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Sarolaner

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Sarolaner
Clinical data
Trade namesSimparica
Other namesPF-6450567
ATCvet code
Legal status
Legal status
Identifiers
  • 1-[6-[(5S)-5-(3,5-Dichloro-4-fluorophenyl)-5-(trifluoromethyl)-4H-1,2-oxazol-3-yl]spiro[1H-2-benzofuran-3,3'-azetidine]-1'-yl]-2-methylsulfonylethanone
CAS Number
PubChem CID
ChemSpider
UNII
KEGG
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.234.000 Edit this at Wikidata
Chemical and physical data
FormulaC23H18Cl2F4N2O5S
Molar mass581.36 g·mol−1
3D model (JSmol)
  • CS(=O)(=O)CC(=O)N1CC2(C1)OCc1cc(C3=NO[C@@](c4cc(Cl)c(F)c(Cl)c4)(C(F)(F)F)C3)ccc12
  • InChI=1S/C23H18Cl2F4N2O5S/c1-37(33,34)9-19(32)31-10-21(11-31)15-3-2-12(4-13(15)8-35-21)18-7-22(36-30-18,23(27,28)29)14-5-16(24)20(26)17(25)6-14/h2-6H,7-11H2,1H3/t22-/m0/s1
  • Key:FLEFKKUZMDEUIP-QFIPXVFZSA-N

Sarolaner, sold under the brand name Simparica, is an ectoparasiticide veterinary medication for the treatment of flea and tick infestations in dogs.[7][8] It is also used off-label to control sarcoptic mange and demodectic mange.[8]

Sarolaner is also a component of the combination drug Simparica Trio, which contains sarolaner, moxidectin, and pyrantel.[9][10] It is used for prevention of heartworm disease caused by Dirofilaria immitis; treat and prevent flea infestations; treat and control tick infestations with the lone star tick, Gulf Coast tick, American dog tick, black-legged tick, and brown dog tick; and treat and control roundworm and adult hookworm infections.[11]

Sarolaner is also an ingredient in feline combination antiparasitic Revolution Plus (or Stronghold Plus[12]), which contains sarolaner and selamectin and is used for prevention of sarcoptic mange, feline hookworms, feline roundworms, ear mites, and heartworms, as well as treating and preventing fleas and ticks.[13]

In November 2024, the FDA approved a supplement that provides for the addition of the indication for the treatment and control of Haemaphysalis longicornis (Asian longhorned tick) infestations for one month in dogs six months of age or older and weighing 2.8 pounds (1.3 kg) or greater.[14][15]

References

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from Grokipedia
Sarolaner is a broad-spectrum isoxazoline ectoparasiticide used in veterinary medicine for the treatment and prevention of flea (Ctenocephalides felis) and tick infestations in dogs (orally, as in Simparica) and cats (topically, often in combination with selamectin as Revolution Plus).[1][2] It is the active ingredient in products such as Simparica, approved by the U.S. Food and Drug Administration (FDA) in 2016, and Simparica Trio, a combination formulation approved in 2020 with additional indications approved in 2025 for preventing flea tapeworm infections and controlling Asian longhorned ticks, that also includes moxidectin and pyrantel for additional parasitic control.[3][4][5] In cats, sarolaner is used topically in combination with selamectin (as Revolution Plus) for monthly prevention of heartworm, fleas, ticks, and treatment of ear mites, roundworms, and hookworms, approved by the FDA in 2019.[2] Developed by Zoetis through a lead optimization program involving over 3,000 isoxazoline compounds, sarolaner features a unique chemical structure with a substituted phenyl ring, isoxazoline core, spiroazetidinebenzofuran moiety, and methylsulfonylethanone tail, synthesized as the chirally pure S-enantiomer.[1] Its molecular formula is C23H18Cl2F4N2O5S.[6] Sarolaner acts by selectively blocking GABA-gated chloride channels in the nervous systems of fleas and ticks, causing hyperexcitation, paralysis, and death, while showing lower affinity for mammalian receptors.[1] In dogs, it demonstrates rapid absorption with a time to maximum concentration (Tmax) within one day, bioavailability exceeding 85%, a plasma half-life of 11–12 days, and high protein binding (>99.9%), supporting once-monthly dosing at a minimum of 2 mg/kg body weight.[1][3] Clinical studies have confirmed sarolaner's efficacy, achieving greater than 99% reduction in flea counts and tick control for at least 35 days post-administration, including against species such as Rhipicephalus sanguineus, Ixodes ricinus, and Dermacentor reticulatus.[1] It is also effective against other parasites like ear mites (Otodectes cynotis) and demodectic mites in generalized demodicosis when given monthly.[7][8] For Simparica, field trials showed sustained flea reduction exceeding 99.4% over 90 days, with tick control meeting or surpassing 90% for the labeled duration.[3] As a member of the isoxazoline class, sarolaner is generally safe for dogs at recommended doses, with no adverse effects observed at up to 5 times the label dose in animals six months or older; however, it has been associated with neurologic events such as tremors, ataxia, and seizures in dogs, even without a prior history of such conditions, and particularly at higher doses in young puppies.[1][3][9] The product is labeled for dogs at least eight weeks old and weighing at least 2.8 pounds, requiring veterinary prescription and heartworm testing prior to use in combination products.[4]

Uses

Indications in dogs

Sarolaner, available as the oral chewable tablet Simparica, is indicated for the treatment and control of flea infestations (Ctenocephalides felis) in dogs six months of age and older weighing at least 2.8 pounds.[10] Tablet strengths and weight ranges may vary by region. For example, in Brazil, Simparica does not have a single weight band labeled 20-49 kg; instead, it includes an 80 mg tablet for dogs weighing 20.1–40 kg and a 120 mg tablet for dogs weighing 40.1–60 kg (covers up to 49 kg), with a minimum recommended dose of 2 mg/kg body weight administered orally once monthly.[11] It provides rapid flea kill, starting within 3 hours of administration, with 100% efficacy achieved within 24 hours and sustained protection for 35 days.[12] Sarolaner has demonstrated efficacy against ear mites (Otodectes cynotis) and demodectic mange in studies, though not all are FDA-approved indications in the U.S.[7][8] The drug is also approved for the treatment and control of tick infestations in dogs, targeting species including the lone star tick (Amblyomma americanum), American dog tick (Dermacentor variabilis), blacklegged tick (Ixodes_scapiularis), brown dog tick (Rhipicephalus_sanguineus), Gulf Coast tick (Amblyomma maculatum), and Asian longhorned tick (Haemaphysalis longicornis).[10] Tick kill begins within 8 hours for most species, extending to 12 hours for others, with efficacy maintained above 96% for at least 30 days post-treatment.[12] Additionally, sarolaner prevents Lyme disease by killing Ixodes scapularis vectors before they can transmit Borrelia burgdorferi, offering 100% protection for 28 days.[10] In a 2024 head-to-head comparative study against Amblyomma americanum, sarolaner (in Simparica Trio) showed a slower initial speed of kill (74% efficacy at 24 hours on day 0) and a significant decline in efficacy over the month, with only 4.9–17.1% efficacy at 24 hours during day 28 reinfestations, requiring 72 hours to achieve high efficacy. In contrast, lotilaner (Credelio) maintained sustained ≥90% efficacy at 24 hours. This finding highlights potential species-specific differences compared to sarolaner's generally high efficacy reported in standalone studies against other tick species. Reif KE et al. (2024). Parasites & Vectors. In November 2024, the FDA expanded Simparica's label to include treatment and control of Haemaphysalis longicornis infestations, addressing the emerging threat of this invasive tick species in dogs.[13] In April 2025, the combination product Simparica Trio (sarolaner with moxidectin and pyrantel) received FDA approval for preventing flea tapeworm (Dipylidium caninum) infections by eliminating vector fleas before they can transmit the parasite.[14] Simparica Trio extends sarolaner's ectoparasite control to include prevention of heartworm disease (Dirofilaria immitis) via moxidectin and treatment of hookworm (Ancylostoma caninum, Uncinaria stenocephala) and roundworm (Toxocara canis, Toxascaris leonina) infections via pyrantel, providing comprehensive monthly protection in a single chewable tablet for dogs eight weeks and older.[4] Simparica Trio is administered orally once a month at monthly intervals, with a minimum dose of 0.54 mg/lb (1.2 mg/kg) sarolaner, 0.011 mg/lb (24 μg/kg) moxidectin, and 2.27 mg/lb (5 mg/kg) pyrantel.[15] Giving Simparica Trio early (before the 30-day monthly interval) generally poses low overdose risk in dogs. Safety studies showed the product is well-tolerated at up to 5 times the labeled dose administered at 28-day intervals for multiple treatments, with no clinically relevant adverse effects in most cases. Occasional early dosing (e.g., a few days to a week early) is typically safe but may slightly increase the chance of mild side effects like vomiting or diarrhea. Avoid frequent early dosing to prevent potential accumulation, and consult a veterinarian if the interval is significantly shorter or if symptoms occur. For missed doses, administer immediately and resume monthly dosing. The prescribing information does not provide explicit guidance or safety data on early administration beyond the recommended monthly interval. Simparica Trio chewable tablets are formulated in weight-specific strengths to deliver the minimum effective doses at the upper limit of each weight band, ensuring efficacy even for dogs at the maximum weight in the band. Dogs at the lower end of a band receive a proportionally higher mg/kg dose, which remains safe. No significant risk of underdosing exists within the labeled weight ranges; concerns typically arise when a dog's weight exceeds the upper limit of the selected band.[15]

Indications in cats

Sarolaner is primarily utilized in cats through topical combination products, such as Revolution Plus (containing sarolaner and selamectin), for the treatment and prevention of various parasitic infestations. This monthly topical application is indicated for killing adult fleas (Ctenocephalides felis) and preventing flea infestations, with efficacy demonstrated by over 98% flea kill within 24 hours post-application and sustained control for at least 35 days. It is also effective against tick infestations, including the paralysis tick (Ixodes holocyclus) in Australia and Ixodes ricinus in Europe, providing treatment and control for 28-30 days depending on the species and region. Additionally, sarolaner addresses ear mites (Otodectes cynotis), achieving greater than 99% efficacy in a single dose, though follow-up treatment may be required in severe cases.[16][17][18] In combination with selamectin, sarolaner extends protection to internal parasites, preventing heartworm disease caused by Dirofilaria immitis with 100% efficacy against infective larvae, and treating or preventing infections from roundworms (Toxocara cati) and hookworms (Ancylostoma tubaeforme), reducing egg counts by 99.4-99.7%. The product also prevents flea tapeworm (Dipylidium caninum) by eliminating the intermediate flea host. In some regions, it treats and controls biting lice (Felicola subrostratus).[16][17] These broad-spectrum indications make it suitable for comprehensive parasitic control in cats exposed to multiple threats, particularly in endemic areas for ticks and heartworm.[16][17] Revolution Plus is safe and approved for kittens eight weeks of age and older weighing at least 2.8 pounds (1.25 kg), with studies showing no significant adverse effects even at up to five times the recommended dose in young cats. The topical formulation is applied directly to the skin at the base of the skull, ensuring systemic absorption for ecto- and endoparasite control without the need for oral administration. Unlike in dogs, where sarolaner is available as a standalone oral tablet, it is not indicated for standalone oral use in cats and is exclusively provided in topical combinations to optimize efficacy and safety for feline physiology.[16][17]

Pharmacology

Mechanism of action

Sarolaner is a member of the isoxazoline family of insecticides and acaricides, designed specifically for ectoparasite control in companion animals.[1] Its primary mechanism of action involves potent non-competitive antagonism of GABA-gated chloride channels (GABACls) and glutamate-gated chloride channels (GluCls) in the nerve and muscle cells of invertebrates. By binding to these ligand-gated ion channels, sarolaner blocks the influx of chloride ions that normally occurs upon activation by GABA or glutamate, thereby preventing the hyperpolarization that inhibits neuronal firing. This blockade disrupts normal nerve impulse transmission, leading to hyperexcitation, uncontrolled neuronal activity, paralysis, and ultimately death of the target parasites upon ingestion or contact with the drug.[1][19][20] The selectivity of sarolaner for arthropod receptors over mammalian ones stems from structural differences between invertebrate and vertebrate chloride channels, resulting in a high affinity for arthropod GABACls and GluCls with minimal interaction at mammalian GABA receptors. This was demonstrated through voltage-clamp electrophysiology assays using CHO-K1 cells stably expressing cat flea (Ctenocephalides felis) RDL GABACl subunits, where sarolaner exhibited IC50 values of 135 nM and 136 nM against susceptible and resistant flea strains, respectively; in contrast, IC50 values for human and canine GABA receptors expressed in Xenopus oocytes ranged from 8.4 µM to >30 µM, indicating over 60-fold lower potency in mammals.[1][21] Sarolaner is effective against adult stages of fleas (e.g., Ctenocephalides felis), ticks (e.g., Ixodes scapularis, Dermacentor variabilis), and certain mites, primarily through systemic exposure that kills parasites feeding on the host. However, it lacks ovicidal activity and does not directly kill parasite eggs.[1][19]

Pharmacokinetics

Sarolaner exhibits favorable pharmacokinetic properties in dogs following oral administration as chewable tablets. It is rapidly absorbed from the gastrointestinal tract with a bioavailability exceeding 85%, achieving peak plasma concentrations (C_max approximately 1.1 μg/mL) within 3 hours post-dose, independent of prandial state.[22][19] The drug is highly bound to plasma proteins (≥99.9%) and widely distributed throughout the body, including to tissues such as skin and adipose where ectoparasites reside, with a volume of distribution of approximately 2.4 L/kg. Metabolism is minimal and primarily hepatic, producing inactive metabolites, while elimination occurs mainly via biliary excretion into feces (predominant route, >70%), with negligible urinary excretion (<5%). The elimination half-life is 11-12 days, supporting monthly dosing intervals.[23][1][10] In cats, sarolaner is administered topically in combination formulations (e.g., with selamectin), where it is absorbed transdermally with a bioavailability of approximately 58%. It reaches systemic circulation and distributes similarly to dogs, with high plasma protein binding and broad tissue penetration, including to the skin. Like in dogs, metabolism is primarily hepatic and minimal, yielding inactive metabolites, and elimination is predominantly biliary/fecal with low urinary contribution. The half-life is notably longer at 41.5 days following topical application, reflecting slower clearance in this species.[24][25] Species-specific differences include the route of administration (oral in dogs, topical in cats) and elimination kinetics, with cats exhibiting a prolonged half-life compared to dogs, potentially due to differences in absorption and clearance. No significant breed-specific variations in pharmacokinetics have been reported in either species. These properties contribute to sarolaner's sustained efficacy against ectoparasites.[19][23]

Chemistry

Chemical structure

Sarolaner possesses the molecular formula C23_{23}H18_{18}Cl2_{2}F4_{4}N2_{2}O5_{5}S and a molecular weight of 581.37 g/mol.[26][27] The IUPAC name of sarolaner is 1-[6-[(5S)-5-(3,5-dichloro-4-fluorophenyl)-5-(trifluoromethyl)-4H-1,2-oxazol-3-yl]spiro[1H-2-benzofuran-3,3'-azetidine]-1'-yl]-2-(methylsulfonyl)ethan-1-one.[28][26] The core structure of sarolaner centers on a 4H-1,2-oxazole (isoxazoline) ring, which bears a substituted 3,5-dichloro-4-fluorophenyl group and a trifluoromethyl substituent at the 5-position, enhancing lipophilicity. This isoxazoline ring connects at its 3-position to a benzene ring that is part of a spiro-fused 1H-2-benzofuran-3,3'-azetidine system, where the azetidine nitrogen is linked via an amide to a 2-(methylsulfonyl)ethanoyl moiety. Sarolaner is chiral at the 5-position of the isoxazoline ring, with the (5S)-configuration being the active enantiomer used commercially.[26][28] The standard depiction of sarolaner's structure illustrates the isoxazoline ring in a five-membered heterocyclic form with the oxygen and nitrogen adjacent, the phenyl and CF3_3 groups geminally attached to the chiral carbon, the spiro junction at the benzofuran, and the sulfonylacetyl chain extending from the azetidine. Sarolaner shares its isoxazoline class with compounds like afoxolaner and fluralaner.[26]

Physical and chemical properties

Sarolaner appears as a white to off-white crystalline powder.[29] It exhibits poor solubility in water, with a value of less than 0.1 mg/mL at room temperature, but is soluble in organic solvents such as DMSO (150 mg/mL), ethanol, and acetonitrile.[29][30] The melting point of sarolaner is approximately 150–155 °C (decomposes).[31] The octanol–water partition coefficient (LogP) is around 5.5, reflecting its high lipophilicity, which supports its pharmacokinetic profile by facilitating skin penetration and tissue distribution.[6] Sarolaner is stable under normal storage conditions at room temperature when protected from light; it degrades under exposure to strong acids or bases or high heat. As a neutral molecule, it has no applicable pKa value.[29] Additional properties include a density of approximately 1.65 g/cm³ and a predicted boiling point exceeding 700 °C.[29]

Synthesis

Sarolaner is synthesized through a lead optimization program involving the screening and modification of over 3,000 isoxazoline compounds. The key steps include the construction of the isoxazoline core via 1,3-dipolar cycloaddition of a nitrile oxide to an alkene, followed by attachment of the spiro[benzofuran-azetidine] moiety and acylation with methanesulfonylacetyl chloride to form the final structure as the (5S)-enantiomer.[1]

Adverse effects

Effects in dogs

Sarolaner, administered orally as a chewable tablet in products like Simparica, is generally well-tolerated in dogs, with clinical field studies reporting a low overall incidence of adverse reactions at approximately 4.3% across treated animals.[32] Common side effects, occurring at rates below 1% in these studies, include vomiting (0.95%), diarrhea (0.63%), and lethargy (0.32%), alongside less frequent reports of anorexia, pruritus, and polyuria observed in post-approval surveillance.[33] Neurological effects are rare, with an incidence below 1%, but include tremors, ataxia, and seizures, particularly in dogs with a prior history of epilepsy or neurologic disorders; the U.S. Food and Drug Administration issued a warning in 2018 for the isoxazoline class, including sarolaner, highlighting these potential risks.[34] Post-approval reports have also noted these signs, though they remain uncommon and often resolve without intervention.[33] Dermatological reactions, such as pruritus or erythema, are infrequent in oral administration and typically mild, with rare instances of alopecia or skin lesions not directly attributed to the application site due to the non-topical route.[35] In cases of overdose, transient vomiting or tremors may occur, but no specific antidote exists; treatment involves supportive care, and clinical studies indicate full recovery without long-term sequelae at up to five times the recommended dose. For combination products containing sarolaner such as Simparica Trio, safety studies have shown the product to be well-tolerated at up to five times the labeled dose administered at 28-day intervals for multiple treatments, with no clinically relevant adverse effects in most cases. Giving Simparica Trio early (before the 30-day monthly interval) generally poses low overdose risk; occasional early dosing (e.g., a few days to a week early) is typically safe but may slightly increase the chance of mild side effects like vomiting or diarrhea. Avoid frequent early dosing to prevent potential accumulation, and consult a veterinarian if the interval is significantly shorter or if symptoms occur.[33][15] Sarolaner is contraindicated in dogs younger than 6 months of age or weighing less than 2.8 pounds. It has been determined to be safe for dogs with the MDR1 gene mutation, such as in some Collies, at labeled doses.[33][36] Post-approval surveillance indicates an overall low adverse event rate, emphasizing the need for veterinarians to monitor for signs and report incidents to regulatory bodies like the FDA.[37]

Effects in cats

In cats, sarolaner is primarily administered topically in combination products such as selamectin/sarolaner for flea, tick, and parasite control. Common adverse effects observed in clinical field studies include application site reactions such as alopecia (hair loss, 1.8% incidence) and skin lesions or irritation (3.5% incidence), as well as gastrointestinal disturbances like vomiting (3-5.7% incidence) and diarrhea (1.6-12.9% incidence).[38] Hypersalivation or drooling may occur if the topical solution is licked shortly after application, leading to transient oral discomfort.[39] Other mild effects reported at low rates include lethargy (4.3% incidence), anorexia (3.2-8.6% incidence), and pruritus (2.5-3.2% incidence).[38] Neurological effects are rare but align with class-wide risks of isoxazolines, including ataxia, tremors, and seizures, even in cats without prior history; these have been noted in post-marketing surveillance with a low report rate.[9][40] Use with caution in cats with a history of neurologic disorders or seizures, as sarolaner may exacerbate such conditions, similar to warnings for canine use.[41] Additional rare effects include increased urination if the product is ingested and mild, transient signs such as conjunctivitis or sneezing in kittens.[39] In cases of overdose, particularly from excessive topical application or ingestion, symptoms may include excessive drooling, tremors, and lethargy; treatment is symptomatic and supportive, with no specific antidote available.[40] Contraindications include use in kittens younger than 8 weeks old or weighing less than 2.8 pounds (1.25 kg), as well as in cats with known hypersensitivity to sarolaner or related compounds.[38] Additionally, cats at risk for heartworm disease should be tested negative prior to administration to avoid complications in heartworm-positive animals.[39] Monitoring for adverse effects is recommended, particularly neurologic signs, in line with FDA alerts for isoxazoline-class products; post-market data indicate a low overall incidence of serious events in cats.[9] Owners should observe cats for 24-48 hours post-application and consult a veterinarian if any unusual signs appear.[41]

History

Development

Sarolaner was developed by scientists at Zoetis, which originated as the animal health division of Pfizer before its spin-off in 2013, as part of an isoxazoline research program initiated in the early 2010s to identify novel oral ectoparasiticides for companion animals.[42] The compound emerged from lead optimization efforts focused on creating an orally active isoxazoline with broad-spectrum activity against fleas and ticks, building on the class's established GABA- and glutamate-gated chloride channel modulation.[1] Key milestones in sarolaner's development included structural modifications to enhance potency, safety margins, and duration of efficacy, culminating in a molecule designed for 35-day protection against ectoparasites following a single oral dose.[42] These optimizations were detailed in publications from 2016, including reports on the discovery process and synthesis route.[42][43] The final structure incorporated a spiroazetidine moiety linked to a benzofuran system, which improved pharmacokinetic properties such as oral bioavailability and systemic exposure in dogs, enabling effective tissue distribution to target parasites.[1] Preclinical testing confirmed sarolaner's efficacy in laboratory models, where doses as low as 1.25 mg/kg achieved 100% flea reduction through Day 35 and ≥97.5% tick efficacy against reinfestations for the same period.[44][45] Safety assessments in dogs demonstrated tolerability at up to five times the intended clinical dose of 4 mg/kg, with no treatment-related adverse events observed even after repeated monthly administration.[46] Zoetis filed patents covering the synthesis, compositions, and veterinary use of sarolaner and related isoxazoline compounds, including US Patent Application Publication No. 2017/0311601 for enantiomerically enriched production processes.[47] This development rationale centered on providing a convenient monthly oral alternative to topical ectoparasiticides, with sarolaner demonstrating faster flea kill—≥98% within 12 hours—compared to competitors like afoxolaner.[48] These efforts paved the way for regulatory approval.

Regulatory history

Sarolaner was first approved for veterinary use in dogs under the brand name Simparica (sarolaner chewable tablets) by the European Commission on November 6, 2015, for the treatment and control of flea and tick infestations.[49] In the United States, the Food and Drug Administration (FDA) granted original approval under New Animal Drug Application (NADA) 141-452 on February 24, 2016, with public announcement on February 25, 2016, allowing once-monthly oral administration for dogs six months and older weighing at least 2.8 pounds.[3] Health Canada approved Simparica on September 12, 2016, and the Australian Pesticides and Veterinary Medicines Authority (APVMA) followed in 2016, establishing early global availability as a prescription-only medication in these regions.[50] Expansion to feline use occurred through combination products. The European Commission approved Stronghold Plus (selamectin/sarolaner topical solution) on February 9, 2017, for cats eight weeks and older, providing protection against fleas, ticks, ear mites, heartworms, and roundworms.[51] The FDA approved Revolution Plus (selamectin/sarolaner) under NADA 141-508 on November 29, 2018, for similar indications in cats eight weeks and older weighing at least 2.8 pounds.[52] Subsequent label expansions for canine products included the FDA's approval of Simparica Trio (sarolaner, moxidectin, and pyrantel chewable tablets) under NADA 141-521 on February 27, 2020, for monthly prevention of heartworm disease, treatment of roundworm and hookworm infections, and control of fleas, ticks, and mites in dogs eight weeks and older weighing at least 2.8 pounds.[4] In November 2024, the FDA approved a supplemental application for Simparica (NADA 141-452) to include treatment and control of Haemaphysalis longicornis (Asian longhorned tick) infestations.[13] On the same date, November 6, 2024, the FDA also approved a supplemental application for Simparica Trio (NADA 141-521) to include treatment and control of Haemaphysalis longicornis infestations.[53] Further expansion came on April 8, 2025, with FDA supplemental approval for Simparica Trio (NADA 141-521) to prevent infections from Dipylidium caninum (flea tapeworm).[54] Regulatory safety updates addressed potential neurologic risks associated with isoxazolines, the class including sarolaner. On September 20, 2018, the FDA issued an alert highlighting reports of adverse neurologic events such as muscle tremors, ataxia, and seizures in some dogs and cats, prompting label updates for affected products and ongoing post-market surveillance without leading to withdrawals.[34] As of November 2025, sarolaner-containing products remain widely available globally under prescription in the United States, European Union, Canada, Australia, and other regions, with no major regulatory withdrawals or suspensions reported.[9]

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