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NexGard Combo For Cats 5.5-16.5 lbs (2.5-7.5 kg)
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Description
NexGard COMBO For Cats 5.5-16.5 lbs (2.5-7.5 kg) is a monthly topical parasiticide from Boehringer Ingelheim that unites three active ingredients, 10.8 mg esafoxolaner, 3.6 mg eprinomectin, and 74.7 praziquantel, in a 0.9 mL single-dose applicator. Each application provides concurrent protection against fleas, ticks, heartworm disease, roundworms, hookworms, and tapeworms. For cats exceeding 16.5 lbs, dosing table specifies combinations of applicators to reach the minimum labeled dose per kilogram.
Recommended for
Cats and kittens weighing 5.6 lbs to 16.5 lbs (2.5 kg to 7.5 kg) from 8 weeks of age.
Indication/Coverage
For cats suffering from, or at risk from, mixed parasitic infections:
- Flea treatment and prevention: Eradicates adult fleas (Ctenocephalides felis) and suppresses new infestations for a full month per dose; achieves flea kill before eggs can be deposited into the environment.
- Tick treatment and control: Delivers ≥95.1% efficacy against Ixodes scapularis (black-legged tick) at 48 hours post-infestation and ≥95.6% efficacy against Amblyomma americanum (lone star tick) at 72 hours post-infestation, sustained for one month.
- Heartworm disease prevention: Eprinomectin halts Dirofilaria immitis larval development before maturation into adult heartworms; requires consistent monthly dosing, with a minimum of three consecutive doses following the cat’s last mosquito exposure.
- Roundworm treatment and control: Resolves fourth stage larval and adult Toxocara cati infections; ongoing monthly application prevents reestablishment of roundworm burdens throughout the year.
- Hookworm treatment and control: Effective against fourth stage larval and adult Ancylostoma tubaeforme and adult Ancylostoma braziliense in one dose.
- Tapeworm treatment: Praziquantel eliminates adult Dipylidium caninum per application; monthly dosing addresses reinfection from continued flea-transmitted tapeworm exposure.
Key Benefits
The characteristics below are drawn directly from the FDA-approved label and Boehringer Ingelheim’s controlled study results for the 0.9 mL applicator:
- Mid-range weight calibration: The 0.9 mL applicator delivers 10.8 mg esafoxolaner, 3.6 mg eprinomectin, and 74.7 mg praziquantel, dosed precisely for cats between 5.6 lbs and 16.5 lbs, covering the body weight bracket occupied by the majority of adult domestic cats.
- Single-dose multi-parasite action: One monthly topical deposit replaces what would otherwise require separate flea, tick, heartworm preventive, and intestinal deworming products administered individually.
- Isoxazoline-driven flea elimination: Esafoxolaner inhibits GABA-gated chloride channels in the flea nervous system, inducing prolonged hyperexcitation and death; laboratory data confirm over 92% of adult fleas destroyed within 24 hours of first application.
- Sustained reproductive disruption in fleas: Egg production control of 99.8% to 100% was recorded at 24 hours post-reinfestation and maintained across the entire monthly dosing period, preventing environmental flea egg accumulation.
- Complete heartworm block in controlled trials: Three consecutive monthly treatments beginning one month before larval inoculation yielded 100% prevention of Dirofilaria immitis development in laboratory studies.
- Topical route for oral-resistant cats: Cats that refuse chewable medication or exhibit distress during oral administration receive equivalent systemic parasite coverage through transdermal absorption at the base of the skull, with no requirement for ingestion.
- Roundworm clearance documented at 98.9-100%: Controlled laboratory studies using the dose-limiting species Toxocara cati recorded near-complete to complete elimination of adult roundworm infections.
Caution
Hazards to Humans
NexGard COMBO is exclusively for animal use. The solution acts as a mild to moderate eye irritant. Avoid contact with the skin and eyes during handling; if the product enters the eyes, flush immediately and thoroughly with water. Wash hands with soap and water directly after each application. Store all applicators where children cannot see or access them. Do not allow the product to contaminate food preparation areas or drinking water.
Hazards to Domestic Animals
This formulation is for topical external use on cats only and is not intended for oral administration; cats that ingest the product through licking display excessive hypersalivation due to the excipient profile. The 0.9 mL applicator is designated for cats from 5.6 lbs to 16.5 lbs (2.5 kg to 7.5 kg), at a minimum age of 8 weeks. Esafoxolaner, the isoxazoline-class component, carries an FDA-mandated label warning for neurologic adverse reactions, including tremors, ataxia, and seizures, which have occurred in cats with and without prior neurologic history. Use with caution in cats with known seizure disorders. The safety profile in breeding, pregnant, or lactating cats has not been fully established through controlled studies.
Possible Side Effects
Closely observe your cat for the initial 24 to 48 hours after each NexGard COMBO dose, particularly noting any shifts in appetite, energy level, or skin condition at the treated area.
The following adverse reactions were identified during Boehringer Ingelheim’s 90-day field safety study conducted across 201 households, in which 244 cats received NexGard COMBO:
- Dermal reactions: Hair change at the application site was reported in 3.69% of treated cats, skin peeling in 1.23%, redness at the deposit site in 0.82%, hair loss in 0.82%, and dermal thickening in 0.82%. These localized findings were generally self-resolving.
- Gastrointestinal signs: Vomiting occurred most frequently at 6.56%, with anorexia reported in 2.87% and diarrhea in 1.23% of treated cats.
- Systemic signs: Lethargy was observed in 2.46%, hyperthermia in 1.23%, and hypersalivation in 1.23%. Hypersalivation was predominantly associated with cats that groomed the wet application area before it had dried fully.
- Isoxazoline class advisory: All isoxazoline-class products, including NexGard COMBO, carry FDA-required labeling regarding the potential for neurologic adverse events (tremors, ataxia, seizures) in cats regardless of prior neurologic status.
Direction
NexGard COMBO For Cats 5.5-16.5 lbs is a topical spot-on administered once monthly to dry skin at the midline of the neck, between the base of the skull and the shoulder blades. Prevent the solution from making contact with your eyes during the application process. Apply at a point the cat cannot reach with its tongue to minimize licking, and isolate treated cats from other household pets for a minimum of 4 hours or until the deposit site has dried visibly.How to Open
- Cut the blister packaging along the dotted line with scissors.
- Peel back the lid to uncover the applicator within.
- Extract the applicator and hold it vertically, tip upward. Pull the plunger back a small distance to prevent solution from dripping when the cap is removed.
- Twist the cap and pull it away completely. The applicator is now ready to dispense.
How to Administer
- Position the cat on a secure, level surface where it can be held comfortably. Part the fur along the midline of the neck between the skull base and the shoulder blades until bare skin is fully exposed.
- Set the applicator tip directly against the visible skin. If the solution is deposited onto the coat rather than the skin surface, transdermal absorption is significantly impaired and efficacy against all six parasite categories is reduced.
- Depress the plunger in a single, steady motion to deliver the complete 0.9 mL volume to one spot. Cats in this weight range require only one application site.
- Refrain from touching the treated area for at least 4 hours or until it has dried completely. In households with multiple cats, separate the treated animal during this drying window to prevent other cats from ingesting the product through grooming.
- Wash hands with soap and water once the application is finished. Discard the spent applicator and packaging material where neither children nor other animals can reach it.
Storage
Keep NexGard COMBO in a location inaccessible to children. The labeled storage range is 59°F to 86°F (15°C to 30°C), with brief excursions up to 104°F (40°C) permitted. Protect from light and retain each applicator in its original sealed blister until the scheduled dosing date. Do not apply the product beyond the expiry date shown on the carton; the printed date refers to the last day of the indicated month.Tips for Using
The following considerations apply specifically to cats in the 5.6 to 16.5 lbs range and the 0.9 mL applicator format:- Prepare the applicator: Hold the syringe upright, pull back the plunger slightly, twist, and pull off the protective cap.
- Part the fur: Part the hair on the midline of the neck, between the base of the skull and the shoulder blades, until the skin is visible.
- Apply directly to skin: Place the tip of the applicator on the skin and express the entire 0.9 mL contents directly onto one spot.
- Do not massage: Avoid rubbing the product into the skin, as this can reduce effectiveness and cause localized fur loss or irritation.
- Ensure dry skin: Apply the solution only onto completely dry skin and never on broken or irritated skin areas.
- Prevent licking: Ensure the application spot is high enough on the neck so the cat cannot lick it, preventing excessive salivation from product ingestion.
- Separate multiple pets: Keep treated cats away from other household pets until the application site is fully dry to prevent mutual grooming.
- Limit human contact: Avoid touching the application site for at least 4 hours, or until the area is completely dry and no longer noticeable.
- Restrict co-sleeping: Do not allow your cat to sleep with you, especially children, on the night of treatment until the application site dries.
- Apply monthly: Administer the treatment once every 30 days all year round to maintain continuous protection against fleas, ticks, heartworms, and intestinal worms.
- Handle missed doses: If a dose is delayed by more than 30 days, administer it immediately and resume a new monthly dosing schedule from that date.
- Switching brands: When transitioning from another heartworm preventive, apply the first dose of NexGard Combo within 30 days of the last treatment.
- Test for heartworms: Ensure your cat is tested for existing heartworm infections before starting treatment if they are 6 months of age or older.
- Monitor neurological history: Use with caution and consult your vet if your cat has a history of seizures or other neurological disorders.
- Store properly: Keep the applicators in their original packaging to protect them from light, at room temperature between 59°F and 86°F (15°C to 30°C).
| Product Name | NexGard Combo for Cats 5.5-16.5 lbs (2.5-7.5 kg) |
|---|---|
| Target Weight | 5.5 – 16.5 lbs (2.5 – 7.5 kg) |
| Packaging Color | Yellow/ Gold |
| Pipette Volume | 0.9 mL per applicator |
| Active Ingredients | Eprinomectin: 3.6 mg per applicator, Esafoxolaner: 10.8 mg per applicator, Praziquantel: 74.7 mg per applicator |
| Key Excipients | Dimethyl isosorbide, unstabilized glycerol formal, butylated hydroxytoluene |
| Application Type | Topical spot-on solution applied directly to bare skin at the base of the skull |
| Appearance | Solution in a single-dose plastic pipette applicator with twist-off cap and pull-back plunger |
| Administration Route | For external use on cats only |
| Pack Sizes Available | 1-pack, 3-pack, or 6-pack applicators |
| Treatment Frequency | Once monthly for all labeled indications; a single dose treats existing roundworm, hookworm, and tapeworm infections; monthly reapplication controls subsequent reinfection |
| Effective Against | – Adult fleas (Ctenocephalides felis) |
| Storage | 59°F to 86°F (15°C to 30°C); brief excursions up to 104°F (40°C) permitted; protect from light |
FAQs
1. My cat weighs 5.6 lbs on the scale today. Is the 0.9 mL applicator the correct choice?
A cat at 5.6 lbs (2.5 kg) falls at the lower boundary of this variant. The 0.9 mL applicator delivers 10.8 mg esafoxolaner, 3.6 mg eprinomectin, and 74.7 mg praziquantel, which meets the labeled minimum dose requirements at this body weight. Cats below 5.6 lbs on the treatment day should receive the smaller 0.3 mL applicator instead with NexGard COMBO For Cats Up to 5.5 lbs (<2.5 kg).
2. Is the esafoxolaner concentration in the 0.9 mL applicator safe for a cat right at 5.6 lbs?
Yes, the esafoxolaner dose in this applicator is within the established safety range for a cat at 5.6 lbs. The 10.8 mg delivered exceeds the labeled minimum of 0.65 mg/lb (1.44 mg/kg), and Boehringer Ingelheim’s margin-of-safety study confirmed no significant adverse findings at the 1X dose level in kittens 8 to 9 weeks old treated six times at 28-day intervals. Neurologic signs were observed only in one kitten at the 5X dose (five times the maximum exposure), and that kitten recovered within 48 hours with supportive care. Cats with a history of seizures or neurologic disorders should receive veterinary assessment before starting any isoxazoline-class product.
3. My cat just grew past 5.5 lbs from the smaller variant. Do I switch to the 0.9 mL applicator immediately?
Yes. At the next scheduled monthly dose, transition to the 0.9 mL applicator once the cat’s verified weight is at or above 5.6 lbs (2.5 kg). Administering the 0.3 mL applicator to a cat that has exceeded its upper weight boundary delivers esafoxolaner, eprinomectin, and praziquantel below the minimum labeled concentrations per kilogram, which compromises efficacy across all six parasite categories. Confirm weight on the dosing day before selecting the applicator.
4. I missed this month’s dose for my cat in the 5.6-16.5 lb range. What should I do?
Administer the 0.9 mL applicator as soon as the missed dose is identified, then resume monthly dosing from that new date forward. Do not apply two doses at once. The FDA-approved label states that if a 30-day interval between doses is exceeded, NexGard COMBO should be applied immediately and the monthly schedule resumed. For heartworm prevention, fewer than three consecutive monthly treatments may not provide complete protection against Dirofilaria immitis larvae already present.
5. Can a cat with a history of seizures receive this product?
Esafoxolaner belongs to the isoxazoline drug class. The FDA has required all isoxazoline-class labels to include warnings for neurologic adverse reactions, including tremors, ataxia, and seizures, and these events have been reported in cats with no prior seizure history. The label specifically states to use with caution in cats with a history of seizures or neurologic disorders. A veterinarian should evaluate the cat before NexGard COMBO is administered.
6. How rapidly does the 0.9 mL applicator begin eliminating fleas?
Laboratory study data show NexGard COMBO killed greater than 92% of adult fleas within 24 hours of the initial dose. In subsequent weekly reinfestation challenges, flea kill of ≥95.5% at 24 hours was maintained through Day 31. Flea egg production was suppressed by 99.8% to 100% at 24 hours post-reinfestation throughout the full monthly period, effectively preventing viable eggs from entering the cat’s environment.
7. My cat in this weight range licked the application site and is salivating heavily. What do I do?
The excessive salivation results from oral contact with the formulation’s excipients (dimethyl isosorbide and glycerol formal), not from toxicity of the active ingredients themselves. In Boehringer Ingelheim’s oral tolerance study, all eight cats that received NexGard COMBO orally displayed immediate hypersalivation, and every cat stopped salivating within one hour without any intervention. If salivation persists beyond one hour, or if tremors, vomiting, ataxia, or disorientation accompany it, contact a veterinarian. To prevent recurrence, apply at the base of the skull where the cat cannot reach, and separate multi-cat households during the 4-hour drying period.
8. Does this variant’s tapeworm coverage include species from hunting prey?
The praziquantel component at 74.7 mg per 0.9 mL dose targets Dipylidium caninum, the tapeworm species acquired when a cat ingests an infected flea. Controlled studies documented an average 92.8% effectiveness against this species. NexGard COMBO also covers Taenia taeniaeformis, the tapeworm cats contract through consuming infected rodents. If your cat regularly hunts, consult a veterinarian to assess whether the praziquantel coverage in this formulation is sufficient for the full spectrum of tapeworm exposure in your cat’s environment.
9. My cat weighs 16 lbs and is still gaining. When do I need to change the dosing approach?
The 0.9 mL applicator is labeled for cats up to 16.5 lbs (7.5 kg). Once the cat’s confirmed weight exceeds 16.5 lbs, the dosing table on the FDA-approved label specifies a combination of one 0.3 mL applicator plus one 0.9 mL applicator (total 1.2 mL), which delivers 14.4 mg esafoxolaner, 4.8 mg eprinomectin, and 99.6 mg praziquantel for the 16.6 to 22 lb weight band. Weigh on dosing day and transition as soon as the 16.5 lb threshold is crossed. Continuing with the single 0.9 mL applicator above this weight delivers sub-therapeutic concentrations of all three compounds.
10. Is NexGard COMBO safe for a pregnant or nursing cat in the 5.6-16.5 lb range?
The FDA-approved label states that the safety of NexGard COMBO has not been fully evaluated in breeding, pregnant, or lactating cats. No controlled reproductive safety data have been published for this formulation. A veterinarian should assess whether the benefit of six-category parasite prevention justifies administration in a pregnant or nursing cat, given the incomplete reproductive safety profile.
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