Heartgard Plus Chew for Dogs, 26-50 lbs, (Green Box), 6 Chews (6-mos. supply)

Remove only one chewable at a time from the foil-backed blister card. Return the card with the remaining chewables to its box to protect the product from light. Because most dogs find HEARTGARD Plus (ivermectin/pyrantel) palatable, the product can be offered to the dog by hand. Alternatively, it may be added intact to a small amount of dog food. The chewable should be administered in a manner that encourages the dog to chew, rather than to swallow without chewing. Chewables may be broken into pieces and fed to dogs that normally swallow treats whole. Care should be taken that the dog consumes the complete dose, and treated animals should be observed for a few minutes after administration to ensure that part of the dose is not lost or rejected. If it is suspected that any of the dose has been lost, redosing is recommended.

To avoid the risk of choking or intestinal obstruction, the chewable should be administered in a manner that encourages the dog to chew, rather than to swallow without chewing (see Precautions and Post-Approval Experience). Alternatively, it may be added intact to a small amount of dog food to encourage chewing, but care should be taken to ensure that the dog consumes the complete dose at one time.

HEARTGARD® Plus chewables contain two active ingredients, ivermectin and pyrantel. The ivermectin works to prevent heartworm disease by allowing the immune system to recognize and inactivate heartworm larvae before they can develop into adults.1 The pyrantel in HEARTGARD® Plus chewables treats and controls hookworms and roundworms.1

Your dog will need an annual negative heartworm test and a prescription for HEARTGARD® Plus chewables from your licensed veterinarian.

Give your dog a HEARTGARD® Plus chewable once a month, year-round.

No, the pyrantel in HEARTGARD® Plus chewables treat and control hookworms and roundworms.1

HEARTGARD® Plus chews are suitable for dogs 6 weeks of age and older. There is no minimum weight requirement to use HEARTGARD® Plus chews.2

Even though the dose of a HEARTGARD® Plus chewable only remains in the dog for a few days, each HEARTGARD® Plus chew works by affecting parasitic infections acquired during the previous month/30 days.2 Therefore, it is critical to ensure that your dog receives the appropriate dose of HEARTGARD® Plus chewable each month/30 days to keep your dog protected from heartworm disease all year long.

The American Heartworm Society recommends giving your dog year-round protection. That’s because the threat of heartworm disease doesn’t stop with dropping temperatures. Many pet owners might assume that they only need to give their dog heartworm disease preventives when it’s warm. While heartworm transmission can decrease in winter months, the risk never reaches zero. What’s more, on-again, off-again heartworm disease protection is unreliable and can leave gaps in protection that can make your dog vulnerable to heartworm disease.3

HEARTGARD® Plus chewables are well tolerated, and HEARTGARD brand products have been trusted over 2 billion times.4 HEARTGARD® Plus chewables are the #1 vet-recommended heartworm preventive.5

HEARTGARD® Plus chewables are available in three different sizes for dogs ranging from small dogs up to 25 pounds, medium dogs weighing 26-50 pounds and large dogs weighing 51-100 pounds. For dogs over 100 pounds use the appropriate combination of these chewables.2 Each size also comes in packs containing 1, 6 or 12 monthly doses. HEARTGARD Plus chews are safe to use in all dogs aged 6 weeks and older. Following the use of HEARTGARD Plus chews, digestive and neurologic side effects have been reported.

HEARTGARD® Plus chews have shown a wide margin of safety at the recommended dose level in dogs, including pregnant or breeding bitches, stud dogs and puppies aged 6 or more weeks.2

HEARTGARD® Plus chewables can be offered to the dog by hand. Alternatively, it may be added intact to a small amount of dog food. The chewable should be administered in a manner that encourages the dog to chew, rather than to swallow without chewing. Chewables may be broken into pieces and fed to dogs that normally swallow treats whole. Care should be taken that the dog consumes the complete dose, and treated animals should be observed for a few minutes after administration to ensure that part of the dose is not lost or rejected.2

Hookworm larvae can be transmitted through the skin or by ingesting larvae in contaminated soil or grass at places like the dog park. Roundworm larvae can be transmitted through a mother’s milk or by ingesting infective eggs from the soil in your backyard.6

Heartworm disease is an invisible, but potentially fatal threat that occurs in dogs and other animals. Heartworms (Dirofilaria immitis) are parasitic worms that are transmitted to dogs by infected mosquitoes. Microscopic larvae of heartworms develop and grow under the skin, then migrate to the blood vessels of the heart and lungs of the infected animal where they rapidly grow, becoming adults that are 5-12 inches in length.7

Dogs get heartworms by being bitten by an infected mosquito. Larvae are deposited on the skin when the infected mosquito bites, then when the infected mosquito leaves the heartworm larvae enter through the bite wound. One bite is all it takes.3

Not all dogs develop noticeable symptoms. While blood tests performed by your veterinarian are the only way to confirm a diagnosis of heartworm disease in dogs, here are five warning signs that are reported in dogs with advanced heartworm disease: A persistent, dry cough is a common sign seen in dogs with heartworm disease. Lethargy and reluctance to exercise are also common signs described in dogs with heartworm disease. Some dogs have a decreased appetite and, as a result, lose weight. As heartworm disease progresses, it can lead to heart failure. You may notice that your dog's belly appears swollen from fluid in the abdomen. In the most advanced cases, dogs can develop more severe respiratory issues like rapid breathing in addition to coughing.

The best way to protect your dog is by giving them a broad-spectrum heartworm preventive like HEARTGARD® Plus chewables that also kill hookworms and roundworms every month.

There are 3 things you can do to help reduce the risk of heartworm disease. Reduce mosquito exposure by eliminating standing water where mosquitoes can breed, avoid known mosquito habitats, and limit outdoor exposure during peak mosquito feeding times.3 Use monthly preventives, like HEARTGARD® Plus chewables, on a year-round basis to safely and effectively prevent heartworm disease by affecting the heartworm larvae before they can grow into dangerous adult heartworms.1 Get Your Dog Tested Every Year. Before getting a prescription for a heartworm disease preventive, your dog must be tested for heartworms. Talk to your vet about testing options.3

Yes, it can be treated, but heartworm disease is a serious condition that can cause heart failure, permanent damage to your pet's lungs, and even death. Treating heartworm disease is costly and complicated.7,8 ### What are HEARTGARD® Plus chewables side effects?

In clinical field trials with HEARTGARD® Plus (ivermectin/pyrantel) chewables, vomiting or diarrhea within 24 hours of dosing was rarely observed (1.1% of administered doses). The following adverse reactions have been reported following the use of HEARTGARD® Plus chewables: Depression/lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions and hypersalivation. ### What is the best number to call regarding any specific HEARTGARD® Plus chewables questions?

For any specific product questions, please call the customer service line of Boehringer Ingelheim Animal Health at 1-888-637-4251.

HEARTGARD® Plus (ivermectin/pyrantel) Chewables are well tolerated. All dogs should be tested for heartworm infection before starting a preventive program. Following the use of HEARTGARD Plus chewables, digestive and neurological side effects have been reported. For more information, contact your veterinarian or refer to the full prescribing information

Lynn RC, Duquette RA. Chapter 6. Antiparasitic Drugs. In: Bowman DD, ed. Georgis’ Parasitology for Veterinarians. 11th ed. St. Louis, MO: Elsevier; 2021: 286-348. HEARTGARD® Plus (ivermectin/pyrantel) Chewables [Freedom of Information Summary; NADA140-971]. Duluth, GA: Boehringer Ingelheim Animal Health USA Inc. Current Canine Guidelines for the Prevention, Diagnosis, and Management of Heartworm Infections in Dogs 2018. American Heartworm Society. https://www.heartwormsociety.org/images/pdf/2018-AHS-Canine-Guidelines.pdf. Accessed Sept 14,2021. Data on file at Boehringer Ingelheim Data on file at Boehringer Ingelheim Carithers D, Miro G. Pet Owner Educational Atlas: Parasites. Zaragosa, Spain: Grupo Asis; 2012. Heartworm Basics. American Heartworm Society. https://www.heartwormsociety.org/pet-owner-resources/heartworm-basics. Accessed September 14, 2021. Weigh the Costs Infographic. American Heartworm Society. https://d3ft8sckhnqim2.cloudfront.net/images/infographics/0010-weigh-the-costs.jpg. Accessed September 14, 2021.