Major Uses

Milbemycin oxime and lufenuron are two different drugs that may be combined to prevent heartworm disease, control fleas, and remove hookworms, roundworms, and whipworms in dogs and puppies. This product is not for use in cats or kittens.

Milbemycin oxime is a macrocyclic anthelmintic that interferes with invertebrate neurotransmission. The drug works to eliminate heartworm, hookworm, roundworm, and whipworm infestations.

Lufenuron is an insect development inhibitor that interferes with chitin production to prevent egg development. It does not kill adult fleas, but rather is passed from mother flea to larvae to prevent hatching and survival, thereby breaking the flea lifecycle.

Common Precautions

Side effects are not typically seen. Rarely, diarrhea, vomiting, itchy skin, and loss of appetite may occur. If the combination of milbemycin oxime and lufenuron is administered to a heartworm positive dog, a severe shock-like reaction may develop.

The milbemycin oxime and lufenuron combination does not kill adult fleas and may therefore not be suitable for dogs with flea bite allergies or severe flea infestations. Ideally, milbemycin oxime and lufenuron should be used in combination with an adulticide. Milbemycin oxime and lufenuron are not for human use. This combination of drugs is not safe for puppies less than four weeks or age and less than two pounds of body weight. No adverse events have been associated with using these drugs in pregnant, lactating, or breeding animals.

Dogs should be tested for heartworm infection before beginning treatment with milbemycin oxime and lufenuron. Dogs with existing infections should be treated for adult heartworms and microfilariae proper to beginning use of milbemycin oxime and lufenuron.

Milbemycin oxime and lufenuron should not be used in animals with a known allergy or hypersensitivity to the drug. Any known or suspected overdose should be reported to a veterinarian right away.


Milbemycin oxime and lufenuron should be stored in a dry location at room temperature, in the original packaging, and away from children and pets.


Milbemycin oxime and lufenuron in combination come as flavor tabs in four sizes, with each tablet size available in a color-coded package for easy administration.

Dosing is based on body weight. Milbemycin oxime and lufenuron are administered orally and once a month at the minimum dosage of 0.23 mg/lb (0.5 mg/kg) milbemycin oxime and 4.55 mg/lb (10 mg/kg) lufenuron.

Doses may vary in different species, when the drug is given by a different route or concurrently with other medications, and with regards to a patient's age, breed, and health status. A veterinarian's dosing instructions and/or those printed on the medication label should be followed closely.

If the dog undergoing treatment refuses to accept the tablet, it can be hidden in food. It is extremely important that the dog consumes the entire tablet(s). This combination of drugs must be administered with or after a full meal for proper absorption.

The drug combination is most effective when given once a month, on the same day of each month. If a dose is missed, it should be given as soon as possible and the dosing schedule should be adjusted. It is important not to give two doses of this product at the same time.

This information is for general reference only and should not be used for the diagnosis or treatment of any condition of your pet. It's intended as a general reference, this information may not include all possible uses, precautions, directions, reactions (including allergic), drug interactions, or withdrawal times. Always consult your local veterinarian and have your pet examined for any advice concerning the diagnosis and treatment of your pet, including which products and doses are most appropriate. Any trademarks are the property of their respective owners. VetDepot is not a pharmacy. All prescription products are dispensed by our Pharmacy Partner. Article last updated 2/2014.