Elanco Credelio PLUS Chewable Tablets for Dogs | Lotilaner + Milbemycin Oxime | Monthly Protection Against Ticks, Fleas, Heartworm & Intestinal Worms | 3 Tablets

Perform a Dirofilaria immitis antigen test before initiating Credelio PLUS in dogs not previously on heartworm prevention — administering Milbemycin Oxime to dogs with patent heartworm infection (high microfilarial burden) can cause anaphylactoid shock from rapid microfilarial kill. Do not use in dogs under 8 weeks of age. Do not use in dogs under 2.8kg body weight. Isoxazoline-class products (Lotilaner) have been associated with neurological adverse events in some dogs including tremors, ataxia, and seizures — use with caution in dogs with a history of neurological disorders including epilepsy. Safety in breeding, pregnant, and lactating dogs not fully established — confirm with veterinarian. Not for use in cats. Keep out of reach of children. Store in original packaging below 30°C. Protect from moisture.

Elanco Credelio PLUS™ Chewable Tablets for Dogs | Lotilaner + Milbemycin Oxime | Monthly Protection Against Ticks, Fleas, Heartworm & Intestinal Worms | 3 Tablets

Elanco Credelio PLUS is a prescription veterinary combination endectocide chewable tablet for dogs that delivers simultaneous monthly protection against ectoparasites (ticks and fleas — Lotilaner) and endoparasites (heartworm larvae, roundworms, hookworms, and whipworms — Milbemycin Oxime) in a single palatable beef-flavoured oral tablet. Credelio PLUS replaces the need for separate ectoparasiticide and endoparasiticide products, simplifying the monthly parasite control programme and improving owner compliance. Available in four weight-banded strengths with fixed Lotilaner:Milbemycin Oxime ratios providing consistent mg/kg dosing across the weight range. Administer monthly with food or immediately after feeding. Must be prescribed by a licensed veterinarian.

Active Ingredients & Mechanisms of Action

• Lotilaner — Isoxazoline-class ectoparasiticide (GABA-gated chloride channel AND glutamate-gated chloride channel dual antagonist): Lotilaner is an isoxazoline (the isoxazoline pharmacophore: a five-membered heterocyclic ring containing one oxygen and one nitrogen atom in 1,2-positions — the same core scaffold shared by Fluralaner, Afoxolaner, and Sarolaner); Lotilaner has a dual mechanism of action distinguishing it from some isoxazolines that predominantly target only one channel type: (1) GABA-gated chloride ion channel (GABA-Cl) antagonism — Lotilaner binds to a transmembrane allosteric site on the homomeric or heteromeric GABA-A-like receptor complexes in arthropod (tick and flea) nerve and muscle cells distinct from the GABA orthosteric binding site and distinct from the organochlorine (lindane/dieldrin) binding site — Lotilaner binding prevents GABA-mediated Cl− channel opening in ectoparasite neurons → loss of GABA inhibitory neurotransmission at arthropod synapses → uncontrolled neuronal excitation → tetanic paralysis and death; the GABA-Cl channel in arthropods is a homomeric or heteromeric pentamer of arthropod-specific GABA receptor subunits (structurally related to vertebrate GABA-A receptors but with significant differences in the allosteric binding pocket architecture that confer the vertebrate selectivity of isoxazolines); (2) GluCl (glutamate-gated chloride channel) antagonism — distinct from macrocyclic lactones (Milbemycin, Ivermectin) which are GluCl positive allosteric modulators/agonists, Lotilaner also antagonises (blocks) GluCl channels by a distinct binding mechanism; this dual GABA-Cl + GluCl antagonism provides broader neurotoxic coverage against ectoparasites; vertebrate safety: mammalian GABA-A receptors differ in subunit composition and allosteric pocket architecture from arthropod GABA-Cl channels → Lotilaner has very low affinity for mammalian GABA-A receptors at therapeutic plasma concentrations; additionally, the blood-brain barrier P-glycoprotein (ABCB1) efflux limits CNS Lotilaner exposure in P-gp-intact dogs; NEUROLOGICAL ADVERSE EVENT WARNING: isoxazoline-class products (including Lotilaner) have been associated with neurological adverse events (tremors, ataxia, seizures) in some dogs, particularly those with pre-existing neurological conditions or compromised BBB; the FDA has issued safety communications for the isoxazoline class; ectoparasite spectrum: Ctenocephalides felis (cat flea — predominant flea on dogs in India), Ctenocephalides canis; Rhipicephalus sanguineus (brown dog tick — primary vector of Ehrlichia canis tick fever in India), Haemaphysalis longicornis, Amblyomma americanum, Ixodes scapularis, Ixodes ricinus, Dermacentor variabilis; speed of kill: flea kill within 4 hours of administration; tick kill within 8–48 hours depending on species; duration: monthly dosing provides continuous protection for 35 days (tick) and 35 days (flea)
• Milbemycin Oxime — Macrocyclic lactone endoparasiticide (GluCl channel positive allosteric modulator/irreversible agonist; same MOA class as Ivermectin): Milbemycin Oxime is a macrocyclic lactone produced by fermentation of Streptomyces hygroscopicus var. aureolacrimosus (distinct fermentation source from Ivermectin’s S. avermitilis); Milbemycin Oxime is a mixture of Milbemycin A3 oxime and A4 oxime in a ~20:80 ratio; mechanism: identical to Ivermectin at the molecular target level — selectively binds and positively allosterically modulates glutamate-gated chloride channels (GluCl — invertebrate-specific Cys-loop receptor family channels absent from vertebrate CNS) in nematode and arthropod nerve and muscle cells → sustained Cl− influx → membrane hyperpolarisation → pharyngeal pump paralysis (starvation) and body wall flaccid muscle paralysis → death of susceptible parasites; key distinction from Ivermectin: Milbemycin Oxime is significantly safer in MDR1/ABCB1-mutant herding breeds (Collie, Sheltie, Australian Shepherd) at therapeutic antiparasitic doses — Milbemycin Oxime has a wider safety margin in MDR1(-/-) dogs than Ivermectin; Milbemycin Oxime at heartworm preventative doses (0.5–1.0mg/kg monthly) provides: (a) Dirofilaria immitis L3/L4 larval kill — monthly administration kills developing heartworm larvae within 30 days of infection (preventing establishment of adult D. immitis infection — the tissue stage that causes cardiopulmonary disease and pulmonary hypertension in dogs; adult D. immitis — a dioecious filarial nematode — reside in the pulmonary arteries and right ventricle of dogs causing progressive endarteritis, pulmonary arterial hypertension, right-sided congestive heart failure, and caval syndrome); (b) microfilaricidal activity — kills D. immitis microfilariae (L1 larvae) in the bloodstream of patent heartworm-infected dogs (WARNING: rapid microfilarial kill in dogs with high microfilarial burdens can trigger anaphylactoid reactions — antigen test before first dose is mandatory in non-previously-protected dogs); at the doses used in Credelio PLUS, Milbemycin Oxime also treats/controls: Toxocara canis (roundworm — the most common GI nematode of dogs — an L2-containing embryonated egg → per-oral ingestion → gastric hatching → L3 hepatoportal migration → pulmonary migration → tracheal ascent → GI adult worm cycle; or somatic larval migration to muscle/CNS/placenta in adult dogs), Toxascaris leonina, Ancylostoma caninum (hookworm — the most pathogenic small intestinal nematode of dogs — produces haemorrhagic enteritis, hypoproteinaemia, and severe anaemia via blood-feeding; percutaneous larval skin penetration is an additional route of infection), Ancylostoma braziliense, Trichuris vulpis (whipworm — large intestinal nematode causing typhlitis and large bowel diarrhoea)

Weight-Banded Dosing

• 2.8–5.5 kg — Lotilaner 112.5mg + Milbemycin Oxime 4.22mg per tablet — ₹1,500 (MRP ₹1,700): Small breed dogs — Toy breeds, Chihuahua, Pomeranian, Shih Tzu, Maltese
• 5.5–11 kg — Lotilaner 225mg + Milbemycin Oxime 8.44mg per tablet — ₹2,200 (MRP ₹2,400): Small-to-medium breed dogs — Beagle, Miniature Poodle, Miniature Schnauzer, Cocker Spaniel
• 11–22 kg — Lotilaner 450mg + Milbemycin Oxime 18mg per tablet — ₹2,400 (MRP ₹2,700): Medium breed dogs — Labrador (small), Springer Spaniel, Border Collie, Standard Poodle
• 22–45 kg — Lotilaner 900mg + Milbemycin Oxime 33.75mg per tablet — ₹2,999 (MRP ₹3,350): Large breed dogs — Labrador Retriever, Golden Retriever, German Shepherd, Rottweiler, Bernese Mountain Dog
• For dogs over 45kg: combine appropriate weight-band tablets as directed by veterinarian
• Administer once monthly on the same calendar date; administer with food or immediately after feeding to maximise Lotilaner absorption (Lotilaner is a highly lipophilic compound — food increases AUC by approximately 2–3× vs fasted administration)
• Parasite Coverage Summary
  • Ticks — Rhipicephalus sanguineus, Haemaphysalis spp., Ixodes spp., Amblyomma spp., Dermacentor spp. (monthly kill; no repellent effect — ticks attach briefly before being killed)
  • Fleas — Ctenocephalides felis, Ctenocephalides canis (kills adult fleas within 4 hours; prevents reinfestation for 35 days; breaks flea lifecycle by eliminating egg-laying adults)
  • Heartworm (Dirofilaria immitis) — monthly prevention of L3/L4 larval establishment; microfilaricidal
  • Roundworm — Toxocara canis, Toxascaris leonina
  • Hookworm — Ancylostoma caninum, Ancylostoma braziliense
  • Whipworm — Trichuris vulpis

Contraindications & Safety

• Heartworm antigen test mandatory before initiating in non-protected dogs in heartworm-endemic areas
• Use with caution in dogs with history of neurological disorders — isoxazoline-class neurological adverse event risk (Lotilaner)
• Do not use in dogs under 8 weeks of age or under 2.8kg
• MDR1/ABCB1 herding breeds (Collie, Sheltie, Australian Shepherd): Milbemycin Oxime is safer than Ivermectin at preventative doses in MDR1(-/-) dogs but confirm with veterinarian; Lotilaner MDR1 interaction — P-gp substrate; confirm safety in MDR1-tested herding breeds
• Not for use in cats
• Concurrent use with other isoxazoline-class ectoparasiticides not recommended
• Treat the environment (flea eggs, larvae, pupae in bedding/home) concurrently for complete flea control — 95% of the flea lifecycle is environmental
• Store below 30°C in original packaging; protect from moisture; keep out of reach of children