Moxidectin for Dogs and Cats

With all of the different types of flea, tick, and heartworm medications available for dogs and cats it’s sometimes difficult to keep track of the ingredients and which parasites they treat. Moxidectin is found in multiple products including Simparica Trio for Dogs, Advantage Multi for Cats, Advantage Multi for Dogs, and Bravecto Plus for Cats. Moxidectin is used in dogs and cats to prevent heartworm disease and treat and control infections of intestinal parasites including roundworms, and hookworms. Moxidectin itself does not kill fleas or ticks, but it is often combined with other active ingredients in topical and oral products that provide broad-spectrum protection against a host of parasites.

How Does Moxidectin Work?

Moxidectin is labeled for the prevention of heartworm disease in dogs and cats. It is important to know that Moxidectin only prevents heartworm disease and does not treat existing heartworm infections. This is because it is only effective in killing immature heartworm larvae (Dirofilaria immitis) and does not kill the adult heartworms found in animals with existing infections. It also treats and controls infections of intestinal parasites including hookworms and roundworms.

Products with Moxidectin

 

Does it Require a Prescription?

Products containing Moxidectin require a prescription from a veterinarian because of their ability to prevent heartworm disease. The American Heartworm Society and most veterinarians recommend an annual heartworm test before prescribing a heartworm preventative for your dog or cat. This is because dogs and cats with existing heartworm infections can have serious complications after taking preventatives. Learn more.

It is always recommended to speak with your veterinarian about the right parasite preventative product for your dog or cat’s needs. Your veterinarian can recommend the best product for your dog or cat based on your location and the type of parasites they may encounter.

 


This information is not intended to diagnose or treat any disease and is purely educational. Please seek advice from your pet’s veterinarian with any questions regarding the health of your pet. 

Selamectin for Dogs and Cats

With so many different flea, tick, and heartworm preventatives available for dogs and cats it’s sometimes difficult to keep track. Selamectin is a topical antiparasitic medication for dogs and cats prescribed for various parasite infections. Selamectin is the active ingredient found in multiple products including Revolution For Dogs, Revolution for Cats, Selarid for Dogs, Selarid for Cats, Revolt for Cats, Revolt for Dogs, Senergy for Cats, and Senergy for Dogs. Selamectin is used in dogs and cats to prevent heartworm disease and treat and control flea and ear mite infestations. In dogs, Selamectin also controls tick infestations of the American dog tick and treats sarcoptic mange. In cats, it also treats intestinal roundworm and hookworm infections. 

How Does Selamectin Work?

Medications containing selamectin are applied to the skin of dogs or cats and are absorbed with the natural oils secreted by their skin. Selamectin works to kill parasites by interfering with the nervous system of the infecting parasite. 

What Parasites Does Selamectin Work Against?

Dogs:

  • Prevents heartworm disease
  • Treats ear mites
  • Treats sarcoptic mange
  • Controls American Dog tick infestations
  • Kills adult fleas and prevents flea eggs from hatching

Cats:

  • Prevents heartworm disease
  • Treats ear mites
  • Treats hookworms & roundworms
  • Kills adult fleas and prevents flea eggs from hatching

Selamectin Prevents Heartworm Disease

Selamectin is labeled for the prevention of heartworm disease in dogs and cats. It is important to know that Selemctin only prevents heartworm disease and does not treat existing heartworm infections. This is because it is only effective against killing the immature heartworm larvae (Dirofilaria immitis) and does not kill the adult stage heartworms found in animals with existing infections. 

Products with Selamectin

Does Selamectin Require a Prescription?

Products containing Selamectin require a prescription from a veterinarian because of their ability to prevent heartworm disease. The American Heartworm Society and most veterinarians recommend an annual heartworm test before prescribing a heartworm preventative for your dog or cat. This is because dogs and cats with existing heartworm infections can have serious complications after taking preventatives.

It is always recommended to speak with your veterinarian about the right parasite preventative product for your dog or cat’s needs. Your veterinarian can recommend the best product for your dog or cat based on your location and the type of parasites they may encounter. 


This information is not intended to diagnose or treat any disease and is purely educational. Please seek advice from your pet’s veterinarian with any questions regarding the health of your pet. 

Heartworm Disease in Cats: Prevention is Treatment

Commonly, we consider heartworm disease as one that only affects dogs, not cats. However, cats are at the same risk of contracting this serious disease. Just like dogs, cats can get heartworms when they are bitten by an infected mosquito.Cats that go outdoors are more likely to be exposed, however, a mosquito can easily get into the house and infect the cat. Different from dogs, most heartworm larvae in cats do not grow into adult worms, because the cat is not the ideal host. Yet, heartworm larvae can create permanent damage to the lungs and blood vessels, and affect the immune system. Adult worms take up residence within the heart, clogging blood vessels and interfering with the heart valves.

Signs & Symptoms

Cats infected with heartworm disease may show little to no symptoms or experience serious complications. Diagnosis can require an exam, blood tests, and X-rays to confirm infection. Symptoms may include the following:

  • Coughing
  • Wheezing
  • Difficulty breathing
  • Asthma-like attacks
  • Loss of appetite and/or weight loss
  • Fainting or seizures
  • Sudden collapse or death

Treatment and Prevention

Prevention equals the best medicine. Currently, no treatment or drug therapy exists for cats infected with heartworm disease. Heartworm preventative medications kill immature worms and keep new infections from developing if an infected mosquito bites your cat again. All heartworm medications require a prescription from your veterinarian, for the purpose of annual blood testing to be sure your cat is not infected. Preventative medications are highly effective, but cats may still become infected. Even with a single missed dose. Giving heartworm medication to infected cats may lead to serious reactions.

April represents National Heartworm Disease Awareness Month, but this disease does not follow a season. Because heartworm disease has been diagnosed in all 50 states, the American Heartworm Society recommends that you “think 12:” (1) get your pet tested every 12 months for heartworm and (2) give your pet heartworm preventive 12 months a year.

VetRxDirect has a variety of heartworm and parasite preventative treatments for cats. Because these require a prescription, choosing the right medication for your cat should be done with the help of your veterinarian to make sure they have the best protection.

Heartgard for Cats at VetRxDirectHeartgard for Cats

  • Kills heartworm larvae in cats
  • Eliminates adult and immature hookworms
  • Tasty chewable
  • Give once a month
  • Safe for cats six weeks and older

 

Revolution for Heartworm Disease Prevention at VetRxDirectRevolution for Cats

  • Kills fleas and controls flea infestations
  • Eliminates hookworm and roundworm
  • Prevents heartworm disease
  • Treats and controls ear mites
  • Convenient monthly topical treatment

 

Advantage Multi At VetRxDirectAdvantage Multi for Cats

  • Prevents heartworm disease
  • Kills fleas and controls flea infestation
  • Eliminates hookworms and roundworms
  • Treats and controls ear mites
  • Broad spectrum, monthly topical treatment

 

Heartworm Disease Affects All Dogs

April represents National Heartworm Awareness Month, and for good reason. Heartworm disease is a serious disease found throughout the entire United States affecting both dogs and cats. Heartworm disease, a parasitic infection spread by mosquitoes, affects any dog. These include young, old, male, female, indoor, and outdoor dogs. Heartworm larvae circulate within the blood. Adult heartworms live for years within the heart, clogging blood vessels and interfering with the heart valves. As a result, the damage is caused to the heart, lungs, blood vessels, kidneys, and liver.

When is Heartworm Season?

Heartworm disease has been diagnosed in all 50 states. Because infected mosquitoes can come inside, both outdoor and indoor pets are at risk. For that reason, the American Heartworm Society recommends that you “think 12:” (1) get your pet tested every 12 months for heartworm and (2) give your pet heartworm preventive 12 months a year.

Signs & Symptoms

Dogs infected with heartworm disease in the early stages show little to no symptoms until eventually, the infection persists. In that case, look for these signs:

  • reluctance to exercise.
  • a soft, dry cough.
  • shortness of breath.
  • weakness.
  • fatigue after moderate activity.
  • decreased appetite.
  • weight loss.

Heartworm Disease Prevention & Treatment

Prevention is the best medicine since it can be very difficult and expensive to treat infected dogs. No treatment currently exists for cats. Heartworm preventative medications kill immature worms and prevent them from maturing into adults that cause illness. For this reason, you give preventive medications continuously every 30 days to kill the existing larvae, and cannot kill adult worms. All heartworm medications require a prescription from your veterinarian, for the purpose of annual blood testing to be sure your pet is not infected. This is including dogs already given prevention year-round. Preventative medications are highly effective, but dogs can still become infected. Consequently, even if you miss just one dose. Giving heartworm medication to infected dogs may lead to severe reactions. Learn more about Heartworm Positive Dogs.

VetRxDirect stocks a variety of heartworm and parasite preventative treatments for dogs. Because these require a prescription, choosing the right medication for your dog should be done with the help of your veterinarian so they receive the best protection.

Heartgard Plus Heartworm Disease PreventativeHeartgard Plus For Dogs

  • Effectively kills heartworms, hookworm, and roundworm
  • Tasty chewable dogs love
  • Convenient monthly dosing
  • Safe for dogs six weeks and older
  • Dog with food allergies or special dietary needs–Heartgard Tablets do not contain any flavors or beef

 

Related imageTri-Heart Plus

  • Triple protection from heartworms and intestinal worms
  • Kills hookworms and roundworms
  • Tasty chewable tablet
  • Same active ingredients as brand name heartworm medications

 

 

Interceptor Plus at VetRxDirectInterceptor Plus

  • Prevents heartworm disease in dogs
  • Kills tapeworms, whipworms, hookworms, roundworms
  • Contains milbemycin oxime and praziquantel
  • Provides 1 month of protection
  • Tasty chew

 

 

Trifexis at VetRxDirectTrifexis

  • Prevents heartworm disease
  • Kills roundworms, whipworms, and hookworms
  • Kills and control fleas
  • Provides 1 month of protection
  • For dogs 8 weeks and older

 

Which heartworm prevention do you give to your dog? Leave us a comment below.

Keep Calm and Be Prepared for Heartworm Season

April is National Heartworm Awareness Month, and for good reason. Heartworm is a serious disease found throughout the entire United States that affects both dogs and cats. Prevention is the best medicine. It can be very difficult and expensive to treat infected dogs, and there is currently no treatment for cats.

The parasite Dirofilaria immitis, commonly called heartworm, is transmitted from animal to animal by mosquitoes. When an infected mosquito bites your pet it can transmit the Dirofilaria larvae into your pet’s bloodstream. Once inside your pet, the larvae continue to develop over the course of about six months. They make their way to the heart or lungs where they mature and reproduce. Adult worms live for years. They can grow to more than 12 inches long and cause blockages in the heart and lungs and damage to arteries.

Is My Pet At Risk?

Heartworm Incidence Map Courtesy of the American Heartworm Society

Heartworm disease is more prevalent throughout the midwest and southeast but has been diagnosed in all 50 states. Because infected mosquitoes can come inside, both outdoor and indoor pets are at risk.

The American Heartworm Society recommends that you “think 12:” (1) get your pet tested every 12 months and (2) give your pet heartworm preventive 12 months a year.

Preventatives

Heartworm medications kill immature worms and prevent them from maturing into adults that cause illness. For this reason, preventive medications are given continuously every 30 days because they kill the existing larvae, and cannot kill adult worms. Heartworm medications require a prescription from your veterinarian because annual blood testing is required to make sure your pet is not infected.

Oral Heartworm Diesease Preventatives Available at VetRxDirect

Oral Heartworm Preventatives Available at VetRxDirect

Some preventatives can also control intestinal parasites like hookworms, roundworms, whipworms, and tapeworms. Some products are even effective in treating external parasites such as fleas, ticks, ear mites, and the mite that causes scabies.

Stop Mosquitoes

It may be next to impossible to keep all mosquitoes away from your pet, but they can carry many other diseases that can harm your pet. Here are some helpful tips you can take to reduce their exposure to mosquito bites.

  • Use a parasite preventative for your pet that repels and kills mosquitoes
  • Use a pet-friendly insect repellant
  • Get rid of standing water sources around your home
  • Grow mosquito repelling plants like basil or marigolds
  • Use caution with yard pesticides

We have a large selection of heart worm and parasite preventative treatments for both dogs and cats. Choosing the right product for your pet should be done with the help of your veterinarian to make sure they have the best protection.

Unflavored Heartworm Prevention

Unflavored Heartworm Prevention Heartgard Tablets are Back!

Unflavored Heartworm Prevention Heartgard Tablets is back in stock.

Unflavored Heartworm Prevention is Now Available!

Does your dog have digestive disorders or meat/additive allergies? If so, buying a monthly heartworm preventative can be challenging. Heartgard has made it easier by providing you with the option of an unflavored tablet. The tablet contains ivermectin, just as the chew does, and is given monthly to prevent heartworm disease in dogs. This is a great option for dogs with allergies to certain foods, treats, etc.

What is the difference between Heartgard Tablets and Heartgard Plus?

Heartgard Tablets is a product similar to Heartgard Plus, except Heartgard Plus contains pyrantel pamoate along with ivermectin. Pyrantel Pamoate provides an added benefit of treating/preventing roundworms and hookworms. Unfortunately, there is no unflavored version of Heartgard Plus available at this time. Therefore, you will want to consult with your veterinarian about the need of adding in a dewormer if your dog is prescribed Heartgard Tablets.

Leave us an Unflavored Heartworm Prevention Review

Have you given Heartgard Tablets in the past? Are you planning on going back to Heartgard Tablets? Leave a Reply below or consider a product rating and review on the VetRxDirect Heartgard Tablets product page. Thank you.

Pet Dewormers and Preventatives

Warmer weather brings a season of critters including intestinal and heart worms. When your pet has intestinal worms, it can be alarming but there is a wide array of treatment options available to rid the worms from your pet. There are also many preventatives for heartworms and intestinal worms, making it easy to keep the infestations at bay. The large amount of different wormers available can be confusing and hard to evaluate. This article, along with your veterinarian’s recommendations, can help you choose between the various de-wormers and preventative treatments against worms.

The right intestinal parasite ID is key:

An accurate identification of the worm is key in treating your pet’s infestation because most products are selective for certain worms. Heartworms will not be visible to you, but your pet will be experiencing serious symptoms such as cough, exercise intolerance, and abnormal lung sounds. These symptoms warrant an immediate visit to a veterinarian and possible hospitalization. When your pet has intestinal worms, you will likely notice the worms in their stools or surrounding fur.  Your veterinarian will probably be able to diagnose the intestinal worm with just a description, but some worms require an exam or stool sample for diagnosis.

Some of the most common worm infestations in dogs and cats include whipworms, heartworms, roundworms, hookworms, and tapeworms. Some of these worms are different in appearance and some are alike, making it hard to distinguish between them. This is especially true for the different types of tapeworms. There is a type called dipylidium caninum and they’re transmitted through infected fleas. They still resemble the appearance of other tapeworms, however these tapeworms are not always killed by the same medications as other tapeworms. It is important to talk to your veterinarian about any intestinal or heartworm infestation, because an accurate diagnosis and treatment is necessary to prevent complications and treatment failure.

More importantly, prevention:

The most important principle with worm infestations is preventing them from happening in the first place. There are several ways to keep worms at bay including keeping stools picked up, avoiding infested areas/pets, proper flea control, etc. You can also choose to use a preventative medication. These medications are usually administered monthly to your pet and can prevent and/or treat certain worm infestations. Heartworm preventative medications are necessary in almost all dogs because of the serious nature and frequency of heartworm infestation. All of the worm preventative medications work against heartworms for this reason but the products vary in what other worms they prevent or treat. You should also initiate worm prevention after an active infestation in your pet to reduce the chance of them coming back. Talk to your local veterinarian about specific ways to prevent worm infestations in your pet.

The two tables below display the various de wormers carried at VetRxDirect and what they are labeled to treat. The first table is the treatments we carry for pets with active intestinal worm infestations. Please note there are no heartworm treatment options from VetRxDirect because it’s an infestation requiring immediate and serious medical attention by your veterinarian. The second table shows the preventatives we carry for heartworms and intestinal worms. These tables can be used to supplement your veterinarian’s recommendations for purchasing worm treatments and preventatives.

Oral Dewormers for Active Parasite Infestation in Pets:

Oral Dewormers for Intestinal Parasites in Dogs and Cats

Click Anywhere on Table to Enlarge

Prescription Monthly Preventatives/Dewormers for Heartworms and Intestinal Parasites:

Prescription Monthly Preventatives/Dewormers for Dogs and Cats

Click Anywhere on Table to Enlarge

Take-home message about dewormers:

Prevention of worm infestations is one of the most important components for your pet’s healthy lifestyle. When prevention fails, the most effective way to treat your pet’s worm infestation is to have your veterinarian diagnose and prescribe medications specifically for your pet. OTC medications can be used with veterinarian approval or they may suggest a prescription product for your pet. Once the worms have been rid from your pet, it is important to initiate preventative measures or medications. Your veterinarian is a great resource to contact about preventing a re infestation in your pet.

What dewormers and worm preventatives have you given your pet? Did they work well? Let us know by leaving comments below or by clicking the ‘Reviews’ tab on any the dewormers or preventatives included in this post. Thank you.

Heartworms: Prevention is the Best Medicine

April showers bring May flowers… and, unfortunately, the onset of heartworm season in much of the country. That’s why it’s National Heartworm Awareness Month. Heartworm can be fatal and it is very difficult – and expensive — to treat so prevention is always your best bet.  Here’s what you need to know.

What types of animals get heartworm?

Many mammals get heartworm including dogs and cats. The disease is rare in humans.  Note that heartworm susceptibility, diagnosis, and treatment are different for dogs and cats.

Where are heartworms prevalent?

Heartworm can be found throughout the U.S. but it’s more prevalent in the Midwest and Southeast because the parasite flourishes in tropical and subtropical climates.  Check this map to see how common it is in your area:

 

Heartworm Incidence Map Courtesy of Heartwormsociety.org

Heartworm Incidence Map Courtesy of the American Heartworm Society

 

How do pets get heartworms?

The parasitic nematode Dirofilaria immitis, commonly called heartworm, is transmitted via mosquitoes. When a mosquito infected with heartworm bites your pet it can transmit heartworm larvae into your pet’s bloodstream. Once inside your pet, the larvae continue to develop over the course of about six months. They make their way to the heart or lungs where they mature and reproduce. Adult worms live for years, can grow to more that 12 inches long and cause blockages in the heart and lungs and damage to arteries.

What are the symptoms of heartworm disease?

Often there are no obvious initial symptoms when your pet is infected with heartworm. Once the disease has progressed, dogs may begin to cough, experience shortness of breath, and be unwilling to exercise. Symptoms in cats are non-specific – like coughing or rapid breathing — and are often mistaken for other medical problems. Some pets show no symptoms until they collapse or faint due to “caval syndrome,” at which stage the body is so infected that treatment and recovery are unlikely.

Why is heartworm prevention so important?

Once a pet has been bitten by an infected mosquito it takes up to six months for the heartworms to show up on tests. By then damage has been done and treatment regimens are costly, complicated and aren’t always effective. Your best bet is to prevent this disease rather than attempt to treat it.

We stock many heartworm preventative treatments for dogs and cats.  Choose from monthly oral medications or topical treatments — both types are effective, convenient, and affordable. Talk to your veterinarian about which treatment is best for your pet and your area.

Want to learn more about heartworm and how to prevent it? Listen to Dr Rubin’s short podcast presented by the American Heartworm Society.

Here’s to a happy, healthy spring for your pet!

Wes

Give Heartworm Preventatives Year Round

Photo by Brian KingHeartworm disease, a parasitic infection spread by mosquitoes, can affect any dog. They might be young, old, male, female, indoor, outdoor, a city and/or country pet, but no pooch is immune. A common disease, it is naturally more prevalent in areas with a large mosquito population.

Heartworms have an extremely long life cycle. Living within a dog’s heart and/or surrounding vessels, they actually grow anywhere from four inches to a foot long, reaching maturity twelve months post infection. These parasites can survive for as long as five to seven years. Offspring of adult heartworms also circulate within the infected animal’s blood. Quite often, a dog infected with heartworms will be asymptomatic in early stages of the disease.

Stressing a dog’s heart by restricting its blood flow as well as damaging other internal organs, heartworms are considered the most dangerous type of parasites that dogs can contract. A dog’s heart can become enlarged and weakened, leading to congestive heart failure which can be fatal.

Other common, less serious, parasitic infections dogs often contract include hookworms, tapeworms and roundworms.

Signs and Symptoms of heartworm disease in dogs include:

  • Dog has problems breathing.
  • Dog develops a cough.
  • Dog tires more quickly than usual.
  • Dog is listless.
  • Dog appears to be losing weight.
  • Dog has a distended abdomen.
  • Dog has a rough coat.

**Note**: Prompt detection and treatment avoid needless suffering for your dog.

If your dog has developed any of the above heartworm disease symptoms, here are steps that should be taken for accurate diagnosis and appropriate treatment:

  1. Blood Testing: Blood serum tests can determine the presence of heartworms in your dog’s bloodstream.
  2. Radiology and/or Ultrasound: In cases of more advanced stages of heartworm, x-rays and/or ultrasound are utilized to detect this parasitic infection.
  3. Medical Evaluation: Your dog’s veterinarian will perform a thorough medical examination to ascertain the progress of the disease.
  4. Follow-up Medication Visits: A series of follow-up visits will be needed in order for the doctor to administer several injections of strong anti-parasitic medication.
  5. Monitoring: Close monitoring of the animal is required, after the initial treatment, including hospitalization for a few days to keep the dog quiet.
  6. Surgery: In very severe cases, surgery may be required. This is very dangerous for the dog as well as expensive for the you.
  7. Confinement: Dead heartworms can cause strokes. Hence, the dog will need to be kept confined to a small room (or large crate) and not allowed to exercise for a few months after treatment is complete.

While you may find the above steps alarming, the good news is that the majority of dogs with heartworm disease can be successfully cured. This is typically accomplished with medications capable of killing both the adult parasites and their offspring.

However, there is no better cure than a proactive heartworm preventative! Heartworm prevention is considerably safer for your dog as well as much less expensive for you!

When given regularly and properly, heartworm preventative medications are very effective. They can successfully keep your beloved pet from contracting serious heartworm disease as well as control other types of parasitic infections (i.e. hookworm, roundworm, etc depending on medication).

It is essential your pet be kept on a monthly heartworm preventative regiment. Your dog still needs to be checked periodically to make sure the prescribed medication is providing adequate protection. 

One very effective heartworm product is Tri-Heart Plus (ivermectin/pyrantel). This combination medication is available in three different dosages of flavoured chewable tablets, depending on the size of your dog. Click here to read about additional pet meds for heartworm prevention or browse through VetRxDirect’s full selection of related treatments.

So do your part to keep your pup healthy and happy year-round by keeping heartworms at bay!

Should I give Heartworm Prevention to my Pet Year Around?

AHS_InfoGraphic

Protect Your Pet – Heartworm InfoGraphic Presented by the American Heartworm Society

One of the most serious diseases your pet can contract, heartworms are transmitted by the bite of an infected mosquito. If left untreated, the larvae will grow into mature worms that settle in the heart and the lungs. An affected dog or cat will tire easily, cough incessantly, and may succumb to the disease after a long and painful period of time. Because there is only one approved treatment for heatworms in dog and zero in cats, prevention is key.

Heartworm Tests for Dogs and Cats

It is important to start your canine or feline friend on a monthly heartworm preventative. First, your veterinarian may need to test your pet for heartworms before safely prescribing a preventative. Dogs should be tested every 12 months and pets should be on a preventative 12 months a year.

Sentinel is Back!

 

Monthly Preventatives for Heartworm Diesase

Advantage Multi: Available in both feline and canine versions, Advantage Multi protects your pet from heartworm disease and other parasites, including fleas, hookworms, roundworms, and whipworms. A single dose once a month is all you need to kill these fearsome freeloaders before they mature. Always consult your veterinarian before administering any prescription medication. In most cases, Advantage Multi is completely safe for puppies and kittens over two months old. On rare occasion, an animal may have an underlying health condition that prevents early treatment.  The topical drug is safe, affordable, and easy to apply.

Heartgard Plus: Formulated for dogs, Heartgard Plus kills heartworms, hookworms, and roundworms. These tasty chewables are safe for dogs six weeks or older, although it is important to consult your veterinarian before administering any prescription medication. This goes double if your pet is pregnant or has any underlying medical condition, especially a chronic one.

Like other preventatives, these once-monthly chewables contain FDA-approved drugs to control heartworms and other parasites.

Iverhart Max: Because it is a common disease, there are a number of safe and effective chewables used to prevent heartworm disease in dogs. Iverhart Max tablets are flavored chewable tables sold in monthly doses. In addition to guarding them from heartworm disease, they can also be used to treat hookworm, tapeworm, and roundworm infestations. Although the label says it is safe for dogs eight week of age and older, it is always best to consult your veterinarian before you give your canine friend any drug or supplement. If he has an underlying medical issue, a new medication could cause complications.