As parasite season approaches (or continues depending on where you live!) choosing the right heartworm/flea/tick preventatives can be a challenge. The market is flooded with choices and it can be confusing for the pet owner to know what to use and also hard for the veterinary clinic to know what to stock! It would be nice if there was one perfect, safe, effective, economical product that eliminated all parasites. But, there is no such thing. My focus today will be on products that control one or more of the following-Heartworms, fleas, and ticks, although many products also control additional parasites.
As a side note Heartworm prevention (and sometimes flea prevention) is recommended year round where I live but may vary in other parts of the country. Check with your vet about what is recommended for you.
Advantage (Imidacloprid) is a topical product for both dogs and cats. Advantage controls only fleas and lasts for 30 days. Advantage is a very safe product and has a relatively fast kill rate. It is available over the counter.
Advantage Multi (Imidacloprid/Moxidectin) is also a once monthly topical product for dogs and cats. Advantage multi controls heartworms, fleas, hookworms, roundworms, whipworms, and ear mites. It does NOT control ticks. While I have not used this product personally it sounds like a good choice for someone looking for broad spectrum parasite control. A recent study showed that it performed very well as a heartworm preventative against a tough strain of heartworms. This is a prescription product.
Capstar (Nitenpyram) is an oral tablet that kills all live fleas on the pet within approximately 30 minutes. It only lasts 24 hours. Personally, I think this product is a waste of money for most pet owners. The only time this product is useful is if your pet picked up few fleas at the dog park, etc. However, if you don't know how long the fleas have been there they may have already laid eggs, or if you are not sure where the fleas came from (as in, they might be in your yard) then this product won't eliminate the problem. At a cost of $3-$6 apiece you can spend about $10 more and get one of the 30 day products. Capstar is available for both dogs and cats.
Comfortis (Spinosad), commonly known as the "flea pill" is a chewable tablet that controls fleas for 30 days. For those concerned with chemicals in their pet Comfortis is a nice choice because spinosad has been awarded the green chemistry award and is approved in a topical version for organic farming. Comfortis should be given with food as it makes the occasional pet vomit. It is only approved for dogs, largely because cats will not eat it. Comfortis kills fleas within four hours before there is a chance to lay eggs. This is what I use in my personal dogs most of the time. It is a prescription product.
Frontline Plus (Fipronil/(s)-methoprene) is a topical product for dogs and cats lasting 30 days. Frontline kills ticks and all stages of fleas including flea eggs. Many people have expressed concern that Frontline is not working as well as it used to. It's hard to say if this is due to compliance or flea resistance but may be a combination of both. Frontline is available over the counter.
Heartgard Plus (Ivermectin/Pyrantel) is a meaty chewable tablet that is give once monthly. Heartgard controls heartworms, roundworms and hookworms. It is available for dogs and cats and is a prescription product.
Interceptor (Milbemycin oxime) is a once monthly chewable tablet that controls heartworms, hookworms, roundworms, and whipworms. It is a prescription product and is available for dogs and cats. This is my product of choice for my personal dogs.
Iverhart Plus and Tri-heart Plus (Ivermectin/Pyrantel) are essentially generic versions of Heartgard but do not come in a meaty tablet.
K9 Advantix (Imidacloprid/Permethrin) is a once monthly topical product. This product was Bayer's attempt to get in on the tick market. This product control fleas and ticks and repels mosquitoes. However, there are some studies that show the addition of the permethrin reduces the length of the flea killing to 3 weeks. Although it claims to repel mosquitoes this product should not be used as an alternative to to heartworm prevention. This product is for dogs only and use on cats can cause a toxic reaction to the permethrin.
Preventic collars (Amitraz) control ticks for 3 months and is available for dogs. Amitraz is not safe for cats.
ProMeris (Metaflumizone/Amitraz) is a once monthly topical that controls fleas and ticks. ProMeris is widely known for it's unpleasant odor and because the amitraz has made several dogs ill. Based on the places I have worked it seems this is a relatively unpopular product and I don't recommend it. It's most useful niche is as a very convenient treatment for demodectic mange. There is a cat version that does not contain amitraz and only controls fleas.
Revolution (Selamectin) is a once monthly topical product for dogs and cats. Revolution controls heartworms, roundworms, hookworms, fleas, ticks and ear mites. However the Revolution works best on ticks after several months of consecutive use. For this reason the company provides a free preventic collar with purchase of a six month supply of Revolution (for dogs only). At least that was still true last time I checked! Revolution is my product of choice for cats although Advantage multi is likely similar. Revolution is a prescription product.
Sentinel (Milbemycin/lufenuron) is an overrated product in my opinion. This products controls heartworms, hookworms, roundworms, and whipworms and sterilizes flea eggs but does not kill live fleas. For approximately the same price you can use Interceptor and one of the better flea products. This is a prescription product.
Vectra 3D (Dinotefuran/permethrin/pyriproxyfen) is a once monthly topical for fleas and ticks. The 3D product is for dogs and cannot be used on cats due to permethrin toxicity. There is a Vectra for cats minus the permethrin which only controls fleas.
Proheart 6 (Moxidectin) is an injectable product that controls heartworms for 6 months and roundworms and hookworms for approximately 3 months. Blood levels of Moxidectin drop to nearly negligible levels at the end of the six months so it is important to not be late for the next injection. Use of the product has some restrictions and requires signing a consent form.
*New* Trifexis (Milbemycin/Spinosad) just arrived on the market and is essentially Interceptor and Comfortis combined in one chewable pill. As these are my favorite products I'm anxious to see how this product performs. It will control heartworms, hookworms, roundworms, whipworms and fleas. This cost is reported to be only slightly higher than Comfortis alone.
This may not make it any easier to choose but hopefully it will make it less confusing!