NexGard Plus for Dogs: Uses, Doses and Side Effects
A guide to NexGard Plus coverage, five weight bands, monthly dosing, side effects, heartworm testing and prescription purchase costs under the current US label.
BVMS MRCVS
Medically reviewed by Dr. Pippa Elliott, BVMS MRCVS · Last reviewed
Drug facts
NexGard Plus· afoxolaner, moxidectin, and pyrantel
Monthly prescription oral chew for dogs at least 8 weeks old and 4 pounds. Treats and prevents flea infestations, controls six labeled tick species, prevents heartworm disease, and treats specified roundworms and hookworms. Does not treat adult heartworms.
Treats
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NexGard Plus for dogs is a monthly prescription chew that prevents heartworm disease, kills fleas and ticks, and treats certain roundworms and hookworms. The US product contains afoxolaner, moxidectin and pyrantel. It is labeled for dogs and puppies at least eight weeks old and weighing at least four pounds.
The important choice is whether its coverage, weight range and precautions fit your dog. NexGard Plus does not treat every parasite, and it has an isoxazoline warning about neurologic reactions. Your veterinarian can check your dog's health history, heartworm testing and current medications before prescribing it.
NexGard Plus is a monthly prescription chew for dogs at least eight weeks old and four pounds. It prevents heartworm disease and covers specified fleas, ticks, roundworms and hookworms. Use the prescribed weight band, and discuss any seizure history with your veterinarian.
What is NexGard Plus for dogs?
NexGard PLUS is a combination canine medication made by Boehringer Ingelheim. The three active ingredients serve different jobs: afoxolaner kills fleas and ticks, moxidectin prevents heartworm disease, and pyrantel contributes intestinal worm treatment. The combination puts several parts of a prevention plan into one oral chew, but the word “Plus” does not mean protection against every parasite.
The current US product insert defines its FDA-approved uses and five strengths. NexGard Plus chewable tablets are available for eligible puppies as well as adult dogs. A puppy must meet both the minimum age and the minimum body weight; meeting just one is insufficient. Growing puppies also need their weight checked before refills.
Check the manufacturer and complete name on the package: NexGard PLUS chews are for dogs, while NexGard COMBO is a different cat product. If you are deciding between the two monthly dog products below, discuss the differences with your veterinarian. The pharmacy listing must still match the product and strength on your prescription.
| Product | Format and practical fit | Important distinction | Main consideration |
|---|---|---|---|
| NexGard PLUS | Monthly oral combination for eligible dogs at least 4 lb | Afoxolaner, moxidectin and pyrantel | Does not carry a US tapeworm-prevention indication |
| Simparica TRIO | Monthly oral combination with a lower 2.8-lb minimum | Sarolaner, moxidectin and pyrantel | Shares the isoxazoline neurologic warning; requires its own prescription decision |
What does NexGard Plus cover?
NexGard Plus provides flea and tick control for dogs along with heartworm prevention and specified adult roundworm and hookworm treatment. Those are different jobs: it prevents heartworm disease but does not remove adult heartworms. Its intestinal worm indications cover the named adult stages, rather than every kind of worm a dog might acquire. That includes the adult hookworms listed below; tapeworm treatment requires a separate veterinary diagnosis and appropriate medication.
| Parasite coverage | Current US labeled use | Important exclusions |
|---|---|---|
| Fleas | Kills adult Ctenocephalides felis and treats and prevents flea infestations for one month | Household flea control may also require treating other pets and the environment |
| Ticks | Treats and controls six tick species for one month | Check your dog for attached ticks despite preventive use |
| Lyme infection | Prevents Borrelia burgdorferi infection by killing Ixodes scapularis ticks | This is a vector-tick claim, not treatment of an existing Lyme infection |
| Heartworm | Prevents disease caused by Dirofilaria immitis | Does not kill adult heartworms |
| Roundworms | Treats and controls adult Toxocara canis and Toxascaris leonina | A fecal diagnosis can identify other parasites requiring treatment |
| Hookworms | Treats and controls adult Ancylostoma caninum, Ancylostoma braziliense and Uncinaria stenocephala | Follow the veterinarian's testing and follow-up plan |
| Tapeworms and whipworms | No US labeled treatment or prevention indication | Do not use PLUS as a substitute for a prescribed tapeworm or whipworm treatment |
The six tick species are lone star, Gulf Coast, American dog, black-legged, brown dog and Asian longhorned ticks. The ingredients do their work after a dose; NexGard Plus is not a topical repellent. The label cites a laboratory study in which afoxolaner alone began killing fleas four hours after administration. That ingredient study does not mean every parasite is eliminated in four hours or that one PLUS chew provides immediate protection against every infection.
Owners sometimes call any combination parasite medicine a “dewormer.” NexGard Plus does treat the adult intestinal worms named above, but it does not cover tapeworms or whipworms. Finding rice-like segments, diarrhea or worms in stool calls for identification and a treatment plan. More of the same preventive is not an appropriate way to expand its coverage. These distinctions come from the US PLUS label.
NexGard Plus dosage and weight ranges
NexGard Plus dosage is selected by your dog's current body weight. The table lists all five weight bands with the amount of each active ingredient, separate from package color. These weight ranges are a reference for checking a prescription, not a formula for making a new dose. Moxidectin is listed in micrograms, while afoxolaner and pyrantel are listed in milligrams. Those units are not interchangeable.
| Current body weight ranges | Afoxolaner dose strengths per chew | Moxidectin dose strengths per chew | Pyrantel dose strengths per chew |
|---|---|---|---|
| 4–8 lb | 9.375 mg | 45 mcg | 18.75 mg |
| 8.1–17 lb | 18.75 mg | 90 mcg | 37.5 mg |
| 17.1–33 lb | 37.5 mg | 180 mcg | 75 mg |
| 33.1–66 lb | 75 mg | 360 mcg | 150 mg |
| 66.1–132 lb | 150 mg | 720 mcg | 300 mg |
Dogs above 132 pounds need an appropriate combination of chews prescribed for their weight. For small dogs, the first PLUS size starts at four pounds. Do not divide a larger dog's chew to create an assumed smaller dose, share a prescription between dogs, or round a puppy into a range without the prescriber's advice. A six-pack is six monthly doses of its stated strength; it does not solve a growing puppy's future weight-band needs.
The manufacturer-submitted carton label illustrates the 4–8-lb strength. Check the printed weight range and ingredients rather than relying only on a red, green, gold or purple package description in a listing. The label's dosing table is the reference for all five sizes.
For an otherwise eligible puppy weighing less than four pounds, your veterinarian may discuss a different product. Simparica Trio for dogs has a minimum of 2.8 pounds and eight weeks, but its suitability still depends on the individual dog. Its lower weight minimum is a specific difference, not a reason to switch products without a prescription plan.
How to give NexGard Plus
The directions for dogs call for a single NexGard Plus dose by mouth each month, with or without food, according to the prescription. Its beef flavor may help acceptance, but watch your dog and confirm that the entire dose is swallowed. A chew found on the floor, a partly eaten portion or an uncertain amount vomited afterward should prompt a call to the prescribing veterinarian for instructions. Do not assume that an empty packet means the full dose was taken.
The label says to give a missed monthly dose and resume monthly dosing. A lapse also deserves a conversation about heartworm risk and follow-up testing, particularly if you do not know when the last full dose was swallowed. Do not double up on your own to make up for a missed month. A calendar reminder is useful, but a written record of the actual administration date is better than a reminder you dismissed without giving the chew.
- Confirm the dog's current prescribed weight band before opening the packet.
- Give the chew on the scheduled monthly date and observe consumption.
- Record the date and any problem with swallowing or vomiting.
- Ask the clinic how to handle an uncertain dose or a gap in protection.
NexGard Plus doses follow a monthly schedule, whether you buy one chew or a six- or twelve-month supply. Avoid a long gap between refills: the time ingredients take to work against fleas is different from the duration of the prevention plan. Do not borrow vomiting or repeat-dose timing from an original NexGard instruction sheet: the current PLUS label does not provide a specific vomit-within-a-number-of-hours rule. Its own administration instructions and your prescriber guide the decision.
Heartworm testing and year-round prevention
NexGard Plus is used to prevent heartworm disease; it does not cover treatment of the adult worms in an already infected dog. A dog with a positive heartworm test needs a veterinarian-directed treatment and prevention plan. Do not start, stop or substitute a preventive as a home treatment for that infection. The label directs testing for existing infection before administration and treatment of infected dogs as appropriate.
Testing is also age-dependent. The American Heartworm Society explains that puppies under seven months can start prevention without an initial heartworm test because infection takes time to become detectable. They need testing six months after the initial visit, again six months later, then annually. Adult dogs need regular testing even when owners believe prevention has been continuous; missed or incompletely swallowed doses can go unnoticed.
Your veterinarian may prescribe NexGard Plus to replace Heartgard Plus in a prevention plan, but any switch needs a scheduled start date and review of overlapping ingredients. Do not give both simply because the names sound different. For the broader plan, see our guide to flea, tick and heartworm prevention for dogs. Bring the names and last dose dates of all preventives to the appointment.
How much does NexGard Plus cost?
The monthly cost of NexGard Plus usually depends on the strength, number of doses and pharmacy. Compare the same weight band and supply duration before applying retailer discounts or a veterinarian-only rebate. A six-month supply and a twelve-month supply cover different numbers of months; neither package total alone establishes the best price. A cheaper-looking offer may also be the wrong prescription.
As a dated example, an indexed Chewy listing checked on September 17, 2026 showed $235.59 for six NexGard Plus chews for dogs weighing 33.1–66 pounds, product 899766. That works out to $39.27 per monthly dose, rounded. This is a search-index price snapshot, not a guaranteed checkout quote; it excludes tax and shipping and does not subtract a veterinarian-only rebate. Check the current price and prescribed strength on the NexGard Plus product listing.
| Cost check | What to compare | Why it matters |
|---|---|---|
| Same weight band | Exact strength on the prescription | A cheaper different strength is not a valid substitute |
| Same number of months | Total payable amount divided by monthly doses | Separates a 6-month supply from a 12-month supply |
| Recurring price | Initial promotion and later refill price | A first-order offer may not continue |
| Rebate eligibility | Veterinary purchase versus retail purchase | A vet-only manufacturer rebate cannot automatically be deducted from a pharmacy quote |
| Additional charges | Shipping, tax and required clinic services | These can change the total cost |
For Costco or Sam's Club, request a current pharmacy quote for the exact PLUS strength and pack and confirm any membership pricing conditions. The same approach applies to a three-month supply, where available, versus a six- or twelve-month purchase. We do not have a matched, verified Costco quote establishing that it is the cheapest seller. A displayed search price or someone else's receipt is not a reliable universal price.
If the total is unaffordable, ask your veterinarian about a less expensive complete prevention plan. The best place to buy is not always the seller advertising a short sale: compare the refill cost and any required separate medicines. A cheaper flea-only alternative may leave heartworm prevention and intestinal parasite treatment to budget for. Choose a workable monthly plan your dog can safely receive on schedule.
What is the cheapest way to buy NexGard?
The cheapest way to buy NexGard starts with confirming whether the prescription is for original NexGard or NexGard Plus. Compare the exact prescribed formulation, weight band and number of monthly doses, including shipping and tax. Then check which discounts apply to that purchase channel: a veterinarian-only rebate cannot automatically reduce a retail pharmacy quote. Ask for both pharmacy and clinic totals; a lower advertised package price alone does not establish the cheapest complete prevention plan.
How much does a three-month supply of NexGard cost?
A three-month supply means three monthly doses of the prescribed formulation. Original NexGard and NexGard Plus have different prices and coverage. As a dated example, Tractor Supply's NexGard Plus listing for dogs weighing 4–8 pounds showed a three-dose, one-time-purchase price of $113.49 in retrieved page content checked September 17, 2026, or $37.83 per month. Confirm the checkout total before ordering. This small-dog example cannot establish a cheaper seller than the differently weighted Chewy six-pack above.
NexGard Plus vs Simparica Trio
Both products combine monthly flea, tick and heartworm protection with treatment of specified intestinal worms. NexGard Plus uses afoxolaner; Simparica Trio uses sarolaner. Both also contain moxidectin and pyrantel, but their ingredient amounts, labeled worm stages and minimum weights differ. Shared ingredient names do not make the strengths interchangeable.
Simparica Trio also has a US indication for preventing Dipylidium caninum infection by killing the fleas that transmit it. That is a specific tapeworm-prevention claim, not treatment of existing tapeworms, and it should not be transferred to PLUS. Both products carry the isoxazoline neurologic warning, so switching between them does not automatically remove that concern.
For the complete coverage, safety and purchasing decision, use Simparica Trio vs NexGard Plus. Reddit experiences and side-effect reviews can raise questions to discuss, but cannot determine which product will be safer for your individual dog. Nor can an unmatched pack price establish a cheaper winner: compare the dog's prescribed strength, monthly cost and eligible discounts before deciding with the veterinarian.
NexGard Plus rebates and discounts
For 2026, the official NexGard rebate page lists NexGard Plus rebates of $25 for six doses or $65 for twelve doses purchased at one time through a veterinarian, with a published expiration of January 31, 2027. Veterinary purchase is an eligibility requirement for this rebate. To apply, save the qualifying receipt and follow the official submission instructions; check the current terms before ordering.
Manufacturer rebates are different from merchant coupons, a promo code or an autoship discount. The veterinarian-purchase condition matters: do not assume that buying the same six-pack from Chewy, Costco or another retail pharmacy qualifies for this particular offer. The rebate should only enter your cost calculation once your actual purchase meets the terms.
When comparing offers, ask the clinic for its total price before and after an eligible rebate, then compare that with the pharmacy's actual checkout total. Check whether discounts can be combined and whether a first-order promotion affects later refills. A code from an expired 2025 offer or an unrelated NexGard-family promotion does not establish a valid PLUS discount today.
Where to buy NexGard Plus with a prescription
NexGard Plus is prescription-only in the United States. Your veterinarian can dispense it or authorize a prescription for a pharmacy that carries the exact product and strength. A site advertising NexGard Plus without a vet prescription or “over the counter” is not a way to avoid the medical assessment required for this medication. The same prescription distinction applies to original NexGard.
Chewy has a verified PLUS product listing linked above. If you need NexGard Plus for dogs near you, call the nearby pharmacy before traveling: an online listing does not guarantee local stock. A search for NexGard on Amazon may also return a different formulation, supplement or accessory, so read the complete product name and seller information.
- Match “NexGard PLUS” and the weight band to the prescription.
- Confirm that the seller uses a valid prescription-approval process.
- Compare the total payable amount and expected delivery date.
- Arrange the refill early enough to avoid missing a monthly dose.
For Petco, PetMeds or Allivet, verify the current PLUS listing and prescription service before relying on availability. Ask Costco or Sam's Club about the pharmacy's current options and fulfillment process. The best place to buy is a legitimate pharmacy that can reliably fill the prescription. If authorization is delayed, contact the clinic before the next dose is due; do not stretch the schedule or use another dog's leftover prescription while waiting.
Can I buy NexGard Plus at Walmart?
Yes. Walmart has an official NexGard PLUS online listing for the 8.1–17-pound strength, marked prescription required and sold and shipped by Walmart.com. That confirms an online PLUS product listing, not availability of every strength or stock at a nearby store. Check the prescribed weight band and selected quantity before ordering; original NexGard is a separate product, and the complete name matters.
Can I buy NexGard at Tractor Supply?
Yes. For the PLUS formulation discussed here, Tractor Supply lists NexGard Plus online, with prescription approval required and fulfillment through Allivet. The verified 4–8-pound, three-month product is online-only; do not assume it is on a local store shelf. If your prescription says original NexGard, select that separate formulation instead. Confirm the strength, quantity and delivery timing with the pharmacy before placing a refill order.
Can I buy NexGard at PetSmart?
Yes. PetSmart's online pharmacy lists both original NexGard and NexGard Plus, with PLUS options in several strengths and quantities. Its pharmacy service explains prescription verification and fulfillment through Vetsource. Choose the exact formulation and weight band prescribed for your dog, rather than treating the two names as interchangeable. Online pharmacy availability does not establish in-store shelf stock, and an advertised promotion should be checked at checkout.
NexGard Plus side effects and safety
Reported NexGard Plus side effects in its US field study included diarrhea, vomiting and lethargy. These signs can have other causes, so a symptom after a dose does not by itself prove the medicine caused it. Tell your veterinarian when the chew was given, when signs started, their severity and any other medicines or illnesses. Persistent vomiting, repeated diarrhea or marked changes in behavior deserve prompt advice.
Afoxolaner belongs to the isoxazoline class. The FDA's safety notice describes potential neurologic reactions including muscle tremors, poor coordination and seizures. Reactions have been reported in dogs without a previous seizure history. FDA also considers these products safe and effective when used appropriately, and reports that most animals do not experience neurologic adverse reactions.
The label lists no known contraindications but instructs caution in dogs with a history of seizures or neurologic disorders. Those statements are compatible: the absence of a listed absolute prohibition does not remove an individual dog's risk factors. Tell the prescriber about previous reactions to flea or tick products, including a different brand, and discuss whether an alternative class of prevention would fit your dog better.
The label has not evaluated breeding, pregnancy or lactation safety. That is a data limitation rather than proof that every exposure will cause harm. A veterinarian should assess an appropriate plan for breeding, pregnant or nursing dogs. Likewise, a dog with an established neurologic condition or a complex medication list needs an individualized discussion rather than a blanket recommendation based on age and weight alone.
Online reviews cannot establish the likelihood of a side effect or long-term safety for all dogs. The product's field study followed dogs through 11 monthly administrations; percentages of events during that study are not the chance of a reaction to one dose and cannot be compared directly with percentages from another brand's separate trial. Ask what the evidence means for your dog's circumstances. Our guide to choosing a flea treatment for your dog explains the broader conversation.
NexGard vs NexGard Plus and Spectra
There is a meaningful difference between NexGard and NexGard Plus. Original US NexGard contains afoxolaner for flea and tick control; it does not provide the heartworm and intestinal worm coverage of the three-ingredient PLUS product. A dog receiving original NexGard may therefore have a separate prescribed heartworm preventive. Do not assume the word “NexGard” alone identifies a complete plan.
NexGard Spectra is another distinct formulation used in other markets. It combines afoxolaner with milbemycin oxime, rather than the moxidectin-and-pyrantel combination in US PLUS. Country-specific indications and instructions must be checked against that product's own label. A familiar box name on an overseas website does not make it the same medicine or justify substituting its dose instructions.
NexGard COMBO is a separate topical product for cats. It is not a dog chew, and “combo” used conversationally to mean a combination medicine should not be mistaken for the COMBO brand. When requesting a prescription, ordering a refill or reporting a possible side effect, provide the full product name and weight band. A clear label photo can help the clinic identify what was actually dispensed.
NexGard Plus questions from dog owners
Frequently Asked Questions
How much does NexGard cost at Walmart?
Walmart lists NexGard Plus online, but the verified PLUS listing displays its price in the cart, so we do not have a reliable dollar cost to quote. Confirm whether you need original NexGard or PLUS, then check the prescribed strength and selected pack quantity. The retrieved listing has inconsistent pack-count text, making a matched checkout quote especially important. The Walmart pharmacy listing requires a valid prescription and does not establish nearby store inventory.
Can cats take NexGard Plus?
Cats should not take NexGard Plus. It is labeled for dogs only; do not give a cat a dog chew or an estimated fraction of one. NexGard COMBO is a different cat medication with different ingredients and topical administration. If a cat swallows a PLUS chew, contact your veterinarian promptly with the package, the cat's weight and the approximate amount eaten.
Does NexGard Plus kill mites?
NexGard Plus is not labeled to kill mites, including ear mites, under its current US label. Itching or ear debris needs a diagnosis and a mite treatment plan rather than an assumption that routine PLUS will treat it. Veterinarians may make specific prescribing decisions for conditions outside a label, but owners should not borrow instructions from a different NexGard product or give extra doses.
Does NexGard Plus prevent screwworm?
Do not rely on NexGard Plus to prevent screwworm. FDA's current New World screwworm treatment reference lists emergency authorizations for certain other named products, including original NexGard; that authorization does not extend to PLUS for screwworm prevention. A wound with maggots or a foul odor needs immediate veterinary care, even if a dog receives routine parasite prevention.
Is there a generic NexGard Plus?
Do not assume that a less expensive chew is an equivalent generic NexGard Plus. The PLUS product combines three active ingredients in specific strengths; sharing one ingredient or a similar name is insufficient. Ask the veterinarian or pharmacist to verify an FDA-approved equivalent and current pharmacy availability before substituting. A different preventive plan may be an option, but its full parasite coverage must be checked.
What if my dog will not eat NexGard Plus?
If your dog will not eat NexGard Plus, contact the prescribing veterinarian about a practical administration plan or another suitable formulation. The label allows dosing with or without food, but the dog must swallow the entire dose. Explain whether any portion was swallowed before giving another chew, because an uncertain partial dose should not be treated as definitely no dose.
$65 · no membershipNeed a prescription for NexGard Plus?
A licensed vet can assess your dog over video and prescribe NexGard Plus online when it's appropriate.
Talk to a vet- Licensed vets
- All 50 states
- same-day Rx
Webvet may earn a commission if you book.
Veterinarian · BVMS MRCVS
Dr. Pippa Elliott, BVMS, MRCVS, is a veterinarian with nearly 30 years of experience in companion animal practice. Dr. Elliott earned her Bachelor of Veterinary Medicine and Surgery from the University of Glasgow. She was also designated a Member of the Royal College of Veterinary Surgeons. Married with 2 grown-up kids, Dr. Elliott has a naughty Puggle named Poggle, 3 cats and a bearded dragon.
