My dog still has fleas! Can I combine topical and oral flea meds?

The short answer is...it is not recommended in most situations. Combining different medications may increase the risk of negative side effects, adverse reactions or can lead to an overdose situation which could put your pet's life at risk. Due to the variety of [different products](https://www.petcoach.co/article/should-you-use-a-prescription-flea-and-tick-preventive) available on the veterinary market today, pet owners are encouraged to discuss the [best preventative option](https://www.petcoach.co/article/whats-the-difference-between-oral-and-topical-flea-and-tick-preve) for their individual pet with their veterinarian. If a pet has[ fleas](https://www.petcoach.co/article/fleas-life-cycle-anatomy-disease-transmission), most pet owners want to find the fastest treatment option available. In these cases, Capstar ([nitenpyram](https://www.petcoach.co/pet-medication/nitenpyram)) is an oral flea medication available over the counter for dogs and cats that starts treating fleas in 30 minutes and kills 90 percent of adult fleas on a pet within four hours. While Capstar dosing can continue as frequently as every day, topical flea and tick preventatives can be used in conjunction with this oral medication to provide longer lasting treatment and prevention. Oral [flea and tick preventives](https://www.petco.com/shop/en/petcostore/category/dog/dog-and-puppy-flea-and-tick) available for dogs with a prescription from your veterinarian are Credelio, Nexgard, Simparica, and Bravecto. Products that are available with a prescription from your veterinarian for flea treatment include Comfortis or Trifexis. These products also begin to kill fleas quickly and provide ongoing prevention, and do not usually require the concurrent use of a topical medication. If a topical [flea preventative fails](https://www.petcoach.co/article/6-reasons-your-flea-prevention-isnt-working), most oral products can be safely used concurrently. ### Capstar is a trademark of Elanco or its affiliates.

Yes they can have both at the same time. The "flea supplement" is not something I would recommend you give though. Fleas are extremely resistant and "natural" products are usually ineffective. They have no clinical trials or testing done on them and there is no ingredient in that product that makes sense to me as to how it would work to repel fleas. I think it is a waste of your money but it should not be harmful to give both products.

I would recommend using caution if the flea/tick shampoo and the topical product both contain permethrins, particularly if you have a small dog. I recommend avoiding all over the counter products containing permethrins for cats since they are prone to toxicity. If you use a flea/tick shampoo with permethrin and a topical product that has a different active ingredient it should be safer. An even safer alternative would be to use blue Dawn dishsoap for bathing, followed by flea combing and then applying a topical product.

I would recommend that you talk to your vet about a prescription oral preventative, since they are a lot easier to give! It would be okay to retreat with a new tube of that preventative at this time. Put Koda in your lap or sit with him on the floor and wait until he is calm to part the hair and apply the medication. It is important to apply the whole tube to ensure he gets the full dose.

Yes, there is a difference in how all the different oral and topical heartworm and flea/tick medications work. Yes, a heartworm medication needs to get into the bloodstream, so even topical heartworm preventions will get absorbed through the skin and into the bloodstream to work. Flea and tick medications can work topically only or can be oral and work internally. Which are safest products is probably a matter of opinion. I will say that a couple of the oral flea/tick medications have been associated with seizures, so I do not recommend those in dogs that have seizures. Potentially, a topical flea/tick medication that does not get absorbed might be considered the "safest", but we certainly see some skin irritation from those products as one of their side effects. I think it's always a good idea to separate out new products, so you know if Doice is having a reaction to either, but since the products work differently, I don't know that there is a huge benefit to giving them separately long term. There are so many products out there on the market that I can't really give you a specific product recommendation for your area, but I would certainly speak with your vet about your concerns and ask them for their recommendations for Doice. I hope that was helpful. Thanks for using Petco Pet Education Center, formerly Petcoach.

Giving her the flea medication should not pose any issues if she is on antibiotics. You can wait about 2-3 hours after giving her the antibiotics before administering the flea medication (if it is oral) to be completely safe. That way, the antibiotics should be out of her stomach.

Please do not feed garlic to your dog, it can cause blood disease in dogs! Here are instructions for flea prevention: Unfortunately fleas only hop on the body of your pet when they want to feed, then they hop off again and stay in your pet's environment. So you need to treat all pets in the household as well as the environment (which contains the fleas, their eggs and larvae). Flea treatment:  1) Get some flea medication such as a Flea spray or a spot on from a pet shop or your veterinarian and apply monthly 2) get flea powder, put some in your vacuum cleaner bag and vacuum your house and furniture and also non-carpeted areas frequently to remove flea larvae and eggs which live off house dust., Dispose of the bag in the trash outside. Hot-wash all the pet's bedding, If you do this diligently for a few months you will get rid of the fleas. Flea products: Spot-ons and/or chews Advantage, Advantix Advantage Multi (Advocate in the UK) Frontline (ticks as well) Bravecto spot on (ticks as well) - for cats, in tablet form for dogs Simparica, Nexgard Revolution (stronghold in the UK) Tablets: comfortis (will only kill fleas once) Collar: Seresto (ticks as well)