Label: IVERHART PLUS- ivermectin/pyrantel tablet, chewable
- NDC Code(s): 51311-170-20, 51311-171-20, 51311-172-20
- Packager: Virbac AH, Inc
- Category: PRESCRIPTION ANIMAL DRUG LABEL
Drug Label Information
Updated January 25, 2024
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- SPL UNCLASSIFIED SECTION
- PRECAUTIONS
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INDICATIONS & USAGE
INDICATIONS: For use in dogs to prevent canine heartworm disease by eliminating the tissue stage of heartworm larvae (Dirofilaria immitis) for a month (30 days) after infection and for the treatment and control of roundworms (Toxocara canis, Toxascaris leonina) and hookworms (Ancylostoma caninum, Uncinaria stenocephala, Ancylostoma braziliense).
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DOSAGE & ADMINISTRATION
DOSAGE: IVERHART PLUS® (ivermectin/pyrantel) Flavored Chewables should be administered orally at monthly intervals at the recommended minimum dose level of 6 mcg of ivermectin per kilogram (2.72 mcg/lb) and 5 mg of pyrantel (as pamoate salt) per kg (2.27 mg/lb) of body weight. The recommended dosing schedule for prevention of canine heartworm disease and for the treatment and control of roundworms and hookworms is as follows:
Dog Weight Flavored Chewable Per Month Ivermectin Content Pyrantel Content Up to 25 lbs 1 68 mcg 57 mg 26 to 50 lbs 1 136 mcg 114 mg 51 to 100 lbs 1 272 mcg 227 mg IVERHART PLUS Flavored Chewables are recommended for dogs 6 weeks of age and older. For dogs over 100 lbs use the appropriate combination of these flavored chewables.
ADMINISTRATION: 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 IVERHART PLUS Flavored Chewables palatable, the product can be ordered to the dog by hand. Alternatively, it may be added intact to a small amount of dog food. 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.
Care should be taken that the dog consumes the complete dose, and 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.
IVERHART PLUS Flavored Chewables should be given at monthly intervals during the period of the year when mosquitoes (vectors), potentially carrying infective heartworm larvae, are active. The initial dose must be given within a month (30 days) after the dog’s first exposure to mosquitoes. The final dose must be given within a month (30 days) after the dog’s last exposure to mosquitoes.
When replacing another heartworm preventive product in a heartworm disease preventive program, the first dose of IVERHART PLUS Flavored Chewables must be given within a month (30 days) of the last dose of the former medication.
If the interval between doses exceeds a month (30 days), the efficacy of ivermectin can be reduced. Therefore, for optimal performance, the flavored 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 IVERHART PLUS Flavored Chewables and resumption of the recommended dosing regimen will minimize the opportunity for the development of adult heartworms.
Monthly treatment with IVERHART PLUS Flavored Chewables also provides effective treatment and control of roundworms (T. canis, T. leonina) and hookworms (A. caninum, U. stenocephala, A. braziliense). Clients should be advised of measures to be taken to prevent reinfection with intestinal parasites.
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SUMMARY OF SAFETY AND EFFECTIVENESS
EFFICACY: IVERHART PLUS Flavored Chewables, given orally using the recommended dose and regimen, are effective against the tissue larval stage of D. immitis for a month (30 days) after infection and, as a result, prevent the development of the adult stage. IVERHART PLUS Flavored Chewables are also effective against canine roundworms (T. canis, T. leonina) and hookworms (A. caninum, U. stenocephala, A. braziliense).
ACCEPTABILITY: In a trial in client–owned dogs, IVERHART PLUS Flavored Chewables were shown to be a palatable oral dosage form consumed at first offering by the majority of dogs.
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PRECAUTIONS
PRECAUTIONS: All dogs should be tested for existing heartworm infection before starting treatment with IVERHART PLUS Flavored Chewables, which are not effective against adult D. immitis. Infected dogs must be treated to remove adult heartworms and microfilariae before initiating a program with IVERHART PLUS Flavored Chewables.
While some microfilariae may be killed by the ivermectin in IVERHART PLUS Flavored Chewables at the recommended dose level, IVERHART PLUS Flavored Chewables are not effective for microfilariae clearance. A mild hypersensitivity-type reaction, presumably due to dead or dying microfilariae and particularly involving a transient diarrhea, has been observed in clinical trials with ivermectin alone after treatment of some dogs that have circulating microfilariae.
Keep this and all drugs out of the reach of children. 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.
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- OTHER SAFETY INFORMATION
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ADVERSE REACTIONS
ADVERSE REACTIONS: In clinical trials with ivermectin/pyrantel, 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 ivermectin: Depression/lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions and hypersalivation.
To report suspected adverse drug events, for technical assistance or to obtain a copy of the Safety Data Sheet (SDS), contact Virbac AH, Inc at 1-800-338-3659 or us.virbac.com. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or http://www.fda.gov/reportanimalae.
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OTHER SAFETY INFORMATION
SAFETY: Studies with ivermectin indicate that certain dogs of the Collie breed are more sensitive to the effects of ivermectin administered at elevated dose levels (more than 16 times the target use level of 6 mcg/kg) than dogs of other breeds. At elevated doses, sensitive dogs showed adverse reactions which included mydriasis, depression, ataxia, tremors, drooling, paresis, recumbency, excitability, stupor, coma and death. Ivermectin demonstrated no signs of toxicity at 10 times the recommended dose (60 mcg/kg) in sensitive Collies. Results of these trials and bioequivalency studies, support the safety of ivermectin products in dogs, including Collies, when used as recommended.
Ivermectin/pyrantel has 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. In clinical trials, many commonly used flea collars, dips, shampoos, anthelmintics, antibiotics, vaccines and steroid preparations have been administered with ivermectin/pyrantel in a heartworm disease preventive program.
In one trial, where some pups had parvovirus, there was a marginal reduction in efficacy against intestinal nematodes, possibly due to a change in intestinal transit time.
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- SPL UNCLASSIFIED SECTION
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INGREDIENTS AND APPEARANCE
IVERHART PLUS
ivermectin/pyrantel tablet, chewableProduct Information Product Type PRESCRIPTION ANIMAL DRUG Item Code (Source) NDC:51311-170 Route of Administration oral Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength IVERMECTIN (UNII: 8883YP2R6D) (IVERMECTIN - UNII:8883YP2R6D) IVERMECTIN 0.068 mg PYRANTEL PAMOATE (UNII: 81BK194Z5M) (PYRANTEL - UNII:4QIH0N49E7) PYRANTEL 57 mg Product Characteristics Color brown Score 2 pieces Shape ROUND Size 9mm Flavor Imprint Code Contains Packaging # Item Code Package Description Marketing Start Date Marketing End Date 1 NDC:51311-170-20 1 in 1 BOX 1 6 in 1 BLISTER PACK Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date ANADA ANADA200302 12/03/2001 IVERHART PLUS
ivermectin/pyrantel tablet, chewableProduct Information Product Type PRESCRIPTION ANIMAL DRUG Item Code (Source) NDC:51311-171 Route of Administration oral Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength IVERMECTIN (UNII: 8883YP2R6D) (IVERMECTIN - UNII:8883YP2R6D) IVERMECTIN 0.136 mg PYRANTEL PAMOATE (UNII: 81BK194Z5M) (PYRANTEL - UNII:4QIH0N49E7) PYRANTEL 114 mg Product Characteristics Color brown Score no score Shape ROUND Size 12mm Flavor Imprint Code Contains Packaging # Item Code Package Description Marketing Start Date Marketing End Date 1 NDC:51311-171-20 1 in 1 BOX 1 6 in 1 BLISTER PACK Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date ANADA ANADA200302 12/03/2001 IVERHART PLUS
ivermectin/pyrantel tablet, chewableProduct Information Product Type PRESCRIPTION ANIMAL DRUG Item Code (Source) NDC:51311-172 Route of Administration oral Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength IVERMECTIN (UNII: 8883YP2R6D) (IVERMECTIN - UNII:8883YP2R6D) IVERMECTIN 0.272 mg PYRANTEL PAMOATE (UNII: 81BK194Z5M) (PYRANTEL - UNII:4QIH0N49E7) PYRANTEL 227 mg Product Characteristics Color brown Score no score Shape ROUND Size 16mm Flavor Imprint Code Contains Packaging # Item Code Package Description Marketing Start Date Marketing End Date 1 NDC:51311-172-20 1 in 1 BOX 1 6 in 1 BLISTER PACK Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date ANADA ANADA200302 12/03/2001 Labeler - Virbac AH, Inc (131568396) Registrant - Virbac AH, Inc (131568396) Establishment Name Address ID/FEI Business Operations Virbac Corporation 829166276 manufacture, analysis, label Establishment Name Address ID/FEI Business Operations Shandong Qilu King-Phar Pharmaceutical Co., Ltd. 421524323 api manufacture Establishment Name Address ID/FEI Business Operations Cosma S.p.A 428655732 api manufacture Establishment Name Address ID/FEI Business Operations Cipla Limited Manufacturing Division 916940208 api manufacture Establishment Name Address ID/FEI Business Operations SOLARA ACTIVE PHARMA SCIENCES LIMITED 676159823 api manufacture Establishment Name Address ID/FEI Business Operations Eurofins SF Analytical Laboratories Inc 119127666 analysis Establishment Name Address ID/FEI Business Operations Particle Technology Labs 808076947 analysis Establishment Name Address ID/FEI Business Operations Alcami Carolinas Corporation 117877975 analysis