NexGard^® PLUS (afoxolaner, moxidectin, and pyrantel chewable tablets) is safe for puppies at 8 weeks, weighing 4 pounds or more. The most frequently reported adverse reactions include diarrhea, vomiting, lethargy, and itching. Use with caution in dogs with a history of seizures or neurologic disorders. Dogs should be tested for existing heartworm infection prior to starting a preventive. For more information, click here for full prescribing information.