Bundle: Nexgard + Heartgard Plus - Flea, Tick, & Heartworm Prevention Bundle for Dogs

What are NexGard Chewables for Dogs?

With one little NexGard (afoxolaner) chewable comes the confidence that you're giving your dog the #1 vet-recommended flea and tick protection and control. Numerous studies have proven that NexGard tasty beef-flavored chew tablets are both effective and safe. NexGard is a revolutionary flea and tick control product that's FDA-approved to prevent infections that cause deadly tick-borne disease like Lyme in dogs as a result of killing black-legged ticks. And each bite-sized monthly dose is gentle enough to give to puppies and dogs as young as 8 weeks, weighing as little as 4 pounds. NexGard’s yummy, beef-flavored soft chew is also the #1 dog-preferred protection against fleas and ticks over other brands. And because you should feel just as good about what your dog eats as he does eating it, the ingredients in each NexGard chew have been carefully designed to quickly kill adult fleas and ticks for a full month, killing fleas before they have a chance to lay eggs and black-legged ticks before they transmit Lyme infections. NexGard for dogs is the flea and tick solution that is easy, effective, and enjoyable, month after month.

Used For:

NexGard Chewable products are ideal for dogs and puppies 8 weeks of age and older weighing 4 pounds of body weight or greater.

Key Benefits:

• #1 vet-recommended flea and tick control that kills fleas fast, before they can lay eggs.
• The tick killer product that is FDA-approved to prevent Lyme infections as a direct result of killing black-legged ticks.
• Kills fleas and ticks all month long.
• #1-preferred tasty morsel for tick and flea protection. Each NexGard chewable for dogs is easy to give because they love the delicious beef-flavored chew.
• Safe for dogs and puppies as young as 8 weeks, weighing 4 pounds or more.
• Can be given with or without food and remains effective for a full month.

How do NexGard Chewables work?

NexGard Chewables contain afoxolaner which is absorbed into the bloodstream after ingestion. When fleas and ticks ingest blood containing afoxolaner, it causes hyperexcitation of the nervous system and death in these parasites.

Caution:

Nexgard Chewables are not for use in humans. In case of accidental ingestion, contact a physician immediately. NexGard is for use as a preventive treatment in dogs only. The most frequently reported adverse reactions include vomiting, itching, lethargy, diarrhea, and lack of appetite. The safe use of NexGard in pregnant, breeding, or lactating dogs has not been evaluated. Use with caution in dogs with a history of seizures or neurologic disorders. For more information, contact your veterinarian or refer to the full prescribing information.

Storage:

Keep NexGard Chewable tablets in a secure location out of reach of children, dogs, cats, and other animals to prevent accidental ingestion or overdose. Store at or below 30°C (86°F) with excursions permitted up to 40°C (104°F).

Brand Name:

NexGard® (afoxolaner) Chewables

What is the most important thing I should know about NexGard Chewables?

NexGard Chewables active ingredient Afoxolaner is used to kill adult fleas and are indicated as an effective drug dosage for the oral treatment and prevention of flea infestations (Ctenocephalides felis), and the treatment and control of many types of ticks, including the American dog tick (Dermacentor variabilis), black-legged (deer) tick (Ixodes scapularis) and Lone star tick (Amblyomma americanum) infestations in dogs and puppies 8 weeks of age and older, weighing 4 pounds of body weight or greater, for one month.

What should I discuss with my veterinarian before giving NexGard Chewables to my dog?

Tell your licensed veterinarian if your dog is pregnant, lactating or has a history of seizures. The safe use of NexGard Chewable flea and tick prevention medication in breeding, pregnant animals, or lactating dogs has not been evaluated. Afoxolaner is a member of the isoxazoline class. This drug class has been associated with neurologic adverse reactions including muscle tremors, ataxia, and seizures. Seizures have been reported in dogs receiving isoxazoline class drugs, even in dogs without a history of seizures. Use with caution in dogs with a history of seizures or neurologic disorders.

How should NexGard Chewables be given?

NexGard Chewables require a prescription from your veterinarian on file. Give the appropriate prescription drug dosage based on your dog's weight. (See How to Use). If it is suspected that any of the dose has been lost or if vomiting occurs within two hours of administration redose with another complete dose. NexGard Chewables can be administered with or without food. NexGard Chewables should be administered all year round. Treat all the pets in your home to reduce the risk of a infestations with fleas.

What are the potential side effects of NexGard Chewables?

The most frequently reported adverse reactions include vomiting, dry skin/flaky skin, diarrhea, lethargy, and lack of appetite. The occurrence of vomiting was generally self-limiting and of short duration and tended to decrease with subsequent doses. There are no known contraindications for the use of NexGard® (afoxolaner) Chewables.

What happens if I miss giving a dose of NexGard Chewables?

If a dose is missed, administer the usual dose of NexGard (afoxolaner) Chewables and resume a monthly dosing schedule.

What happens if I overdose my pet on NexGard Chewables?

Seek emergency veterinary medical treatment.

What should I avoid while giving NexGard Chewables to my pet?

Avoid giving NexGard (afoxolaner) Chewables if your pet is pregnant, lactating or has a known history of seizures.

What other drugs will affect NexGard Chewables?

There are no known contraindications or harmful interactions for the use of NexGard (afoxolaner) Chewables.

What are HEARTGARD® Plus (ivermectin/pyrantel) Heartworm Disease Preventative Chewables for Dogs?

HEARTGARD® Plus (ivermectin/pyrantel) Chewables for Dogs fight against heartworm disease – an invisible threat that can be caused by just one bite from an infected mosquito and can lead to permanent damage to a dog’s lungs and even heart.² HEARTGARD Plus chews also treat and control 3 species of hookworms and 2 species of roundworms in dogs, which are among the most prevalent intestinal nematode parasites.³ With cases in all 50 states, it’s important to protect your dog with a monthly heartworm disease preventive year-round.³ Following the use of HEARTGARD Plus chewable, digestive and neurologic side effects have been reported.

HEARTGARD® Plus chews are tasty, Real-Beef chews easy to give to your dog for heartworm disease prevention. HEARTGARD Plus is safe to use in dogs aged 6 weeks and older. The American Heartworm Society recommends that all dogs receive monthly heartworm disease prevention year-round. Ask your veterinarian about preventing heartworm disease in your dog with HEARTGARD Plus chews, and make sure they have a current annual heartworm test result on file.

For:

For dogs and puppies 6 weeks of age and older.

Benefits:

• Effectively prevents heartworm disease
• Also treats and controls roundworms & hookworms
• From the brand trusted over 2 billion times⁴
• Delicious once a month real-beef chew that dogs love⁵
• Safe for puppies 6 weeks and older

How do HEARTGARD® Plus (ivermectin/pyrantel) Heartworm Disease Preventative Chewables for Dogs work?

HEARTGARD^® Plus (ivermectin/pyrantel) Chewables contain two active ingredients, ivermectin and pyrantel, that work together to prevent heartworm disease and treat and control hookworms and roundworms.

Side Effects:

In clinical field trials with HEARTGARD® Plus (ivermectin/pyrantel) chews, vomiting or diarrhea within 24 hours of dosing was rarely observed (1.1% of administered doses). The following adverse reactions have been reported following the use of HEARTGARD Plus chews: Depression/lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions and hypersalivation.

Brand Name:

Heartgard PLUS (Boehringer Ingelheim Animal Health USA, Inc.)

Active Ingredients:

Ivermectin, pyrantel

Important Safety Information

All dogs should be tested for heartworm infection before starting a preventive program. Following the use of HEARTGARD^® Plus (ivermectin/pyrantel) Chewables, digestive and neurologic side effects and itching have been reported. For more information, contact your veterinarian or refer to the full prescribing information

What should I discuss with my veterinarian before giving HEARTGARD® Plus (ivermectin/pyrantel) Heartworm Disease Preventative Chewables for Dogs to my pet?

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.

How should HEARTGARD® Plus (ivermectin/pyrantel) Heartworm Disease Preventative Chewables for Dogs be given?

Remove only one chewable at a time from the foil-backed blister card. Return the card with 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. To avoid the risk of choking or intestinal obstruction, 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.

What happens if I miss giving a dose of HEARTGARD® Plus (ivermectin/pyrantel) Heartworm Disease Preventative Chewables for Dogs?

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.

What happens if I overdose my pet on HEARTGARD® Plus (ivermectin/pyrantel) Heartworm Disease Preventative Chewables for Dogs?

Seek emergency veterinary medical treatment. Keep HEARTGARD® PLUS in a secure location out of reach of dogs, cats, and other animals to prevent accidental ingestion or overdose. In case of ingestion by humans, clients should be advised to contact a physician immediately. Physicians may contact a Poison Control Center for advice concerning cases of ingestion by humans.

What should I avoid while giving HEARTGARD® Plus (ivermectin/pyrantel) Heartworm Disease Preventative Chewables for Dogs to my pet?

Avoid using HEARTGARD® Plus if your dog has had a known allergic reaction to ivermectin or pyrantel. Do not administer HEARTGARD® Plus if your dog has not been tested for heartworm disease. Dogs with active infections can experience severe adverse reactions to ivermectin. HEARTGARD® Plus is formulated specifically for dogs and should not be given to other animals, like cats or other pets.

What other drugs will affect HEARTGARD® Plus (ivermectin/pyrantel) Heartworm Disease Preventative Chewables for Dogs?

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.

Storage:

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

HEARTGARD^® Plus (ivermectin/pyrantel) Chewables FAQs:

How Do HEARTGARD® Plus (ivermectin/pyrantel) Chewables Work?

HEARTGARD^® Plus chewables contain two active ingredients, ivermectin and pyrantel. The ivermectin prevents the development of heartworm larvae in dogs.¹ The pyrantel treats and controls hookworms and roundworms.¹

Do you need a prescription for HEARTGARD® Plus chewables?

Your dog will need an annual negative heartworm test and a prescription from your veterinarians for HEARTGARD® Plus chewables.

How often do I give my dog HEARTGARD^® Plus chewables?

Give your dog a HEARTGARD^® Plus chewable once a month, year-round.

Do HEARTGARD® Plus chews only prevent Heartworm disease?

No, the pyrantel in HEARTGARD® Plus chewables also treats and controls hookworms and roundworms.¹

Is there a weight or age requirement to give my dog HEARTGARD® Plus chewables?

HEARTGARD® Plus chews are suitable for dogs 6 weeks of age and older. There is no minimum weight requirement to use HEARTGARD® Plus chews.²

How long does a dose of HEARTGARD® Plus chews last & how often should I treat my dog?

Even though the dose of a HEARTGARD® Plus chewable only remains in the dog for a few days, each HEARTGARD® Plus chew works by affecting parasitic infections acquired during the previous month/30 days.² Therefore, it is critical to ensure that your dog receives the appropriate dose of HEARTGARD® Plus chewable each month/30 days to keep your dog protected from heartworm disease, hookworms, and roundworms all year long.

Do HEARTGARD® Plus chewables need to be used all year even when it is cold outside?

The American Heartworm Society recommends giving your dog year-round protection. That’s because the threat of heartworm disease doesn’t stop with dropping temperatures, and it takes just one mosquito bite to transmit the disease to your dog. Many pet owners might assume that they only need to give their dog heartworm disease preventives when it’s warm. While heartworm transmission can decrease in winter months, the risk never reaches zero. What’s more, on-again, off-again heartworm disease protection is unreliable and can leave gaps in protection that can make your dog vulnerable to heartworm disease.³

Are HEARTGARD® Plus chewables safe?

HEARTGARD® Plus chewables are well tolerated, and HEARTGARD brand products have been trusted over 2 billion times.⁴ HEARTGARD® Plus chewables are the #1 dog-preferred chew.⁵

In what sizes and options are HEARTGARD® Plus chews available?

HEARTGARD® Plus chewables are available in three different sizes ranging from small dogs up to 25 pounds, medium dogs weighing 26-50 pounds and large dogs weighing 51-100 pounds. For dogs over 100 pounds use the appropriate combination of these chewables.² Each size also comes in packs containing 1, 6 or 12 monthly doses. HEARTGARD Plus chews are safe to use in dogs aged 6 weeks and older. Following the use of HEARTGARD Plus chews, digestive and neurologic side effects and itching have been reported.

Can HEARTGARD® Plus chewables be given to pregnant dogs?

HEARTGARD® Plus chews have shown a wide margin of safety at the recommended dose level in dogs, including pregnant or breeding bitches, stud dogs and puppies aged 6 or more weeks.²

How should I give HEARTGARD® Plus chewables to my dog?

Because most dogs find HEARTGARD® PLUS palatable, the product can be offered to the dog by hand. To avoid the risk of choking or intestinal obstruction, 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. Alternatively, it may be added intact to a small amount of dog food to encourage chewing, but care should be taken to ensure that the dog consumes the complete dose at one time. Treated animals should be observed for a few minutes after administration to ensure that part of the dose is not lost or rejected. If it is suspected that any of the dose has been lost, redosing is recommended. ²

How do dogs get Hookworms and Roundworms?

Hookworm larvae can be transmitted through the skin or with mother’s milk, or by ingesting larvae in contaminated soil or grass at places like the dog park. Roundworm larvae can be transmitted through a placenta from mother to puppies, mother’s milk or by ingesting infective eggs from the soil in your backyard.⁶

What is heartworm disease?

Heartworm disease is an invisible, but potentially fatal threat that occurs in dogs and other animals. Heartworms (Dirofilaria immitis) are parasitic worms that are transmitted to dogs by infected mosquitoes. Microscopic larvae of heartworms develop and grow under the skin, then migrate to the blood vessels of the heart and lungs of the infected animal where they rapidly grow, becoming adults that are 5-12 inches in length.⁷

How do dogs get heartworms?

Dogs get heartworms by being bitten by an infected mosquito. Larvae are deposited on the skin when the infected mosquito bites, then when the infected mosquito leaves the heartworm larvae enter through the bite wound. One bite is all it takes.³

What are the signs of Heartworm disease?

Not all dogs develop noticeable symptoms. While blood tests performed by your veterinarian are recommended to confirm a diagnosis of heartworm disease in dogs, here are five warning signs that are reported in dogs with advanced heartworm disease:

• A persistent, dry cough is a common sign seen in dogs with heartworm disease.
• Lethargy and reluctance to exercise are also common signs described in dogs with heartworm disease.
• Some dogs have a decreased appetite and, as a result, lose weight.
• As heartworm disease progresses, it can lead to heart failure. You may notice that your dog's belly appears swollen from fluid in the abdomen.
• In the most advanced cases, dogs can develop more severe respiratory issues like rapid and difficulty breathing in addition to coughing.

What is the best way to protect my dog from heartworm disease, hookworms and roundworms?

The best way to protect your dog from heartworm disease, hookworms, and roundworms is by giving them a monthly, year-round, broad-spectrum heartworm disease preventive like HEARTGARD® Plus chewables that also kill hookworms and roundworms every month.

How can I reduce the risk of heartworm disease in my dog?

There are 3 things you can do to help reduce the risk of heartworm disease.

• Reduce mosquito exposure by eliminating standing water where mosquitoes can breed, avoid known mosquito habitats, and limit outdoor exposure during peak mosquito feeding times.³
• Use monthly preventives, like HEARTGARD® Plus chewables, on a year-round basis to safely and effectively prevent heartworm disease by affecting the heartworm larvae before they can grow into dangerous adult heartworms.¹
• Get your dog tested every year. Before getting a prescription for a heartworm disease preventive, your dog should be tested for heartworms. Talk to your vet about testing options.³

Can heartworm disease be treated?

Yes, it can be treated, but heartworm disease is a serious condition that can cause heart failure, permanent damage to your pet's lungs, and even death. Treating heartworm disease is costly and complicated.^7,8

What are HEARTGARD® Plus chewables side effects?

In clinical field trials with HEARTGARD® Plus (ivermectin/pyrantel) chewables, vomiting or diarrhea within 24 hours of dosing was rarely observed (1.1% of administered doses). The following adverse reactions have been reported following the use of HEARTGARD® Plus chewables: Depression/lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions and hypersalivation.

What is the best number to call regarding any specific HEARTGARD® Plus chewables questions?

For any specific product questions, please call the customer service line of Boehringer Ingelheim Animal Health at 1-888-637-4251.

References

• Lynn RC, Duquette RA. Chapter 6. Antiparasitic Drugs. In: Bowman DD, ed. Georgis’ Parasitology for Veterinarians. 11^th ed. St. Louis, MO: Elsevier; 2021: 286-348.
• HEARTGARD® Plus (ivermectin/pyrantel) Chewables [Freedom of Information Summary; NADA140-971]. Duluth, GA: Boehringer Ingelheim Animal Health USA Inc.
• Current Canine Guidelines for the Prevention, Diagnosis, and Management of Heartworm Infections in Dogs 2024. American Heartworm Society. https://www.heartwormsociety.org/images/pdf/2018-AHS-Canine-Guidelines.pdf. Accessed May 10, 2022.
• Data on file at Boehringer Ingelheim
• Data on file at Boehringer Ingelheim
• Carithers D, Miro G. Pet Owner Educational Atlas: Parasites. Zaragosa, Spain: Grupo Asis; 2012.
• Heartworm Basics. American Heartworm Society. https://www.heartwormsociety.org/pet-owner-resources/heartworm-basics. Accessed February 11, 2025.
• Weigh the Costs Infographic. American Heartworm Society. https://d3ft8sckhnqim2.cloudfront.net/images/infographics/0010-weigh-the-costs.jpg. Accessed February 11, 2025 .