Table of Contents
Table of Contents
Parasite prevention is one of the most important parts of keeping dogs healthy in the United States. Fleas, ticks, heartworms, hookworms, and roundworms are not seasonal concerns in many regions they can pose a year round risk depending on climate and exposure.
NexGard Plus for dogs is a prescription chewable medication designed to provide broad parasite protection in a single monthly dose. Because it combines flea and tick prevention with heartworm and intestinal parasite protection, many veterinarians recommend it as a simplified, all in one option for pet owners.
However, before giving any medication to your dog, it's essential to understand:
- How NexGard Plus works
- What parasites it protects against
- Possible side effects
- Safety considerations
- What real world reviews say
This guide provides a detailed, veterinarian-informed overview of NexGard Plus for dogs, including safety insights and when to consult a licensed veterinarian.
Reviewed for medical accuracy by Dr. Micky Mopin, DVM.
What Is NexGard Plus for Dogs?
NexGard Plus for dogs is a prescription, monthly chewable medication designed to protect dogs against both external and internal parasites. It combines flea and tick prevention with heartworm disease prevention and intestinal parasite treatment all in one flavored chew.
Unlike the original NexGard (which only covers fleas and ticks), NexGard Plus adds protection against:
- Heartworms
- Roundworms
- Hookworms
This broader protection is one reason many veterinarians prefer NexGard Plus for dogs who need comprehensive parasite control in a single product.
It is FDA approved for use in dogs and puppies:
- 8 weeks of age and older
- Weighing at least 4 pounds
Because dosing is weight based, using the correct size chew is critical. Giving an incorrect dose or using medication intended for another species can result in treatment failure or increased risk of adverse reactions.
NexGard Plus is available only with a veterinary prescription. That's important because heartworm prevention requires testing before starting the medication.
How NexGard Plus for Dogs Works (Active Ingredients Explained)
Understanding how NexGard Plus works helps pet owners feel more confident about what they're giving their dog.
NexGard Plus contains three active ingredients:
1️⃣ Afoxolaner
This ingredient belongs to a class of drugs called isoxazolines, commonly used in modern flea and tick preventatives.
It works by overstimulating the nervous system of fleas and ticks. This leads to paralysis and death of the parasites after they bite the dog. Because it is systemic (circulates in the bloodstream), parasites must attach and begin feeding to be exposed to the medication.
Afoxolaner is effective against:
- Fleas
- American dog ticks
- Black legged ticks
- Lone star ticks
- Brown dog ticks
2️⃣ Moxidectin
Moxidectin provides heartworm prevention and contributes to controlling certain intestinal parasites.
It works by interfering with nerve transmission in worms, causing paralysis and eventual elimination.
Moxidectin helps protect against:
- Heartworms
- Roundworms
- Hookworms
3️⃣ Pyrantel
Pyrantel is a well known deworming agent that specifically targets intestinal worms by blocking their neuromuscular activity, causing them to detach and pass naturally through the digestive tract.
Together, these three ingredients make NexGard Plus for dogs a broad spectrum parasite preventive.
From a clinical perspective, combination products improve compliance. When pet owners only have to remember one chew per month, they are less likely to miss doses which is critical for heartworm prevention.
What Does NexGard Plus for Dogs Treat and Prevent?
NexGard Plus is designed to protect against multiple parasites that commonly affect dogs in the United States.
External Parasites
NexGard Plus begins killing fleas within hours after administration. It eliminates adult fleas before they can lay eggs, helping prevent infestations in the home.
It protects against several major tick species known to transmit diseases such as Lyme disease and ehrlichiosis.
Internal Parasites
Heartworm disease is transmitted by mosquitoes and can cause life threatening damage to the heart and lungs. NexGard Plus provides monthly heartworm prevention when administered consistently.
These intestinal parasites are common in puppies and adult dogs. They can cause gastrointestinal upset, weight loss, and, in severe cases, anemia.
Because NexGard Plus covers both internal and external parasites, it is often prescribed as a comprehensive parasite control plan rather than using multiple separate medications.
However, no preventive product is one-size fits all. Your veterinarian will consider:
- Your geographic region
- Your dog's health history
- Seizure history or neurologic conditions
- Lifestyle and exposure risks
When discussing NexGard Plus for dogs, veterinary professionals also evaluate whether combination prevention is appropriate or if individual products are better suited.
NexGard Plus vs NexGard: What’s the Difference?
This is one of the most searched comparisons by dog owners.
Both NexGard and NexGard Plus are monthly chewable parasite preventatives, but they are not the same product.
NexGard (Original)
- Covers fleas
- Covers ticks
- Does NOT prevent heartworm
- Does NOT treat intestinal worms
NexGard Plus
- Covers fleas
- Covers ticks
- Prevents heartworm disease
- Treats and controls roundworms and hookworms
The key difference is that NexGard Plus includes heartworm prevention and intestinal parasite protection, while the original NexGard only covers external parasites.
From a veterinary standpoint, combination products like NexGard Plus can improve compliance. Instead of remembering separate flea/tick and heartworm medications, pet owners administer one chew monthly.
However, some dogs may already be on a separate heartworm preventive, or their veterinarian may recommend a different protocol based on medical history.
When deciding between NexGard vs NexGard Plus, your veterinarian will consider:
- Heartworm testing results
- Regional parasite risk
- Previous medication tolerance
- Neurological history
If your dog needs comprehensive protection, NexGard Plus for dogs may offer a simplified solution.
NexGard Plus Dosage for Dogs
NexGard Plus is given once monthly, year-round.
It is approved for:
- Dogs and puppies 8 weeks and older
- Dogs weighing 4 pounds or more
Dosage is determined strictly by body weight. Each chew is formulated for a specific weight range. Using the correct size chew is essential for safety and effectiveness.
Common weight categories include:
- 4–10 lbs
- 10.1–24 lbs
- 24.1–60 lbs
- 60.1–121 lbs
Your dog should be weighed regularly to ensure proper dosing. Underdosing can reduce effectiveness, while overdosing increases risk of side effects.
How to Give NexGard Plus
- Administer orally once a month
- Can be given with or without food
- Ensure the entire chew is consumed
If vomiting occurs within two hours of administration, contact your veterinarian — they may advise redosing.
Important Note
Before starting NexGard Plus, dogs must be tested for existing heartworm infection. Giving heartworm prevention to a heartworm positive dog can lead to complications.
NexGard Plus for Dogs Side Effects
One of the most searched concerns is:
“What are the side effects of NexGard Plus for dogs?”
Like all medications, NexGard Plus can cause side effects, although most dogs tolerate it well.
Common (Uncommon but Possible) Side Effects
- Vomiting
- Diarrhea
- Decreased appetite
- Lethargy
- Itchy or dry skin
These reactions are typically mild and resolve without intervention.
Neurological Side Effects
Because NexGard Plus contains an isoxazoline (afoxolaner), neurological side effects have been reported in rare cases.
These may include:
- Muscle tremors
- Loss of coordination
- Difficulty walking
- Seizures
Dogs with a history of seizures or neurological disorders should use NexGard Plus with caution. This is a discussion that must happen with your veterinarian before prescribing.
It's important to understand that while reports exist, millions of doses have been administered safely. The overall incidence of serious neurological reactions remains low, but awareness is important.
Allergic Reactions
In rare cases, dogs may experience:
- Facial swelling
- Hives
- Severe lethargy
These reactions require immediate veterinary attention.
When to Contact a Veterinarian
Seek veterinary care immediately if you notice:
- Seizures
- Persistent vomiting
- Collapse
- Severe lethargy
- Unusual behavior
If you are unsure whether a symptom is related to NexGard Plus, consult a licensed veterinarian promptly.
TelaVets provides virtual consultations where licensed veterinarians can evaluate side effects and help determine next steps if concerns arise after administering NexGard Plus.
NexGard Plus for Dogs Reviews: What Pet Owners Are Saying
When searching “NexGard Plus for dogs reviews,” pet owners are usually looking for real-world experiences beyond the label description.
Common Positive Feedback
Many dog owners report:
- Convenience of one monthly chew
- Good palatability (dogs willingly eat it)
- Effective flea control
- Reduced need for multiple parasite medications
- Peace of mind with heartworm coverage included
The convenience factor is frequently mentioned. Instead of juggling separate heartworm and flea/tick medications, NexGard Plus simplifies parasite prevention.
Concerns Raised in Reviews
Some reviews mention:
- Gastrointestinal upset after dosing
- Neurological reactions in sensitive dogs
- Cost compared to separate products
It's important to recognize that online reviews often reflect extreme experiences either very positive or very negative. The vast majority of dogs tolerate NexGard Plus without significant issues.
From a veterinary perspective, anecdotal reviews should never replace medical guidance. Every dog's health profile is unique, and risk tolerance varies.
How to Interpret Online Reviews
When reading NexGard Plus for dogs reviews:
- Consider whether the dog had pre existing conditions
- Check if dosing instructions were followed
- Evaluate whether heartworm testing was performed
- Avoid relying solely on social media discussions
For personalized guidance, discussing concerns with a licensed veterinarian is always safer than relying on internet commentary.
Dogs Who Should Not Take NexGard Plus
Although NexGard Plus is widely prescribed, it is not appropriate for every dog.
Dogs That Require Caution
- Dogs with a history of seizures
- Dogs with diagnosed neurological disorders
- Dogs younger than 8 weeks
- Dogs under 4 pounds
- Dogs who have not been tested for heartworm
Dogs that are heartworm positive require veterinary treatment protocols before beginning preventive medications.
Drug Interactions & Health Considerations
Veterinarians may also evaluate:
- Concurrent use of other parasite preventives
- Use of certain neurological medications
- Chronic liver or kidney conditions
If your dog has complex medical issues, a direct conversation with a veterinarian is essential before starting NexGard Plus.
What to Do If You're Unsure
If you're debating whether NexGard Plus for dogs is right for your pet:
- Do not split chews
- Do not combine with other heartworm preventives
- Do not skip heartworm testing
Instead, consult with a veterinarian who can review your dog's history and recommend the safest plan.
TelaVets offers virtual consultations where licensed veterinarians can assess whether NexGard Plus fits your dog's specific health profile.
What to Do If You Miss a Dose of NexGard Plus
Consistency is key for effective parasite prevention. Missing a monthly dose of NexGard Plus can leave your dog vulnerable to fleas, ticks, and heartworms.
Guidelines for Missed Doses
- Administer the missed chew as soon as you remember.
- Resume your regular monthly schedule afterward.
- Do not double the dose to "catch up" this can increase the risk of side effects.
For cats on NexGard COMBO, apply the missed topical dose immediately to the recommended site, then continue monthly. Avoid giving extra doses.
Why Timely Dosing Matters
- Fleas and ticks can transmit disease quickly.
- Heartworm prevention relies on monthly administration to maintain protective blood levels.
- Regular dosing ensures parasite cycles are broken and minimizes reinfestation risk.
When in doubt, consult a veterinarian. TelaVets online vet consultations allow you to get guidance without leaving home.
Overdose & Emergency Information for NexGard Plus
While NexGard Plus has a wide margin of safety, overdoses can happen accidentally. Prompt action is essential.
Signs of Overdose in Dogs
- Vomiting
- Diarrhea
- Lethargy
- Muscle tremors
- Loss of balance
- Seizures (rare but serious)
Immediate Actions
- Contact your veterinarian immediately.
- Seek emergency veterinary care if severe symptoms appear.
- You can also call Pet Poison Helpline: 855-764-7661 or ASPCA Animal Poison Control: 888-426-4435.
Overdose in Cats (NexGard COMBO)
Cats may experience:
- Muscle tremors
- Loss of balance
- Drooling
- Lethargy
As with dogs, contact a veterinarian or poison control hotline if any overdose is suspected.
Storage & Handling of NexGard Plus
Proper storage preserves the medication’s potency and ensures safety for pets and humans.
Storage Guidelines
- Store NexGard Plus tablets at controlled room temperature (77°F / 25°C or below).
- Short-term exposure up to 104°F is acceptable but should be minimized.
- Keep the medication in blister packs until ready to use this protects against moisture and light.
- Keep out of reach of children and pets.
Handling Precautions
- Wash hands thoroughly after handling tablets or topical products.
- Avoid contact with eyes and skin especially with NexGard COMBO topical solution.
- Do not allow cats or other pets to lick application sites until dry.
FAQs About NexGard Plus for Dogs
1. Is NexGard Plus safe for all dogs?
Yes, NexGard Plus is safe for most dogs and puppies over 8 weeks old and weighing more than 4 lbs. Dogs with a history of seizures or neurological disorders should use it under veterinary guidance. Always consult your vet, like Dr. Micky Mopin, DVM, for personalized advice.
2. What are the common side effects of NexGard Plus?
Most dogs tolerate NexGard Plus well. Uncommon side effects may include:
- Vomiting or diarrhea
- Lethargy
- Loss of appetite
- Allergic reactions such as hives or swelling
- Rare neurological effects like tremors or seizures
If any severe reaction occurs, contact your vet immediately.
3. How quickly does NexGard Plus work?
NexGard Plus kills fleas within 4–24 hours and ticks within 48–72 hours. Regular monthly dosing ensures full protection against parasites and heartworm.
4. Can NexGard Plus be given with food?
Yes, NexGard Plus can be given with or without food, which makes it easier for owners to administer to picky eaters.
5. Do I need a prescription for NexGard Plus?
Yes, NexGard Plus is a prescription only medication. Your veterinarian will determine the correct dose based on your dog's weight and health status. TelaVets online vet consultations make it easy to get prescriptions from licensed vets remotely.
6. What should I do if my dog misses a dose?
Administer the missed dose as soon as you remember, then continue with the regular monthly schedule. Do not double doses, as this can increase the risk of side effects.
Conclusion
NexGard Plus is a highly effective, veterinarian-approved solution for protecting dogs from fleas, ticks, heartworms, and intestinal parasites. With proper dosing, safe handling, and regular veterinary guidance, it can keep your furry friend healthy, happy, and parasite-free all year round.
By following EEAT-based veterinary advice, like from Dr. Micky Mopin, DVM, you ensure your dog’s treatment is safe and effective. NexGard Plus provides peace of mind for dog owners who prioritize their pet's well being, comfort, and health.
If you're unsure about dosing, side effects, or whether NexGard Plus is right for your dog, you can book a consultation with a licensed vet online at TelaVets for personalized advice without leaving your home.
Reviewed by Dr. Micky Mopin, DVM
Related Articles
Pet Benefits Programs for Employees: How Companies Are Supporting Pet Parents with Virtual Vet Care
Discover how pet benefits programs help companies attract and retain employees. Learn how TelaVets offers virtual vet care as a modern employee pet benefit.
Dog Grooming Tips for Beginners: How to Groom Your Dog at Home | TelaVets
Discover beginner-friendly dog grooming tips to keep your dog healthy, clean, and happy. Learn how to groom at home, make it fun, and know when to seek professional advice.
Are raw eggs good for dogs?
Are raw eggs safe for dogs? Learn the benefits, risks, and safe ways to feed eggs to your dog. Get tips on cooked eggs, egg yolks, eggshells, and more for a healthy canine diet
