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Advantage Multi for Cats: A Combination Medication to Get Rid of Fleas and Worms

Sarah J. Wooten, DVM, CVJGhanasyam Bey, DVM
Published on March 26, 2024

Key takeaways:

  • Advantage Multi for cats is a medication used to prevent and kill several types of internal and external parasites.

  • Advantage Multi contains imidacloprid and moxidectin, which treat and prevent fleas, heartworm disease, ear mites, hookworms, and roundworms.

  • Cats will need to be given Advantage Multi once a month. It’s easy to give this medication, which is applied right on your cat’s skin.

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A cat is examined at an animal hospital.
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If you have a cat, you are likely motivated to keep them parasite-free as much as possible. Nobody wants their cat to get fleas, mites, or intestinal worms and heartworms. 

The good news is that you have options when it comes to medications that can prevent these pests. Advantage Multi for cats is one such option. 

If you want to learn more about Advantage Multi for cats, you’ve come to the right place. Let’s get started.

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Advantage Multi for cats at a glance

Common names

Advantage Multi (imidacloprid and moxidectin)

What it treats

Kills adult fleas and ear mites

Prevents heartworm disease

Treats hookworms and roundworms

How it comes (forms)

Topical single-dose applicators

Common side effects

Agitation

Excessive grooming

Hiding

Pacing

Spinning

Cost

$120 for a 6-month supply

What is Advantage Multi for cats, and how does it work?

Advantage Multi is an FDA-approved medication that is used to prevent specific external and internal parasite infestations in cats. It contains two active ingredients: 10% imidacloprid and 1% moxidectin. 

Imidacloprid is an insecticide that kills fleas. The benefit of using imidacloprid for flea prevention is that it can kill fleas on contact even before they bite your cat. This has several benefits, including: 

  • Reducing pain and irritation associated with flea bites

  • Lowering the chance of your cat contracting infectious diseases that are transmitted by flea bites

  • Killing fleas before they have a chance to reproduce

Moxidectin can keep your cat free of several types of worms. It kills heartworm larvae, hookworms, and roundworms, as well as ear mites. 

Advantage Multi is labeled for use in cats and kittens that are at least 9 weeks old and weigh 2 pounds or more.

How is Advantage Multi dosed and given for cats?

Advantage Multi for cats is a topical medication that is applied to the skin once a month. It comes prepackaged in ready-to-use single-dose applicator tubes based on a cat’s weight:

  • 2 to 5 pounds (package includes 3 doses)

  • 5.1 to 9 pounds (package includes 6 doses)

  • 9.1 to 18 pounds (package includes 6 doses)

The formulation of each single dose and the dosing schedule are designed to provide a minimum of 4.5 mg/lb of body weight imidacloprid and 0.45 mg/lb of body weight moxidectin. Cats that weigh more than 18 pounds receive the proper combination of smaller weight doses. 

How do you give cats Advantage Multi?

Give your cat Advantage Multi once a month right on their skin at the base of the neck.

Dosing instructions for cats are as follows:

  1. Only remove the dose applicator tubes that you plan to use that day from the packaging. Wearing gloves is recommended.

  2. Remove the cap from the tube while the tube is in an upright position.

  3. Turn the cap upside down, push the “up” end of the cap into the tip of the tube, and twist to break the seal.

  4. Part your cat’s hair at the base of their neck so that you can see the skin. Do not apply Advantage Multi to irritated skin. Take care to not get the product in your cat’s eyes or mouth. 

  5. Put the tip of the tube on your cat’s skin. Then squeeze the entire contents of the tube right onto the skin. 

  6. Once you’ve squeezed out the medication, don’t release pressure on the tube until you’ve removed it from your cat’s skin.

  7. Wash your hands immediately after handling the tube. 

  8. Do not allow your cat to lick or groom the application site for 30 minutes after you’ve applied the medication. 

Additional precautions you’ll want to take:

  • Don’t touch the application site for at least 30 minutes after application.

  • Do not let children pet your cat for at least 30 minutes after application.

  • Avoid getting the liquid medication on your clothing. If the product gets on clothing, immediately change clothes and wash contaminated clothing.

  • Advantage Multi can cause eye irritation. If the product gets in your eyes, immediately flush them with a lot of water. 

Advantage Multi for cats contains imidacloprid, which is a neonicotinoid insecticide. While it works great to kill fleas, it can also negatively affect honeybees if it contaminates the environment. Do not pour Advantage Multi down the drain or toilet, and ask your veterinarian how to dispose of used tubes.

What are the common side effects of Advantage Multi in cats?

Advantage Multi is generally well tolerated by most cats, with a low risk of negative side effects. The most common side effect reported by pet parents in a field study was behavioral changes, including: 

  • Agitation

  • Excessive grooming

  • Hiding

  • Pacing

  • Spinning

Other, less-common side effects seen in cats after treatment with Advantage Multi include:

  • Excessive tiredness

  • Drooling (the medication has a bitter taste if it is accidentally licked)

  • Signs of discomfort, including scratching, head-shaking, and rubbing

  • Increased thirst

  • Coughing and gagging

If you notice any negative side effects in your cat after applying Advantage Multi, contact your veterinarian.

What are the most serious risks of Advantage Multi for cats?

Serious, negative reactions to Advantage Multi have been reported. Based on the information experts have so far, we don’t know for sure whether the negative reactions were caused by the medication. However, call your veterinarian or the local emergency animal clinic for support if you notice any of the following symptoms after giving your cat Advantage Multi:

  • Severe skin reactions at the site of application

  • Itching

  • Swollen face

  • Vomiting

  • Difficulty breathing

  • Loss of appetite

  • Collapse

  • Tremors

  • Dilated pupils

Advantage Multi should not be used for cats that are already infected with heartworms, as it may cause shock-like symptoms associated with worm die-off. If your cat is older than 6 months, your veterinarian may recommend testing for heartworm disease before prescribing Advantage Multi. 

Don’t give Advantage Multi to cats that are sick for any reason, debilitated, or underweight. Some negative reactions — especially excessive sleeping — have been noted when Advantage Multi is used in older, thin, otherwise healthy cats. 

Consult your veterinarian before using this product for cats with liver or kidney disease or that are pregnant, nursing, or breeding. 

Does Advantage Multi interact with any other cat medications?

The imidacloprid in Advantage Multi for cats does not have any notable medication interactions. Moxidectin, the other active ingredients in the product, may interact negatively with some medications, including: 

  • Heart medications

  • Macrolide antibiotics, such as erythromycin

  • Azole antifungal medications

  • Cyclosporine

Advantage Multi for cats contains ingredients that may be toxic if combined with other heartworm medications or flea treatments. Do not combine any heartworm or flea/tick treatments in or on your cat without first consulting with your veterinarian. 

And as always, let your veterinarian know about any medications, vitamins, herbs, or supplements you are giving your cat before they are prescribed Advantage Multi. 

What should you do if your cat misses a dose of Advantage Multi?

If you miss giving your cat their monthly dose of Advantage Multi, give the next dose as soon as you remember and resume the regular dosing schedule for the next month. If you go longer than 2 months between doses, consult your veterinarian before giving the next dose.

If you are switching from one heartworm preventative to another, give the first dose of Advantage Multi within 1 month of the last dose of the previous medication.

The bottom line

Advantage Multi for cats is a good choice to prevent internal and external parasites in many, but not all, cats. It’s given once a month using a squeeze tube, so it’s easy to apply the medication directly on your cat’s skin. Consult with your veterinarian to ensure that your cat is healthy enough to receive Advantage Multi before applying it, and follow all dosing instructions carefully. 

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Why trust our experts?

Sarah J. Wooten, DVM, CVJ
Dr. Sarah Wooten, DVM, CVJ, is a well-known international influencer in the veterinary and animal healthcare spaces. She has 16 years of experience in private practice and more than 15 years experience in veterinary media work.
Renée Fabian, MA
Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.
Ghanasyam Bey, DVM
Reviewed by:
Ghanasyam Bey, DVM
Ghanasyam Bey, DVM, is from Cleveland, Ohio, and attended Princeton University for undergraduate studies. After a year of biology research at Duke University, he attended Ohio State College of Veterinary Medicine.

References

Bayer HealthCare LLC. (2015). Advantage Multi for cats- imidacloprid and moxidectin solution [package insert]. FDA.report.

Elanco US Inc. (2024). Advantage Multi for cats: Product information. VetLabel.com.

View All References (2)

Fairbrother, A., et al. (2014). Risks of neonicotinoid insecticides to honeybees. Environmental Toxicology and Chemistry.

Your Pet & You. (2023). Advantage Multi for cats. Elanco.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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