Is There A Trifexis Alternative?


Have you ever wondered how to protect your dog from parasites such as heartworm, whipworm, roundworm and hookworm? 

Maybe you’ve heard of Trifexis, a popular oral medication to treat intestinal parasites as well as outside pests like fleas and ticks. 

But is it safe? 

What are the other options? 

Are there natural remedies? 

Deciding whether a medication is right for your dog can be an overwhelming process, so we’ve done all the leg work for you. 

This comprehensive article will help you answer the question: Is Trifexis right for my dog? 

We also answered common questions surrounding the medicine while also providing a list of alternatives, both prescribed and over-the-counter.

What is Trifexis?

Trifexis is a chewable beef-flavored tablet for your dog that kills fleas and treats hookworm, roundworm and whipworm.

It also prevents future infestations from fleas as well as heartworm disease. 

The tablet should be taken once a month by your dog.

Trifexis comes in five different sizes for dogs of different weights.

Its chewable and tasty texture makes it easy for dogs to swallow.

Giving it to your dog with food increases its effectiveness.

Be sure to monitor your dog one hour after they take the dose.

Trifexis is notable for its triple parasite protection from fleas, heartworm disease and intestinal parasites.

Parasites live feed off of their hosts’ body, thus harming your dog.

Trifexis provides a proactive approach to protecting your pet.

Trifexis contains two main ingredients: spinosad and milbemycin oxime.

Spinsad is a natural substance that kills insects such as fleas.

Milbemycin oxime prevents heartworm disease and treats intestinal parasites.

Combined, the two ingredients make the triple parasite protection.

What are its side effects?

As your pet starts any new medication, it is completely normal to have concerns about side effects.

Fortunately, Trifexis’ side effects are rare, and even when they do occur, they are usually mild.

In a 180-day study, no serious side effects were noted up in dogs taking Trifexis.

The only side effects recorded were considered mild.

The adverse reactions to the tablet happened in less than one percent of the dogs studied. 

The side effects reported were:

  • Vomiting
  • Itching
  • Lethargy
  • Diarrhea
  • Skin irritation and inflammation
  • Skin reddening
  • Decreased appetite
  • Inner ear reddening

Vomiting was the most frequent side effect.

To report your pet’s side effects to Trifexis, you can contact the FDA at 1-888-FDA-VETS or

Is Trifexis vet prescribed?

Yes, Trifexis does require a prescription from a vet.

The FDA determines which medications require a prescription.

Usually, the FDA decides this based on whether the medication requires a follow up from a vet.

While Trifexis usually doesn’t cause adverse side effects that need to be monitored, it does include a heartworm prevention component. 

With heartworm prevention, it’s critical that your vet know your dog and their heartworm status before prescribing Trifexis since it can be harmful to dogs who already have heartworm disease.

Can Trifexis be bought on Amazon or at PetSmart?

Although Trifexis is prescribed, you can still buy it at almost any pet store! You name it—Chewy, Walmart, Amazon, PetSmart, PetCo—they all have Trifexis. 

Obtaining Trifexis is super simple considering it’s prescribed. Before ordering online, websites will ask for your pet and vet information. They will then contact your vet to ask for confirmation that your dog has been prescribed Trifexis. If you buy in store, the employees will call your vet and ask for confirmation on the spot.

What are the commercial alternatives to Trifexis?

When considering whether to put your dog on a new medication, it is important to look at the other options and what they offer. Four of the main alternatives to Trifexis are Nexgard, Sentinel, Comfortis and Frontline.

Each of the four alternatives offer different protections and benefits. Deciding which medication to buy depends on your dog’s needs and your vet’s recommendations.

Nexgard is a beef-flavored tablet used to kill fleas and ticks. It uses the ingredient afoxolaner. After afoxolaner is ingested by a dog, it is distributed through his body. When fleas or tick bite the dog, they come in contact with the drug and are killed, protecting your dog. The majority of flea and ticks die within an hour of the dog taking the medication.

Sentinel is a pork-flavored tablet that protects against the same five different parasites as Trifexis: fleas, hookworms, roundworms, heartworms and whipworms. It uses lufenuron to kill flea eggs before they hatch.

Comfortis is a beef-flavored tablet that kills fleas and protects against flea infestation. In studies, it began killing fleas in 30 minutes, and eliminated 100% of fleas in dogs within four hours. It is recommended to serve the tablet with food. 

Frontline is a topical cream that protects your dog by killing fleas and ticks and repels mosquitoes that can transmit heartworm disease. It also kills flea eggs, flea larvae and lice. 

How are these different products the same and different?

Each of these products protect your dog against different types of parasites.

Nexguard kills fleas and ticks, but it does not protect against intestinal parasites like Trifexis does. Sentinel protects against all the same parasites as Trifexis, but it uses lufenuron to kill fleas instead of spinosad.

Comfortis only treats fleas and no other parasites.

Frontline repels and kills parasites outside the body via a cream rather than a tablet. For a visual comparison, see the chart below:

Kills fleasYesYesYesYesYes
Kills ticksYesYes
Kills liceYes
Prevents HeartwormYesYesYes
Prevents Lyme diseaseYesYes
Treats RoundwormYesYes
Treats HookwormYesYes
Treats WhipwormYesYes
Prescription required?YesYesYesYesNo
Cost per 6 pack$117-$125$159-$169$50-$72$102-$113$58-$68

Is there an over-the-counter alternative to these products?

Out of all the aforementioned products, only Frontline can be bought without a vet’s prescription. However, there are many other over-the-counter medications and creams that treat and prevent many of the same parasites.

Nemex is a liquid dewormer, making it perfect for the dog who won’t eat a tablet.

It offers a safe treatment for hookworms and roundworms in dogs as young as two weeks as well as pregnant dogs.

Just one teaspoon of this FDA-approved medicine and your dog will be protected from intestinal parasites for a month.

Another option, Panacur C, treats hookworms, roundworms, tapeworms and whipworms currently in your dog.

For three days, mix it in your dog’s food for the medicine to take effect.

Similar to Panacur C, Bayer Quad Dewormer removes current parasites.

This chewable tablet treats hookworms, roundworms and whipworms.

K9 Advantix II, often compared to Frontline, is a monthly cream that provides your dog with protection against fleas, ticks, mosquitoes, biting flies and chewing lice.

Repelling and killing such pests and parasites helps prevents infestations and flea-borne and tick-borne diseases.

Capstar is a tablet that begins working in 30 minutes to kill fleas. It is an as-needed medicine, so if your dog gets fleas again, you can redose.

PetArmor offers a variety of treatments, from a topical cream that kills fleas, ticks and chewing lice for up to 30 days and a flea and tick collar to flea and tick shampoo and spray.

Is there an effective natural alternative to Trifexis?

There are a few different natural alternatives to Trifexis, including store-bought medicines and home-made remedies.

Only Natural Pet HW Protect Liquid Herbal Formula provides a herbal alternative to heartworm prevention and flea repellant. The tincture should be mixed with food or applied directly into your dog’s mouth three times a day.

Petguard Yeast & Garlic wafers can be sprinkled on your dog’s food or given directly. When dog’s consume small amounts of garlic, the smell your dog excretes after two weeks repels ticks and fleas.

Raw apple cider vinegar (ACV) can not only repel fleas and ticks, but also help with arthritis, indigestion and other ailments. ACV can be put in your dog’s water bowl or sprayed directly on their fur.

A combination of Diatomeceous Earth, Neem Powder and Yarrow Powder in equal parrots repels fleas, ticks, flies and mosquitoes. To use, mix the ingredients well before applying the powder evenly to your dog’s fur. 

Is Trifexis safe for puppies?

Yes! As soon as a dog reaches eight weeks old and five pounds, they are safe to take Trifexis. The treatment does recommend different dosages based on weight in categories 5-10 lbs, 10-20 lbs, 20-40 lbs, 40-60 lbs and 60-120 lbs. Be sure to buy the right package based on your dog’s size. 


Now you know everything there is to know about Trifexis! Hopefully with this information, you can decide what method is best for you and your dog. If you’re still unsure, you can always consult a veterinarian and see what they recommend. However, any of the treatments listed above are safe and valid options for your pet. 

After choosing a treatment, your dog will soon be good-to-go. Now that your dog is safe from parasites and pests, you can take them outside worry-free! Happy playing!

James Grayston

My name is James and I love dogs. have owned four Golden Retrievers in the past 15 years. Currently I own two "Goldies"- a five year old and a seven month old. The photo shows me with our youngest when she was about 7 weeks old!