KAC

We now carry NexGard®, a new flea and tick chewable from the makers of HeartGard® and FrontLine Plus®. It is a prescription product designed to treat and prevent flea infestations and treat and control the American dog tick (Dermacentor variabilis) in dogs and puppies for one month. The most frequently reported adverse reactions include vomiting, dry or flaky skin, diarrhea, lethargy and anorexia.  As with all prescritpion medications, you should discuss it with your veterinarian before deciding to put your dog on NexGard. There is currently a promotion by the manufacturer where if you buy HeartGard & NexGard at the same time you'll get a $25 mail in rebate.

We also carry Comfortis®, Frontline Plus®, Frontline Tritak®, Revolution® (For cats), Advantage Multi®, Seresto® and Advantix®, so there are a number of options available! We recommend HeartGard for most canine patients for heartworm protection. Since Comfortis is the product most similar to NexGard®, we have provided a comparison below based on information from the National Institutes of Health published labels for each. Follow the links in the table to view the actual labels.

	Comfortis	NexGard
NIH Label URL	http://tinyurl.com/lgj63te	http://tinyurl.com/kgsjzpe
Active Ingredient	spinosad	afoxolaner
Indication	kills fleas and is indicated for the prevention and treatment of flea infestations (Ctenocephalides felis), for one month, on cats and kittens 14 weeks of age and older and two pounds of body weight or greater.	kills adult fleas and is indicated for the treatment and prevention of flea infestations (Ctenocephalides felis), and the treatment and control of American Dog tick (Dermacentor variabilis) infestations in dogs and puppies 8 weeks of age and older, weighing 4 pounds of body weight or greater, for one month.
Contraindications	There are no known contraindications for the use of COMFORTIS.	There are no known contraindications for the use of NEXGARD.
Precautions	Use with caution with concomitant extra-label use of ivermectin. The safe use of COMFORTIS in breeding, pregnant, or lactating cats has not been evaluated.	The safe use of NEXGARD in breeding, pregnant or lactating dogs has not been evaluated. Use with caution in dogs with a history of seizures
Most Common Adverse Reactions reported in order of occurence (> 1%)	Vomitting Lethargy Anorexia Weight Loss Diarrhea	Vomitting (with & without blood) Dry / Flaky skin Diarrhea (with & without blood) Lethargy Anorexia
Effectiveness	Begins to kill fleas 30 minutes after administration 98% effective within 4 hours 100% effective within 24 hours >90% effective on Day 30 Existing Flea infestations 97.5% reduction after 1 month, 99.3% after 3 months	>= 93% effective at 12 hours post infestation through day 21 81.1% effective at 12hours post infection on day 28 100% effective against adult fleas 24 hours post infestation for 35 days Existing Flea infectations 98%, 99.7%, 99.9% at 30, 60 and 90 days. >97% effectiveness against Dermacentor variabilis, 48 hours post-infestation for 30 days.
Kills Ticks	No	Yes (One species of tick)
Available for Cats	Yes	No
Cost	$$$	$$$$
Rebates Available	$10 MIR	$25 MIR with purchase of HeartGard

* Since this was originally published, some label information on NexGard has changed, including the listing of additional tick species that the product is effective against. See the NIH links above for the most recent versions.