Your Veterinarian, You and Your Dog

What should I discuss with my veterinarian regarding Trifexis® (spinosad + milbemycin oxime) for my dog?

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[Dr. Jeff Werber:
No one knows your dog’s health better than your veterinarian. That’s why it’s so important to talk with her about the prevention and treatment of parasites. Fleas, heartworms and intestinal parasites can cause a variety of harmful conditions such as skin inflammation, blood disorders and heart disease. Giving your dog Trifexis can help you prevent and control these problems.

Before you start a new treatment program for your dog, it’s a good idea to discuss a few key topics with your veterinarian. First, confirm your dog has been tested for heartworms. Giving any type of heartworm preventative to a dog that has an existing heartworm infection can be harmful or even fatal to the pet. So be sure to have your dog tested.

Next, talk with your veterinarian about what to do if your dog misses a scheduled treatment. It’s important to administer Trifexis every month as directed by your veterinarian. And for heartworm prevention, give it monthly for least three consecutive months after exposure to mosquitoes. This will help ensure that your dog receives continuous protection against fleas, heartworm disease and intestinal parasites. To help keep your dog on schedule with each treatment, sign up to receive monthly reminder emails or text messages at trifexis.com. If you miss a dose, give your dog’s prescribed Trifexis tablet with food as soon as possible. Then adjust your monthly dosing schedule based on the new date. You should also ask your veterinarian whether your dog needs to be retested for heartworms.

Finally, if you have other pets in the family, be sure to ask about parasite prevention and treatment strategies for all of the animals living in your home.

Trifexis is made for dogs, not cats or other pets. To avoid potential flea infestations in your home, treat all of your animals with an approved flea protection product. It will help your other pets stay happier and healthier. And it will help prevent your dog from being re-infested. And remember, Trifexis is a prescription medication. So keep it out of reach of children and pets.

Your veterinarian is your best resource regarding your dog’s health. Don’t hesitate to ask questions you may have about keeping your pets and your home protected against parasites.

Ask about Trifexis, the combination product that kills fleas and prevents infestations, prevents heartworm disease, and treats and controls hookworm, roundworm and whipworm infections. See the full product label for complete safety information.

Serious adverse reactions have been reported following concomitant extra-label use of ivermectin with spinosad alone, one of the components of Trifexis. Treatment with fewer than three monthly doses after the last exposure to mosquitoes may not provide complete heartworm prevention. Prior to administration of Trifexis, dogs should be tested for existing heartworm infection. Use with caution in dogs with pre-existing epilepsy.

The most common adverse reactions reported are vomiting, depression, itching and decreased appetite. To ensure heartworm prevention, observe your dog for one hour after administration. If vomiting occurs within an hour of administration, redose.]

Your veterinarian is your dog’s health care expert and can make the best recommendations about flea medicine for dogs, heartworm medicine for dogs and any other medicine your dog may need. This includes the prevention, control and/or treatment of parasites such as fleas, heartworms and intestinal parasites that may cause conditions including flea allergy dermatitis, anemia, heart disease and other parasite-related problems. Key points of your discussion may include the following:

  • As with other heartworm prevention, dogs should be tested for heartworm before beginning treatment with Trifexis.
  • If your dog misses a dose and/or you exceed the monthly interval between doses, immediately give Trifexis with food and resume monthly dosing. This practice will minimize the opportunity for heartworms to grow. Also, continuing normal monthly dosing will allow you to gain control of any flea or intestinal parasites (hookworm, roundworm and whipworm) that might have infected your dog.
  • To help minimize the likelihood of fleas continuing to jump onto your dog, it is important to treat all household pets with an approved flea-protection product.
  • Like all medications, keep Trifexis out of reach of children. Trifexis is not for use in humans.

Why did my veterinarian prescribe Trifexis?

Your veterinarian prescribed Trifexis to protect your dog from problems that an infection from common parasites can cause. Heartworm infection can make dogs very sick and can even be fatal. Trifexis can prevent flea infestations in dogs from becoming established and can also remove any fleas on your dog at the time of treatment. Trifexis will also treat and control common adult intestinal worm infections in dogs (hookworms*, roundworms and whipworms).

*A. caninum

How can I purchase Trifexis?

Trifexis is a prescription medicine for dogs that should only be purchased from a licensed veterinarian.

Does my dog need a heartworm test before starting Trifexis?

It is important for your veterinarian to assess your dog’s heartworm status prior to initiating a monthly heartworm disease preventive, or changing from one brand of preventive to another.

Will my dog still need to be tested for heartworm infection while taking Trifexis?

The American Heartworm Society and Companion Animal Parasite Council recommend annual testing for heartworm infection. You should ask your veterinarian about the recommended frequency of heartworm testing for your dog while taking Trifexis.2,3

How do I switch to Trifexis from another heartworm preventive?

If you use another heartworm medicine for dogs, follow your veterinarian’s advice about switching to Trifexis.

Can other medications be given while my dog is taking Trifexis?

Yes. In well-controlled field studies, Trifexis was administered safely with a wide variety of products and medications. Trifexis is not contraindicated for use with any other veterinary product or medication when used at label doses. However, there is a label warning that serious adverse reactions have been reported following the use of ivermectin at higher than FDA-approved doses at the same time as spinosad, one of the components of Trifexis. Remember to inform your veterinarian about all products you administered or intend to administer to your dog.

Can Trifexis be given if my dog has food allergies?

Trifexis contains some hydrolyzed soy and is flavored with artificial beef from a pork-based protein.1 The amount of hydrolyzed soy in Trifexis is comparable to the amount of the hydrolyzed soy in hypoallergenic diets.1 If your dog is allergic to soy or pork, you may consider talking to your veterinarian about whether other heartworm, intestinal parasite or flea protection products may be more appropriate for your dog.

Should I give Trifexis each month all year?

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[Dr. Jeff Werber:
Some people think that dogs only need parasite protection during the spring and summer months. But parasites can be present in all parts of the country, all year round. That’s why the Companion Animal Parasite Council, the American Heartworm Society and most experts recommend that you keep your dog on monthly heartworm prevention all year long.

After all, heartworm disease is one of the most deadly threats to your dog. Spread by infected mosquitoes, it’s a serious problem. Keep in mind that heartworm preventatives work by killing infective larvae from mosquitoes that have already bitten your dog. So remember to give your dog her heartworm prevention after her last exposure to mosquitoes.

If you don’t administer Trifexis year-round, it’s important to give it to your dog for three consecutive months after exposure to mosquitoes. When you give your dog Trifexis all year long, you not only get the benefit of protecting against heartworm disease, you’re also guarding against fleas and intestinal parasites.

Fleas can be found both indoors and outdoors in all areas, at all times of the year. They’re not only annoying, but fleas can be dangerous to your pet’s health. They can cause your dog to have skin inflammation, blood disorders and even some types of tapeworms.

Your dog also requires year-round protection from intestinal parasites – or worms – which are a constant and widespread danger. Dogs contract worms by ingesting worm eggs or larvae in feces, in animal remains, or in infected soil. They can also be infected directly from their mothers while she's still pregnant or while nursing, or even through skin penetration. Intestinal parasites can cause lots of health problems for your dog, and in some cases, can even be fatal.

It’s not worth the risk. Make sure your dog is constantly protected from these dangerous parasites. Your veterinarian can advise you on the best protection schedule for your dog. So be sure to talk with him before making any changes to your dog’s preventative plan.

Ask about Trifexis, the combination product that kills fleas and prevents infestations, prevents heartworm disease, and treats and controls hookworm, roundworm and whipworm infections. See the full product label for complete safety information. Serious adverse reactions have been reported following concomitant extra-label use of ivermectin with spinosad alone, one of the components of Trifexis.

Treatment with fewer than three monthly doses after the last exposure to mosquitoes may not provide complete heartworm prevention. Prior to administration of Trifexis, dogs should be tested for existing heartworm infection. Use with caution in dogs with pre-existing epilepsy.

The most common adverse reactions reported are vomiting, depression, itching and decreased appetite. To ensure heartworm prevention, observe your dog for one hour after administration. If vomiting occurs within an hour of administration, redose.]

The Companion Animal Parasite Council, an independent group established to create parasite-control guidelines, and the American Heartworm Society both recommend treating dogs year-round with broad-spectrum parasite protection.2,3 However, you should consult your veterinarian regarding specific recommendations. If you do not administer Trifexis monthly throughout the year, continue administering the medication for at least three months following the last exposure to mosquitoes.