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Trifexis (spinosad/milbemycin oxime)

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Treatment Type: Antiparasitics
Caregiver: Needs a Prescription from a Vet - then Do it Yourself

Trifexis (spinosad/milbemycin oxime) combines an insecticide (spinosad), which kills adult fleas, with a broad spectrum antiparasitic medication (milbemycin oxime) that kills heartworm as well as intestinal worms such as hookworms, whipworms, and roundworms.

If your dog is an indoor pet and you don't need tick prevention, Trifexis might be the only treatment you'll need for fleas and internal parasites. However, because Trifexis does not kill ticks, it is not the best product if your dog is exposed to ticks.

Trifexis Dosage and Administration

Trifexis (spinosad/milbemycin oxime) is a 3-in-1 parasite protection which is given as a flavored tablet once a month. Trifexis can be used in puppies 8 weeks and older, and 5 pounds and greater.

Before using Trifexis, you must test your dog for an existing heartworm infection. Trifexis will kill any immature heartworms the dog was exposed to in the preceding month. If your pet already has intestinal parasites your veterinarian will likely prescribe an additional dewormer to clear the existing infection and then you will continue to give a monthly preventative.

Trifexis is available in six different dosage sizes, for dogs:

  • 5 - 10 lbs. (2.2 - 4.5 kg)
  • 10.1 - 20 lbs. (4.5 - 9 kg)
  • 20.1 - 40 lbs. (9 - 19 kg)
  • 40.1 - 60 lbs. (19 - 27 kg)
  • 60.1 - 120 lbs. (27 - 54 kg)

Trifexis Cost and Availability
In the United States and Canada, Trifexis, and its competitor Bravecto (fluralaner), each cost around $15 per month (when you take into account Bravecto only has to be given once every 3 months). Trifexis is not available on Amazon or over-the-counter in pet stores, and needs to be purchased at a veterinary clinic, or online pet med drugstore with a prescription.

Elanco offers a Trifexis rebate of $25 after purchasing a 12 month supply (a 10% discount).

Trifexis Side Effects and Safety
A 2015 European study, found that, "Trifexis(®) was shown to be safe and effective against natural infestations of fleas as well as mixed and single intestinal nematode infections in client owned dogs in Europe when administered as a single oral administration at the recommended dose."

According to the Trifexis product labeling, "The most common adverse reactions reported are vomiting, depression/lethargy, itching, decreased appetite, and diarrhea. In a well-controlled US field study, which included a total of 352 dogs (176 treated with TRIFEXIS and 176 treated with an active control), no serious adverse reactions were attributed to administration of TRIFEXIS. All reactions were regarded as mild."

Compare Trifexis with Other All-in-One Dog Parasite Meds

Trifexis vs Bravecto Bravecto Trifexis
Kills Fleas X X
Repels Fleas No No
Kills Flea Eggs and Larvae X X
Prevents Flea Egg Development X X
Kills Ticks X No
Repels Ticks No No
Kills / Repels Mosquitoes No No
Prevents Heartworm No X
Kills Internal Parasites No X
Price per Month $15 / month $15 / month

Trifexis vs Sentinel Sentinel Trifexis
Kills Fleas No X
Repels Fleas No No
Kills Flea Eggs and Larvae No X
Prevents Flea Egg Development X X
Kills Ticks X No
Repels Ticks No No
Kills / Repels Mosquitoes No No
Prevents Heartworm X X
Kills Internal Parasites X X
Price per Month $7 / month $15 / month

Trifexis vs NexGard Nexgard Trifexis
Kills Fleas X X
Repels Fleas No No
Kills Flea Eggs and Larvae No X
Prevents Flea Egg Development X X
Kills Ticks X No
Repels Ticks No No
Kills / Repels Mosquitoes No No
Prevents Heartworm No X
Kills Internal Parasites No X
Price per Month $16 / month $15 / month

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