Frontline Vs Others

[Guest june]

I used Comfortis and it works great. .... It must be given with food as it has caused some really serious side effects in dogs.

Can you expand on the "really serious side effects"?

 

Giving it with food is necessary to make sure it absorbs maximally to provide the full month of protection. It also helps to reduce the risk of vomiting. There are a small percentage of dogs that vomit (usually just once) after their first dose of Comfortis, even if given with food. And most of these dogs are fine for subsequent doses. We've been carrying Comfortis at the clinic and using it for our own dogs since it came out, and have found it to be a safe medication.

 

I've had a couple patients that couldn't tolerate it (had GI upset and lethargy for a few days that cleared up without treatment) even if it was given with food. For those, I just recommended not using it anymore and going back to one of the topicals. Had one owner who tried it for 4 months, with the same side effect each time, before he told me, and I told him to stop giving it!

 

For those of you using Comfortis and Heartgard, or Comfortis and Interceptor, ask your vet about Trifexis. It's Comfortis along with the active ingredient in Interceptor in the same tablet.

 

The really serious side effects are pretty much what you listed. There have been incidents of dogs having uncontrolled vomiting and becoming dehydrated and I think there was at least one incident where a dog died. This is not the norm, but on the package it does warn to give it with a meal to help avoid the stomach upset. It can also cause drooling and one of my dogs becomes very vocal for a few hours after taking it.

 

My vet has the Trifexis, but I haven't tried it yet. I really like for a new product to be on the market for a while before I try it. Right now I give my Intercepter at the beginning of the month and my flea treatment in the middle of the month. No support for this but I feel more comfortable giving them at different times as it seems it would be easier on the dogs.

june

[Guest LindsaySF]

I do the same thing June.

 

Thanks for the Frontline/tick info Jing!

[JJNg]

I don't think you want to use a Preventic if you have cats or serious chewers? but I won't swear to the cats part.

Preventic collars are ok to use on dogs that live with cats. Even direct contact with the collar or dog doesn't expose the cat to enough of the amitraz to cause a problem. Just don't actually put it on the cat, or let the cat eat it. Dogs can have serious side effects from eating the collar too.

 

The really serious side effects are pretty much what you listed. There have been incidents of dogs having uncontrolled vomiting and becoming dehydrated and I think there was at least one incident where a dog died.

I don't consider the side effects I mentioned to be serious because they were all self limiting. I haven't seen any dogs that needed to be treated for the mild side effects they had from Comfortis. Even the couple patients I've had who had more persistent vomiting, diarrhea, and lethargy, it wasn't serious enough to cause dehydration or require any treatment, and the dog was back to normal after 3-4 days.

 

Did you personally know the dogs that had "uncontrolled vomiting" and became dehydrated? Any more info about the possible death? Did these dogs receive vet care, and were the cases reported to Elanco/Lilly? What is your source for this info? Don't mean to belabor the point, but I feel it's important to clarify these types of reports about meds. If they are true, we need to be aware of these issues and investigate further. If they're not true, we shouldn't contribute to unproven rumors being spread on the internet.

[Guest june]

 

 

I don't consider the side effects I mentioned to be serious because they were all self limiting. I haven't seen any dogs that needed to be treated for the mild side effects they had from Comfortis. Even the couple patients I've had who had more persistent vomiting, diarrhea, and lethargy, it wasn't serious enough to cause dehydration or require any treatment, and the dog was back to normal after 3-4 days.

 

Did you personally know the dogs that had "uncontrolled vomiting" and became dehydrated? Any more info about the possible death? Did these dogs receive vet care, and were the cases reported to Elanco/Lilly? What is your source for this info? Don't mean to belabor the point, but I feel it's important to clarify these types of reports about meds. If they are true, we need to be aware of these issues and investigate further. If they're not true, we shouldn't contribute to unproven rumors being spread on the internet.

 

Do a Google search: Comfortis, side effects

here is one article I picked at random

http://www.examiner.com/pet-health-in-atlanta/comfortis-flea-treatment-causes-vomiting-and-death-dogs

 

The following is from this website:

http://www.drugs.com/pro/comfortis.html

 

Post Approval Experience (June 2009):

The following adverse reactions are based on post-approval adverse drug event reporting. The adverse reactions are listed in decreasing order of frequency: vomiting, depression/lethargy, anorexia, ataxia, diarrhea, pruritus, trembling, hypersalivation and seizures.

 

Following concomitant extra label use of ivermectin with Comfortis, some dogs have experienced the following clinical signs: trembling/twitching, salivation/drooling, seizures, ataxia, mydriasis, blindness and disorientation.

 

Post approval experience continues to support the safety of Comfortis when used concurrently with heartworm preventatives according to label directions.

 

Please understand, I am not saying it can't be used, but I am saying it needs to be used with caution and following the label directions.

[Guest jbbuzby]

I get Revolution free from work for being a veterinary employee, which has thus far seemed to work well for my grey with no chemical burns or reactions. However, I was too afraid to use the tick collar that comes along with it because of all the fore-warnings about flea collars on these guys. Is it safe, or should I continue to not bother?

[NancyB]

I just went through this recently. I found some fleas and asked my vet what I should use, if anything, on Albi (has cancer, had an amputation). She told me she prefers Advantage over any of the Frontline products, it works better.

[JJNg]

Do a Google search: Comfortis, side effects

I searched for both "comfortis side effects" and "comfortis death". Mostly what I got out of browsing the search results were a few unsubstantiated claims from owners blaming Comfortis for deaths that probably had nothing to do with the product. If you search the internet, you can find similar claims for just about any prescription medication on the market. Sorry, but in general, I don't consider people with no medical knowledge posting on web forums to be the best source of product information.

 

I'm not saying that it's a completely safe product - all drugs have side effects. Nor am I discounting all anecdotal accounts. I do believe it is important to look more closely at these cases. I can see some validity in claims of liver failure; since the liver is the organ that processes most chemicals that are ingested, that can be a potential reaction to just about any medication. But while Comfortis can cause vomiting, even intense vomiting does not cause the stomach to 'tear loose and twist' as that article claimed. Also found a report of a 12 year old dog that died 5 weeks after getting a dose of Comfortis, for which the tablet was blamed.

 

Please understand, I am not saying it can't be used, but I am saying it needs to be used with caution and following the label directions.

I'm glad you're making this point, and I think it's very important to emphasize this for all meds. However, the label and even the FDA Post Approval Experience side effects do not include death. I would seriously reconsider recommending a flea control product if I believed that death was a potential result (other than a freak accident, like choking to death on it, or a rare idiosyncratic reaction that can happen with anything). Even following label directions does not eliminate all risk, as there are always individuals that are going to show side effects. The most common side effect of vomiting is seen in a small percentage of dogs even when the appropriate dose is given with food as instructed.

 

The following adverse reactions are based on post-approval adverse drug event reporting. The adverse reactions are listed in decreasing order of frequency: vomiting, depression/lethargy, anorexia, ataxia, diarrhea, pruritus, trembling, hypersalivation and seizures.

With the exception of seizures, all of the other listed adverse reactions can range from mild to severe. And this list doesn't break it down into degree of severity. As I mentioned before, in my personal experience, all the side effects I've seen have been mild. (Doesn't mean more serious cases don't happen - I just haven't seen or heard about them.) The label specifically says to 'use with caution' in dogs with epilepsy. However, it is not a contraindication, and after serious discussion, I've had a couple owners with dogs who are epileptic and have occasional seizures (less than 2-3 a year) elect to still use Comfortis. They have not had any problems, nor any seizures which were thought to be triggered by the medication.

 

Following concomitant extra label use of ivermectin with Comfortis, some dogs have experienced the following clinical signs: trembling/twitching, salivation/drooling, seizures, ataxia, mydriasis, blindness and disorientation.

This is an important drug interaction, and one that all vets need to be aware of. This is only seen with the high doses of ivermectin used to treat demodectic mange (doses in the range of 50-100 times the HW preventative dose, given daily). The signs seen are not directly due to the Comfortis. It is due to a drug interaction in which the Comfortis increases absorption of the ivermectin, so the signs are due to ivermectin toxicity.

[Guest june]

I'm not saying that it's a completely safe product - all drugs have side effects. Nor am I discounting all anecdotal accounts. I do believe it is important to look more closely at these cases. I can see some validity in claims of liver failure; since the liver is the organ that processes most chemicals that are ingested, that can be a potential reaction to just about any medication. But while Comfortis can cause vomiting, even intense vomiting does not cause the stomach to 'tear loose and twist' as that article claimed.

 

Like you, I feel it is important that owners understand all the risks associated with the use of products. I do understand the difference between anecdotal reports and research findings, but sometimes am suspect about research that is done by the developing drug company. Also side effects can present when a drug is used in an uncontrolled environment such as the interaction between large doses of ivermectin and comfortis. On the other hand drug companies have become more diligent in their research over the years.

 

As I stated before I have and do use Comfortis with my dogs. It is an effective product, but it also is a very strong drug that needs to be used correctly and according to label directions. Too many people don't read the labels of products they use.

 

On an aside: I have to say though, if my dogs had experienced vomiting and lethargy for several days after taking this or any drug they would not have been given the medication again. I guess my idea of serious side effects and yours differ.

[Batmom]

Thanks for posting your thoughts and analysis, jjng.

 

As you note, you can find anecdotal reports of just about anything on the internet, and you can find warnings about side effects on pretty much any package of medication you might give your pet or take yourself.

 

 

[JJNg]

I do understand the difference between anecdotal reports and research findings, but sometimes am suspect about research that is done by the developing drug company.

Oh, I'm always suspicious of research done by drug companies. Whether done by biased companies, or impartial (if that exists) researchers, many scientific studies are flawed and results are suspect. I'm also usually not one to jump on new products as soon as they come out, but I liked what I saw with Comfortis and Trifexis, and they fill a much-needed niche. So far, they have not disappointed.

 

On an aside: I have to say though, if my dogs had experienced vomiting and lethargy for several days after taking this or any drug they would not have been given the medication again. I guess my idea of serious side effects and yours differ.

Just want to clarify, for the few cases that have experienced vomiting and lethargy lasting several days, I do not recommend continuing to use Comfortis. The dog that did this for 4 months in a row was given the doses by his owner (human doctor, btw), without consulting with me. He even asked about trying Comfortis again the next year, but I gave him an adamant no. Also had a greyhound who experienced the same side effects. She weighed about 62 lbs, and since she was close to the cut-off between 2 sizes (60-120 lbs or 40-60 lbs), we went down to the lower dose, and she's been fine with it ever since.

 

While still unusual, the more common side effect is vomiting 1 time following the dose, with no other problems. Most of these dogs do fine with their next dose. I understand that relative severity of side effects is somewhat subjective. Personally, if vomiting and lethargy resolve on their own in a few days without needing any treatment, I wouldn't consider it too serious. But if it's persistent vomiting that leads to dehydration and requires medical treatment, I'd consider that serious. So far, I haven't seen any cases of the latter with Comfortis.

Edited October 13, 2011 by jjng

[Guest Cardiffcouple]

I was going to start a topic on fleas but here you are. After years and years of successfully using Frontline we have a flea infestation. Mercy and Ben are covered with scabs from scratching so much. We stripped the house, practically boiled their bedding, vacuumed over and over, tossing the bags each time (ouch! $$$). Ben and Mercy have been bathed more in the past three weeks than the whole year and a half we have had them. As of last night we are still losing this battle. Our vet gave us a number to call to the company that makes Frontline. Apparently they have had a lot of complaints this year about Frontline not working. They are asking for proof of purchase for the last three months and they "might" consider you for an in-home inspection and a treatment by Terminix. Well, I doubt we could have the treatment because of how sensitive the greys are.

 

Before I saw this topic I was going to ask if anyone had any suggestions on what to do but it doesn't sound as though anyone is dealing with a flea infestation. (We don't have tick issues here.)

 

Anyone have anything to offer that might help our poor kids?

 

Thanks!

[Guest verthib]

Thank you everyone for writing. My final thought on this is, after continuing to find multiple fleas PER DAY on my dogs, is we are going to try switching to Advantix. If Frontline only kills ticks after 24-48 hours, that gives the tick enough time to transmit Lyme disease. If we are finding multiple ticks on our animals per day, I am definitely concerned about Lyme. I also don't like picking blood-bloated ticks off my animals. If Advantix repells ticks, it seems to be a no brainer. From what I understand on this forum, other greyhound owners use Advantix with no adverse events, so I'm willing to try that. Thank you everyone for your input! This forum has been so helpful !

[Guest greyers]

Frontline us to work great for my house, hounds and cats, but last year was a really bad year and my vet suggested switching it up and sometimes using advantage so we did. The results were much much better.

 

This year we had no issue until recently and the frontline only stopped thing (or slowed them down) for about a week. We got the newer advantage 2 and it worked fabulous on all our cats and dogs. Might be worth a try for you. Not sure if anyone else on here has had good success with advantage 2??

[JJNg]

If Frontline only kills ticks after 24-48 hours, that gives the tick enough time to transmit Lyme disease. If we are finding multiple ticks on our animals per day, I am definitely concerned about Lyme. I also don't like picking blood-bloated ticks off my animals. If Advantix repells ticks, it seems to be a no brainer.

If you have that much of a tick problem, you may want to ask your vet about the new product Certifect, which I mentioned in post #19 earlier in this thread. In the clinical trials so far, I believe Certifect has shown 100% efficacy against ticks in a 6-18 hr period, which is significantly better than any other product on the market. Disclaimer: I haven't tried this product myself, and it's brand new to the market, but the active ingredients have been around for a long time. It's essentially Frontline plus a lower dose of the same active ingredient in Preventic collars.

 

While Advantix may have a 'repel' claim on the label, it is far from 100%. Studies show that it only repels about 60-80% of the time and only for about 3 weeks. The ticks that aren't repelled can take up to 48 hours to die. I also found a study that showed Frontline may be a little more effective at killing the ticks that do attach than Advantix. IMO, both are decent products for ticks, but neither is great.

 

If you're looking for a more established product than Certifect, I'd got with a Preventic collar. I know others on here have used it on their greys with no problems. I believe their label claim is 92% efficacy after 24 hrs. Couldn't find any data on how well it actually repels, but most of the anecdotal reports I've heard have been good.