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Trifexis®(spinosad + milbemycin oxime) is the #1 prescribed canine combination parasiticide1.

Trifexis kills fleas and prevents infestations, prevents heartworm disease, and treats and controls hookworm, roundworm, and whipworm infections in dogs and puppies 8 weeks of age or older and 5 pounds or greater.


Serious adverse reactions have been reported following concomitant extra-label use of ivermectin with spinosad alone, one of the components of Trifexis chewable tablets.

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 breeding females. The safe use of Trifexis in breeding males has not been evaluated. Use with caution in dogs with pre-existing epilepsy.

The most common adverse reactions reported are vomiting, depression/lethargy, itching, decreased appetite, and diarrhea. To ensure heartworm prevention, observe your dog for one hour after administration. If vomiting occurs within an hour of administration, redose with another full dose. Puppies less than 14 weeks of age may experience a higher rate of vomiting.

View full product label for complete safety information.


1. Vet Insite Analytics. Based on total canine combination parasiticide product data (flea, tick, heartworm), 6/2014