Isoxazoline Flea & Tick Medications

Ectoparasiticides (Systemic Drugs)

(Bravecto, Credelio, NexGard, Simparica)

Chewable oral ectoparasiticides labeled for treatment of flea infestations and treatment and control of a variety of tick species in dogs

Fluralaner topical solutions available for use in cats and dogs

Uses, Indications

• Specific tick species included on the label vary for each product. Check product labels for species information.

• Afoxolaner is approved for treatment and prevention of flea infestations and treatment and control of tick infestations for 1 month

  • Afoxolaner has also been reported efficacious for extra-label treatment of generalized demodicosis, sarcoptic mange, and ear mite infestations

• Fluralaner is approved for treatment and prevention of flea infestations and treatment and control of tick infestations for 12 weeks

  • Fluralaner also has been demonstrated as efficacious for extra-label treatment of sarcoptic mange

• Lotilaner is approved for treatment of flea infestations and treatment and control of tick infestations for 1 month

  • Extra-label use has been suggested for treating generalized demodicosis

• Sarolaner is approved for use in dogs for treatment and prevention of flea infestations and treatment and control of tick infestations for 1 month 

  • Sarolaner is also labeled in Europe for treatment of sarcoptic mange

Precautions, Warnings

• Precautions

  • Use afoxolaner, fluralaner, and lotilaner with caution in patients with a history of seizures or neurologic abnormalities

• Warnings

  • Afoxolaner is not labeled for use in dogs <1.8 kg or younger than 8 weeks

  • Chewable fluralaner is not labeled for use in dogs <2 kg or younger than 6 months 

  • Lotilaner is not labeled for use in dogs <2 kg or younger than 8 weeks

  • Sarolaner is not labeled for use in dogs <2 kg or younger than 6 months

• No adverse effects were noted with fluralaner or sarolaner when administered to collies homozygous for the MDR1 mutation at 3 times label doses

Side Effects

• Well tolerated; however, vomiting, diarrhea, and lethargy may rarely be observed

• Dose-related abnormal neurologic signs may be seen; tremors and ataxia have been noted with sarolaner at 3 times labeled dose and seizures at 5 times labeled dose

• Cats receiving topical fluralaner have been reported to develop pruritus and alopecia

Drug Interactions

• None reported

Dosage Forms

• Afoxolaner chewable tablets: 11.3 mg, 28.3 mg, 68 mg, and 136 mg

• Fluralaner chewable tablets: 112 mg, 250 mg, 500 mg, 1000 mg, and 1400 mg; topical solutions are available for cats and dogs

• Lotilaner chewable tablets: 56.25 mg, 112.5 mg, 225 mg, 450 mg, and 900 mg

• Sarolaner chewable tablets: 5 mg, 10 mg, 20 mg, 40 mg, 80 mg, and 120 mg

—Compiled and summarized from Plumb’s Veterinary Drugs by Shannon Palermo, VMD

Information about this drug was adapted from Plumb’s Veterinary Drugs. Further details and more therapeutics can be found with a subscription at plumbsveterinarydrugs.com