clearance. A mild hypersensitivity-type reaction, presumably due to dead or dying microfilariae and particularly involving a transient diarrhea, has been observed in clinical trials with ivermectin alone after treatment of some dogs that have circulating microfilariae.

Store Heartgard Plus between 68°- 77°F (20°- 25°C). Excursions between 59° - 86°F (15° - 30°C) are permitted. Protect product from light.

Adverse Reactions:

Vomiting or diarrhea within 24 hours of dosing was rarely observed in clinical trials. The following adverse reactions have been reported: Depression/lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions and hypersalivation.

Safety:

Heartgard Plus has been shown to be bioequivalent to Heartgard, with respect to the bioavailability of ivermectin. The dose regimens of Heartgard Plus and Heartgard are the same with regard to ivermectin (6 mcg/kg). Studies with ivermectin indicate that certain dogs of the Collie breed are more sensitive to the effects of ivermectin administered at elevated dose levels (more than 16 times the target use level) than dogs of other breeds. At elevated doses, sensitive dogs showed adverse reactions which included mydriasis, depression/lethargy, anorexia, mydriasis, ataxia, staggering, convulsions and hypersalivation.

Heartgard Plus has a wide margin of safety at the recommended dose level in dogs, including pregnant or breeding females, stud dogs and puppies aged 6 or more weeks. In clinical trials, many commonly used flea collars, dips, shampoos, anthelmintics, antibiotics, vaccines and steroid preparations have been administered with Heartgard Plus in a heartworm disease preventive program.

Possible Side Effects:

In clinical field trials with Heartgard Plus, vomiting or diarrhea within 24 hours of dosing was rarely observed (1.1% of administered doses). Other reported adverse reactions include depression/lethargy, anorexia, mydriasis, ataxia, staggering, convulsions and hypersalivation.