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Trifexis by Elanco

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Trifexis Generic Name:

Spinosad + Milbemycin oxime

Trifexis General description:

A monthly pill which prevents heartworm disease, kills fleas and prevents flea infestations, and kills parasites such as hookworms, roundworms and whipworms in dogs 8 weeks of age or older and 5 or more pounds of body weight. Flavored, chewable tablets are available in 5 different sizes in color-coded packages containing a 6 month supply.

What is Trifexis?
  • Spinosad is a biologic product, an ultra-fast flea-killing tablet. It is classified by the USDA as an organic substance (considered a drug, not an insecticide)
  • Milbemycin is a strong drug able to interfere with a parasite's nerve transmission, causing death of many forms of parasites
  • Spinosad + milbemycin oxime are flavored chewable tablets given by mouth
Reasons for prescribing heartworm prevention:
  • To prevent heartworm disease in dogs
  • To kill fleas and to prevent flea infestations in dogs
  • To treat and control common adult intestinal worm infections (roundworms, hookworms and whipworms) in dogs
What dogs/cats should not take Trifexis?
  • This product is approved for use in dogs only
  • Puppies less than 8 weeks of age
  • Dogs with a body weight less than 5 pounds
  • Pets who have tested positive for heartworm
  • Use with caution in dogs who have previously seizured
  • Ask your veterinarian about the use of this product prior to use in breeding males and females
  • Dogs known to have had an allergic reaction to spinosad or milbemycin oxime or like products

Give as directed by your veterinarian. Your veterinarian will choose the package size appropriate to your pet's weight. Read and follow the label carefully.
Give with food monthly for maximum effectiveness. Since the tablet is chewable, it may be given as a treat.
Fleas: Treatment may begin at any time of the year. Ideally, begin administration one month before fleas become active, and then continue monthly throughout flea season. Should your area experience fleas year-round, give spinosad + milbemycin oxime monthly without interruption.
To minimize re-infestation, treat all pets in the house with an approved product. When used as directed, spinosad + milbemycin oxime will kill fleas before they can lay eggs. Your dog may continue to be exposed to fleas from his/her living environment. Any fleas that jump on to your dog will be killed by the active ingredients.
Intestinal worms: Dogs may be exposed to and can be infected with roundworms, whipworms and hookworms throughout the year.
Heartworm: If you do not give this product monthly throughout the year (ie. you discontinue administration during the winter), the final dose must be given no fewer than 3 months following the last exposure to mosquitoes.
You can play with your dog immediately after treatment. There is no need to isolate your pet or restrict his or her activity.
Ensure your pet consumes the entire dose. If it is not entirely consumed, re-dose the full recommended dose as soon as possible.
Spinosad + milbemycin oxime is given once a month, preferably on the same day of each month.
If the animal vomits within an hour of the dose, and you feel it is unrelated to the medication, give another dose.
Missed doses reduce the effectiveness of therapy.

What if dose is missed?

If a dose is missed, give it as soon as you can with food. Resume the normal monthly schedule. Do not give two doses at the same time. If you miss more than 8 weeks in a row, give the drug as soon as you remember, but you should have your pet's blood tested for heartworms within 6 months (as infection may have occurred).

What to tell/ask veterinarian before giving Trifexis?
  • What tests may need to be performed prior to treatment with this drug
  • What are the risks and benefits of using this drug?
  • If your pet has experienced side-effects on other drugs/products
  • If your pet has experienced any other medical problems or allergies now or ever
  • All medicines and supplements that you are giving your pet or plan to give your pet, including those you can get without a prescription. Your veterinarian may want to check that all of your pet's medicines can be given together.
  • If you pet is pregnant or nursing or if you plan to breed your pet
Trifexis Storage and Warnings:

Store at 68-77°F (20-25°C). Temporary periods of time outside this range between 59-86°F
(15 -30°C) are permitted.
Remove tablet from original pack only at time of administration.
Humans should maintain good personal hygiene as hookworm and roundworm infections could easily be contracted.
Do not allow pets to eat rodents or raw flesh or fish. Pet feces should be removed daily and the premises kept clean.
Keep this and all medication out of reach of children and pets. Call your physician immediately if you accidentally take this product.

Potential side effects of Trifexis:
  • A mild, transient hypersensitivity reaction (labored breathing, vomiting, salivation and lethargy) has been noted in some dogs carrying a large number of circulating microfilariae (immature heartworm). These reactions are likely due to the parasites dying all at once.
  • Puppies less than 14 weeks of age may experience a higher rate of vomiting
  • More serious side effects could occur in a dog with pre-existing heartworm infection
  • If you notice anything unusual, contact your veterinarian
Can this drug be given with other drugs?
  • Yes, no known drug interactions have been noted.
  • Do not give this product if your dog is already taking heartworm medication.
  • If your pet experiences any unusual reactions when taking multiple medications, contact your veterinarian

Contact your veterinarian immediately if pet consumes more than the prescribed amount.

What else should I know about Trifexis?

Notify your veterinarian if your animal's condition does not improve or worsens despite this treatment.

As with all prescribed medicines, spinosad + milbemycin oxime should only be given to the dog for which it was prescribed. It should be given only for the condition for which it was prescribed.

This is just a summary of information about spinosad + milbemycin oxime. If you have any questions or concerns about spinosad + milbemycin oxime or the conditions for which it was prescribed, contact your veterinarian.

Milbemycin oxime plus Spinosad

Common Drug Name
Milbemycin oxime plus spinosad

Common Brand Names
No generic products are available.

Store at room temperature.

Milbemycin oxime is used as a heartworm preventive, and treats and controls hookworms, roundworms and whipworms. The spinosad is used for the prevention and control of flea infestations by killing adult fleas.

Dose and Administration
Always follow the dosage instructions provided by your veterinarian. If you have difficulty giving the medication, contact your veterinarian.
Give with food for maximum effectiveness. 
Follow your veterinarian?s directions on when to give this medication. If advised to give it seasonally for heartworm prevention, remember to give it during and for 3 months beyond the mosquito season, preferably on the same date each month. 
Treatment with fewer than 3 monthly doses after the last exposure to mosquitoes may not provide complete heartworm protection. 
If a dose is missed, give the tablet imme­diately and resume giving a tablet every 30 days (once a month). Contact your veterinarian regarding the need to have your pet heartworm tested in 6-7 months.
If vomiting occurs within one hour of administration, redose with another full dose.
This medication should only be given to the pet for whom it was prescribed.

Possible Side Effects
Side effects are rare at the recommended dosage. May see vomiting, decreased activity, decreased appetite, diarrhea, itching and reddening of the skin. If you observe any of these signs, contact your veterinarian. Puppies less than 14 weeks of age may experience a higher rate of vomiting.
If your pet experiences an allergic reaction to the medication or the dying of parasites, signs may include facial swelling, hives, scratching, sudden onset of diarrhea, vomiting, shock, seizures, pale gums, cold limbs, or coma. If you observe any of these signs, contact your veterinarian immediately.

Not for use in animals who are hypersensitive (allergic) to it.
Consult your veterinarian regarding heartworm testing your pet prior to, and during, treatment with this medication.
Use with caution in dogs with pre-existing epilepsy.
Not for use in Collies or other herding breeds over the recommended heartworm prevention dose unless under the strict supervision of a veterinarian. If your dog is one of these breeds and received a higher dose, observe your pet for at least 8 hours after giving the medication for weakness, staggering, fever, dilated pupils, trembling, or pressing the head against a wall. Contact your veterinarian immediately if you see these signs.
Do not use in puppies less than 8 weeks of age or less than 5 pounds.
Use with caution in breeding females. The safe use of milbemycin oxime plus spinosad in breeding males has not been evaluated.
Consult your veterinarian regarding physical examinations and heartworm testing your pet prior to, and during, treatment with milbemycin oxime plus spinosad.
Properly dispose of unused medication, as it may be toxic to fish and other animals.

Human Precautions
Some intestinal parasites may be zoonotic (able to infect humans). Consult your veterinarian or physician on how to prevent human infection and reinfection of your pet.

Drug, Food and Test Interactions
Notify your veterinarian of any other medications, including vitamins and supplements, your pet is taking while your pet is receiving milbemycin plus spinosad.
Serious adverse reactions have been reported following the simultaneous use of spinosad and ivermectin at doses higher than the heartworm prevention dose. 
No known food interactions.

Signs of Toxicity/Overdose
Rare. May see vomiting, tremors, decreased activity, salivation, coughing and vocalization.
If you know or suspect your pet has had an overdose, or if you observe any unusual signs, symptoms, or behaviors, contact your veterinarian immediately.
Keep this and all other medications out of the reach of children and pets.

This information may not cover all possible uses, directions, side effects, precautions, allergic reactions, drug interactions, or withdrawal times. Always consult your own veterinarian for specific advice concerning the treatment of your pet.


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