Credelio Plus (Lotilaner+Milbemycin Oxime)
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Fact Table
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| Formula | C20H14Cl3F6N3O3S + C126H176N4O28 |
| License | FDA and EMA approved veterinary medicinal product (dogs) |
| Bioavailability | Lotilaner approximately 75%; milbemycin oxime approximately 60% (oral, with food enhances absorption) |
| Legal status | Veterinary prescription only |
| Chemical Name | Lotilaner + milbemycin oxime |
| Elimination half-life | Lotilaner terminal half-life approximately 24 days; milbemycin oxime approximately 1 week |
| Dosage (Strength) | Chewable tablets: 56.25 mg/2.11 mg, 112.5 mg/4.22 mg, 225 mg/8.44 mg, 450 mg/16.88 mg, and 900 mg/33.75 mg (lotilaner/milbemycin oxime); oral monthly dosing with or after food according to body weight |
| Pregnancy | Safety in breeding, pregnant, or lactating dogs has not been established; use only according to the veterinarian’s benefit-risk assessment |
| Brands | Credelio Plus |
| Protein binding | High for both lotilaner and milbemycin oxime (>95%) |
| PubChem CID | Lotilaner: 76959255; Milbemycin oxime: 145710041 |
| MedlinePlus | Not applicable / no dedicated MedlinePlus monograph identified for this veterinary combination product |
| ChEBI | Lotilaner: 229657; Milbemycin oxime: 201396 |
| ATC code | QP54AB51 |
| DrugBank | Lotilaner: DB17992; Milbemycin oxime: DB11531 |
| KEGG | Lotilaner: D11212; Milbemycin oxime: not clearly assigned in standard public KEGG references |
| Routes of administration | By mouth (oral chewable tablets) |
Credelio Plus (lotilaner and milbemycin oxime) is a combination antiparasitic medication for dogs and puppies. Lotilaner belongs to the isoxazoline drug class and milbemycin oxime is part of the macrocyclic lactone family. Both work by targeting the nervous and muscular systems of parasites, which leads to their paralysis and death. It comes as a monthly oral chewable tablet that protects against fleas, ticks, and internal worms.
Directions
Credelio Plus is given as a chewable tablet once a month, with the dosage based on the dog's weight (20 to 41 mg of lotilaner per kilogram and 0.75 to 1.53 mg of milbemycin oxime per kilogram). Pet owners should choose the appropriate tablet strength for their dog's weight and can give it with or without food.
The medication comes in five different strengths to fit dogs from small puppies to large breeds. Dogs should eat the entire tablet, and if vomiting occurs within an hour of giving it, owners may need to give another dose. Dogs should be tested for heartworm before starting treatment. The product can be used in puppies as young as eight weeks old that weigh at least 1.4 kg (3 lbs).
Ingredients
The active ingredients in Credelio Plus are lotilaner and milbemycin oxime.
Cautions
Before using this medication, you may want to consult a veterinarian about the following:
- Any existing health conditions
- Any allergies
- A list of all medications currently being taken by the dog
All dogs in the household should be treated. To help control fleas, ticks, and parasites, veterinarians usually recommend treating every dog in the home with an appropriate product.
Fleas and ticks must bite first. Parasites need to attach and begin feeding before the medication can kill them, so the risk of disease transmission from fleas or ticks cannot be completely eliminated.
Parasites may develop resistance over time. Frequent or repeated use of the same type of deworming medication can make parasites harder to treat. Your veterinarian may adjust treatment based on your dog’s risk and local parasite patterns.
Dogs in areas where heartworm is common should be tested before starting preventive treatment. Credelio Plus prevents heartworm but does not treat adult heartworm infections.
The medication is generally intended for dogs at least 8 weeks old and weighing at least 1.4 kg (about 3 pounds). Your veterinarian will decide if it is appropriate for smaller or younger puppies.
Certain breeds may need extra caution. Dogs with the MDR1 gene mutation, often seen in breeds such as Collies and related herding dogs, may be more sensitive to some medications.
Reactions may occur in dogs with heavy heartworm infection. Giving the medication to dogs with large numbers of circulating heartworm larvae may cause allergic-type reactions due to dying parasites.
Keep the tablets away from children. Accidental ingestion may cause stomach upset, so tablets should stay in the original packaging and be stored out of reach of children.
Wash your hands after handling. Always wash hands after giving the tablet to your dog to reduce the chance of accidental exposure.
Tell your veterinarian about other medications. Credelio Plus may interact with certain drugs, including some heart medications or other parasite treatments.
Use in pregnant or nursing dogs should be evaluated by a veterinarian. Safety has not been fully studied in breeding, pregnant, or lactating dogs, so a veterinarian should determine if it is appropriate.
Contraindications
Avoid taking or using this medication if any of the following apply:
- The dog has a known hypersensitivity to lotilaner, milbemycin oxime, or any of the inactive ingredients in the formulation
- The dog is less than 8 weeks of age
Side Effects
Common side effects of Credelio Plus include:
- Diarrhea
- Vomiting
- Loss of appetite
- Tiredness or lethargy
Some pets may also experience itching, mild muscle tremors, or temporary changes in behavior. These side effects are usually mild and short-lasting. In most cases, they resolve on their own without treatment.
More serious side effects are rare but possible. Neurological symptoms such as seizures, tremors, or loss of coordination (ataxia) have been reported in rare cases. These reactions typically improve after the medication is stopped. Contact your veterinarian if your pet develops seizures, severe weakness, or unusual behavior after taking Credelio Plus.
Frequently Asked Questions about Credelio Plus
What is Credelio Plus used for in dogs?
Credelio Plus is a monthly chewable veterinary medicine for dogs that combines lotilaner and milbemycin oxime. It is used for broad parasite protection, including fleas and ticks, and depending on the approved market labeling, it may also help protect against certain intestinal worms and heartworm-related parasite risks. It is meant for dogs, not for cats or people.
How does Credelio Plus work?
Credelio Plus contains two active ingredients that work in different ways. Lotilaner kills external parasites such as fleas and ticks, while milbemycin oxime helps control certain internal parasites. This combination allows one product to cover both external and internal parasite concerns when prescribed appropriately.
How is Credelio Plus usually given?
Credelio Plus is given by mouth as a chewable tablet once a month. The correct tablet strength is chosen based on the dog’s body weight, so it is important to use the exact weight range recommended on the product label or by the veterinarian. It should be given regularly each month for ongoing protection.
Should Credelio Plus be given with food?
Credelio Plus is generally recommended to be given with food or around mealtime to support proper absorption. Giving it with a full meal can help the medicine work as intended. Owners should follow the specific package directions for their country and product version.
What parasites does Credelio Plus cover?
Credelio Plus is mainly used for flea and tick control along with protection against certain internal parasites. Depending on the local approved labeling, this may include roundworms, hookworms, whipworms, and prevention of heartworm disease. Coverage can vary somewhat by country, so the product should be used according to the veterinarian’s instructions.
What are the common side effects of Credelio Plus?
Common side effects are usually mild and may include vomiting, diarrhea, reduced appetite, tiredness, or temporary stomach upset. Many dogs tolerate the medication well, but any new symptoms after dosing should be watched closely. If symptoms are severe, persistent, or unusual, the prescribing veterinarian should be contacted.
Are there important neurologic warnings with Credelio Plus?
Yes. Because lotilaner belongs to the isoxazoline class, there is a known warning that this type of medication has been associated in some dogs with neurologic reactions such as tremors, unsteadiness, or seizures. These events are uncommon, but dogs with a history of seizures or neurologic disease should be discussed carefully with a veterinarian before use.
Can puppies take Credelio Plus?
Credelio Plus is approved only for dogs that meet the minimum age and weight listed on the product labeling. Those limits can vary by market, so puppies should not receive it unless they meet the approved age and weight requirements for that specific product pack. A veterinarian can confirm whether a puppy is eligible.
What happens if a dose is missed?
If a monthly dose is missed, the dog may lose part of its parasite protection, especially against fleas, ticks, and heartworm-related risks. The missed dose should usually be given as soon as possible, and then monthly dosing is continued from there based on veterinary advice. Because timing matters with parasite prevention, owners should not delay restarting protection.
Who should use Credelio Plus carefully?
Dogs with a history of seizures, dogs that are underweight for their age, dogs that are sick or recovering from illness, and dogs taking other medications should be reviewed carefully before starting Credelio Plus. It should also be used cautiously in breeding, pregnant, or nursing dogs unless the veterinarian decides it is appropriate. Because parasite control needs differ by region and lifestyle, veterinary guidance is important for choosing the right product and schedule.
