For how long can NexGard Combo, Advantage Multi, and Bravecto be used consecutively on cats?
- Veteriner Hekim Ebru KARANFİL
- Dec 23, 2025
- 13 min read
What are NexGard Combo, Advantage Multi and Bravecto?
NexGard Combo , Advantage Multi , and Bravecto are for cats. These are modern veterinary antiparasitic products used to provide protection against internal and/or external parasites . These products can offer protective and curative effects against parasites such as fleas , ticks , ear mites , intestinal nematodes, and some types of heartworm . However, they are not all the same , and their intended uses, spectrums of activity, and application ranges differ.
NexGard Combo is a combined spot-on (drop) preparation developed for cats. With the same application, it is effective against both external parasites (fleas, ticks, mite agents) and some internal parasites (roundworms, hookworms, and heartworm larvae). This feature makes it particularly preferred for cats at risk of multiple parasite infestations .
Advantage Multi is a broad-spectrum product for internal and external parasites, also used in drop form. It is effective against fleas, ear mites, and many intestinal parasites. It also has a heartworm-preventing effect. Due to its long history of use, it is among the products with high clinical experience .
Bravecto is a long-acting external parasite product for cats. It is primarily effective against fleas and ticks. It is not effective against internal parasites. Its most important feature is that a single application provides external parasite protection for weeks (usually up to 12 weeks) . Therefore, it can be preferred for cats where frequent applications are difficult.
The common thread among these three products is their important role in preventing parasite-related diseases in cats. However, their areas of effectiveness are not the same , and the answer to the question "how many months can they be used consecutively?" depends on the product's composition and active ingredient.
NexGard Combo, Advantage Multi, and Bravecto Active Ingredients and Mechanisms of Action
The main reason for the different consecutive usage periods of these products is the active ingredients they contain and how these ingredients behave in the body . Each active ingredient has different pharmacological properties, from how it kills the parasite to its duration of stay in the body.
The active ingredients in NexGard Combo include esafoxolaner, eprinomectin, and praziquantel .
Esafoxolaner targets the nervous system in fleas and ticks, leading to the death of the parasite.
Epinomectin neutralizes internal parasites by disrupting their neuromuscular transmission.
Praziquantel is particularly effective against tapeworms and targets the parasite's cell membrane.
The combination of these three active ingredients makes NexGard Combo suitable for monthly use . The active ingredients do not accumulate permanently in the body; therefore, regular monthly applications can be planned.
Advantage Multi's main active ingredients are imidacloprid and moxidectin .
Imidacloprid acts quickly by affecting the nervous system in fleas.
Moxidectin is a long-acting compound against internal parasites and heartworm larvae.
Moxidectin has a longer-lasting presence in the body, but it is considered safe when used at the recommended doses and intervals. Therefore, Advantage Multi is generally administered monthly and is suitable for long-term protection plans.
Bravecto's active ingredient is fluralaner . Fluralaner works by blocking specific ion channels in the nervous system of parasites. Because this substance remains in the cat's bloodstream for a long time, its effect lasts for weeks after a single application. This long duration of action is the main reason why Bravecto provides protection for months.
However, due to the long-lasting effect of fluralaner, the rationale for consecutive monthly use of Bravecto is not the same as with NexGard Combo or Advantage Multi. This difference is the most critical point that will determine the answer to the question of "how many months can it be used consecutively" in later sections.
Uses (Indications) Against Internal and External Parasites in Cats
The use of internal and external parasite medications in cats is not limited to simply checking for fleas. The type of parasite, the cat's living environment, age, immune status, and contact with other animals directly influence which product should be used for what purpose. NexGard Combo, Advantage Multi, and Bravecto have different indications in this regard.
The table below clearly summarizes which parasites these three products are used against :
Parasite / Area of Use | NextGard Combo | Advantage Multi | Bravecto (Cat) |
Piraeus | ✔️ | ✔️ | ✔️ |
Tick | ✔️ | ❌ | ✔️ |
Ear mites (Otodectes) | ✔️ | ✔️ | ❌ |
Roundworms | ✔️ | ✔️ | ❌ |
Hookworms | ✔️ | ✔️ | ❌ |
Stripes | ✔️ | ❌ | ❌ |
Heartworm prevention | ✔️ | ✔️ | ❌ |
Only external parasites. | ❌ | ❌ | ✔️ |
This table reveals a clear fact:
Bravecto is primarily for external parasite protection .
NexGard Combo and Advantage Multi are combined products that target both internal and external parasites.
This distinction plays a critical role in answering the question of "how many months can it be used consecutively?" This is because long-term use planning for products that target internal parasites requires more careful consideration than for products that target external parasites.
The Necessity of Regular Use of Internal and External Parasite Medications in Cats
The regular use of antiparasitic drugs should be planned as part of a preventive medicine approach , not just when there is an active infestation. Cats, especially those that go outside or have contact with other animals, can be constantly exposed to parasites.
The need for regular use depends on the following factors:
The cat's living environment (indoor / outdoor)
Having other animals in the same house
Regional parasite density
Seasonal risk increase
Previous parasitic infections
The following table summarizes common use cases:
Cat Profile | Is Regular Use Necessary? | Proposed Approach |
A cat that lives only at home. | Middle | Regular but controlled. |
The cat that went outside | High | Uninterrupted protection |
A house with many cats | High | All the cats together |
kitten | Variable | According to age and weight |
Cat with a weak immune system | High | With close monitoring |
Cost of Use for NexGard Combo, Advantage Multi and Bravecto (EU and US Prices)
Cost is a significant factor in long-term planning of internal and external parasite medications for cats. There can be considerable differences in total annual costs between monthly and long-acting products. The table below provides an approximate comparison based on average retail prices for single doses . (Prices may vary by country, dose, and duration.)
Product | Application Range | EU Average Price (EUR) | US Average Price (USD) | Estimated Annual Cost (EU/US) |
NextGard Combo | Once a month | €20–30 | $25–35 | €240–360 / $300–420 |
Advantage Multi | Once a month | €15–25 | $20–30 | €180–300 / $240–360 |
Bravecto (Cat) | Once every 12 weeks | €35–45 | $40–55 | €140–180 / $160–220 |
This table clearly demonstrates the following fact:
Bravecto , although it only provides protection against external parasites, may be more advantageous in terms of annual cost .
NexGard Combo and Advantage Multi have higher annual costs because they target both internal and external interference simultaneously.
Therefore, the question of "how many consecutive months can it be used" should be considered not only from a medical perspective but also from an economic planning standpoint .
For how many consecutive months can NexGard Combo, Advantage Multi, and Bravecto be used on cats?
This point is the most critical and often misunderstood aspect of the issue. The duration of consecutive product use is directly related to the retention time and spectrum of action of the active ingredients in the body.
The following table summarizes the generally accepted framework for usage:
Product | Consecutive Use | General Safe Period | Explanation |
NextGard Combo | Monthly | 6–12 months | Combined structure, monthly planning |
Advantage Multi | Monthly | 6–12 months | A formula that has been used for many years. |
Bravecto (Cat) | Once every 12 weeks | 2–4 doses / year | Long-lasting, no monthly requirement. |
NextGard Combo
NexGard Combo is designed for monthly use . For most cats, consecutive use for up to 6 months is common. In areas with high parasite infestation or in multi-cat households, this period may be extended to 12 months . However, for continuous year-round use, periodic evaluations are recommended to avoid unnecessary repetitions.
Advantage Multi
Advantage Multi is suitable for monthly application and has a high level of experience with consecutive use due to its long history of use. In most scenarios, consecutive use for 6–12 months is considered safe. Regular monthly application is particularly important in areas with a high risk of heartworm.
Bravecto
Bravecto operates on a completely different principle. This product is a long-acting external parasite medication, not a monthly one . Therefore, it does not need to be applied every month. Generally, 2-4 applications per year are sufficient. Consecutive monthly use is not in line with the product's design and can lead to unnecessary drug exposure.
The basic rule here is: long-term use doesn't mean the same thing for every product. Monthly products are planned month by month; long-acting products are applied as needed .
NexGard Combo, Advantage Multi and Bravecto Application Methods (Step-by-Step)
The effectiveness of internal and external parasite medications depends not only on the active ingredient but also on the correct application technique . Incorrect application can lead to insufficient absorption of the medication, reduced effectiveness, or local skin reactions.
The table below summarizes the basic application steps for each product:
Product | Method of Application | Basic Steps | Point to Note |
NextGard Combo | Neck drops (spot-on) | The hairs are separated and applied to a single point on the skin. | Licking should be prevented after application. |
Advantage Multi | Neck drops (spot-on) | The skin is made visible, and the entire mixture is dripped into a single spot. | Do not apply to wet fur. |
Bravecto (Cat) | Neck drops (spot-on) | Applied to the skin between the shoulders. | The dose should be chosen correctly according to the weight. |
The key points to consider during the procedure are as follows:
The application area must be clean and dry .
The cat should not be bathed for several hours after the procedure.
In households with many cats, cats should not be allowed to lick each other.
Correct application is important, especially for monthly use, to ensure safety during consecutive use . Incorrect application can lead to unnecessary repeat doses.
Differences Between NexGard Combo, Advantage Multi, and Bravecto (Comparison Table)
Although these three products are often considered interchangeable, their purposes and scope of use are not the same . The comparison table below clearly highlights the key differences between the products:
Feature | NextGard Combo | Advantage Multi | Bravecto (Cat) |
Internal parasite effect | ✔️ | ✔️ | ❌ |
External parasite effect | ✔️ | ✔️ (flea) | ✔️ |
Tick protection | ✔️ | ❌ | ✔️ |
Heartworm prevention | ✔️ | ✔️ | ❌ |
Frequency of application | Monthly | Monthly | Once every 12 weeks |
Long-term planning | Suitable | Suitable | Dose-based |
Is it enough on its own? | In most cases | In most cases | No (for internal parasites) |
Looking at this table, the following conclusions can be drawn:
If you want both internal and external parasite protection with a single product, NexGard Combo or Advantage Multi are more suitable.
Bravecto is the ideal choice if you're only looking for external parasite control and long-term protection .
Cats treated with Bravecto may require a separate treatment plan for internal parasite control.
These differences directly affect how many months the products can be used consecutively and which one should be preferred in which scenario.
Possible Side Effects of Long-Term Internal and External Parasite Medication Use in Cats
With the sequential and long-term use of internal and external parasite medications, most cats do not experience any problems. However, due to the pharmacological properties of the active ingredients , mild and temporary side effects may occur. These effects usually appear shortly after administration and often resolve spontaneously.
The following table summarizes the most frequently reported potential side effects in clinical practice:
Side effect | NextGard Combo | Advantage Multi | Bravecto (Cat) | Explanation |
Redness at the application site. | Middle | Middle | Low | Local skin reaction |
Itching / licking | Middle | Middle | Low | Temporary behavioral change |
Weakness | Low | Low | Low | Usually short-term |
Decreased appetite | Low | Low | Low | First 24–48 hours |
Digestive sensitivity | Low | Low | Very low | Vomiting is rare. |
Key points to consider for long-term use include:
Using the same product unnecessarily frequently can increase the risk of side effects.
Long-acting products (e.g., Bravecto) are not recommended to be used outside of their intended range .
If side effects recur, the treatment plan should be reviewed.
Therefore, when determining the consecutive usage period, not only the risk of parasites but also the cat's individual tolerance should be taken into account.
Use of NexGard Combo, Advantage Multi, and Bravecto in Kittens, Pregnant, and Lactating Cats
In cats going through specific physiological phases (kittens, pregnant, or lactating), the use of internal and external parasite medications should be planned more carefully . Metabolism and drug responses may differ during these periods.
The following table summarizes the general framework for use:
Cat Group | NextGard Combo | Advantage Multi | Bravecto (Cat) | Overall Assessment |
Kittens | Annoyed | Annoyed | Annoyed | Age and weight criteria are important. |
pregnant cats | Carefully | Carefully | Limited data | Risk-benefit analysis |
Nursing cats | Carefully | Carefully | Limited data | Contact with offspring should be considered. |
Things to consider in these groups:
Minimum age and weight limits must be carefully considered when buying kittens.
In pregnant cats, unnecessary treatments should be avoided unless there is a parasite infestation.
In nursing cats, contact between the kittens and the back of the neck should be limited after the procedure.
During these special periods, the question of "how many months can it be used consecutively?" should be approached differently than with standard adult cats and often requires individual assessment.
In what situations is veterinary approval required for internal and external parasite medications?
While internal and external parasite medications can be routinely used for most cats, there are some situations where deviations from standard treatment protocols are necessary . In these scenarios, determining how many months consecutively the products should be used requires individual assessment .
The table below summarizes the main situations requiring veterinary approval:
Situation | Why is approval required? | Risk assessment |
Cat with a chronic illness | Metabolism and drug tolerance may change. | Medium-high |
Liver or kidney problem | Drug elimination may be affected. | High |
Using multiple medications at the same time | Drug interactions may occur. | Middle |
Previous history of side effects | Risk of recurrence | Middle |
Long-term uninterrupted use | Risk of unnecessary exposure. | Middle |
Very underweight cats | Dose sensitivity | Middle |
The key point in these cases is that "routine protection" is not the same as "long-term, uninterrupted use." Especially with monthly products like NexGard Combo and Advantage Multi, if year-round use is planned , a periodic evaluation is recommended.
Follow-up, Protection Period, and Efficacy Check After Internal and External Parasite Treatment
The process doesn't end with the application of antiparasitic drugs. Effective protection requires proper follow-up after application and a correct understanding of the protection period . Otherwise, unnecessary repeat applications may be necessary.
The following table summarizes the product-based tracking approach:
Product | Protection Period | Points to Note During Monitoring | Risk of Unnecessary Repetition |
NextGard Combo | 1 month | External parasite contact and stool condition. | Middle |
Advantage Multi | 1 month | Itching, flea observation | Middle |
Bravecto (Cat) | ~12 weeks | Do not reapply before the time limit expires. | High |
The following points are important in event control:
The medication should not be reapplied prematurely while its effect is still ongoing.
With long-acting products like Bravecto, one should avoid making the mistake of premature dosing based on the perception of "seeing a flea."
The presence of parasites does not always mean the treatment is ineffective ; environmental contamination should be re-evaluated.
Therefore, the correct approach is this: the treatment schedule should be planned according to the duration of the product's effect, not the biology of the parasite.
Frequently Asked Questions
For how many consecutive months can NexGard Combo be used on cats?
NexGard Combo is a combined internal and external parasite medication developed for monthly application. Continuous use for 6 months is commonly accepted in most healthy adult cats. In areas with high parasite infestation or in multi-cat households, this period may be extended to 12 months. However, for continuous year-round use, periodic evaluations are necessary to avoid unnecessary repetitions.
Can Advantage Multi be used on cats for a long period of time, consecutively?
Advantage Multi is based on monthly use and is a product that has been used in clinical practice for many years. Regular use for 6–12 months is generally tolerated in healthy cats. It is important not to miss monthly use, especially in areas with a risk of heartworm. During long-term use, the cat's general condition and skin reactions should be monitored.
Can Bravecto be used monthly for cats?
Bravecto is not designed for monthly use on cats. A single application provides protection against external parasites for approximately 12 weeks. Therefore, monthly application is unnecessary and not recommended. Generally, 2 to 4 applications per year are sufficient. More frequent use does not provide additional benefits and may lead to unnecessary drug exposure.
Can NexGard Combo and Bravecto be used together?
Although these two products theoretically have different areas of effectiveness, using them together is not a routine approach. Since NexGard Combo already acts against external parasites, simultaneous use with Bravecto is unnecessary in most cases. If internal parasite treatment plus long-term external parasite treatment is required, the timing and need for application should be carefully considered.
Do I also need external parasite medication while using Advantage Multi?
Advantage Multi is effective against fleas but does not provide tick protection. In areas with a high risk of ticks, additional planning may be necessary for external parasite protection. In this case, the areas of effectiveness and application intervals of the products should be evaluated to ensure they do not overlap.
Should cats be used year-round for internal and external parasite treatments?
This question depends on the cat's lifestyle. For cats that live indoors and never go outside, continuous year-round use may not always be necessary. However, for cats that go outside, live in multi-cat households, or reside in areas with high parasite levels, regular and planned use is more meaningful.
Does long-term use affect a cat's immunity?
Current scientific data does not provide strong evidence that internal and external parasite medications, when used at the recommended doses and intervals, suppress the immune system. However, unnecessary and frequent repetitions can increase the body's drug burden. Therefore, the principle of "as needed" use is important.
For how many consecutive months can these medications be used on kittens?
The duration of use for kittens depends on age and weight criteria. Once the minimum age and weight limits are met, monthly products can be used for specific periods. However, long-term planning for kittens requires more careful consideration compared to adult cats.
Are NexGard Combo or Advantage Multi safe for pregnant cats?
The use of internal and external parasite medications in pregnant cats requires a risk-benefit analysis. If there is no active parasite threat, unnecessary applications should be avoided. If use is necessary, a more controlled approach should be adopted instead of routine application over consecutive months.
Are kittens at risk after using eye drops on nursing cats?
After applying spot-on products to nursing cats, direct contact with the neck area of the kittens should be avoided. Therefore, limiting contact in the first few hours after application is important. This must be considered if long-term use is planned.
If the parasites continue to be present, does that mean the medication isn't working?
Not always. Environmental contamination is particularly common with fleas. Even if the medication is still effective, parasites can reappear in the environment. This often doesn't mean the medication is ineffective, but rather indicates inadequate environmental control.
If a cat is receiving internal parasite medication, is external parasite medication necessary?
Products effective against internal parasites do not always cover external parasites. Therefore, the product's spectrum of activity must be considered. While combined products can meet this need with a single application, external parasite-only products are not sufficient for internal parasites.
Is a break necessary during long-term use?
In some cases, yes. If the risk of parasites decreases periodically and the cat is in a low-risk group, it may make sense to take certain breaks. However, in high-risk environments, this decision should be made carefully.
Do internal and external parasite medications cause addiction in cats?
These medications are not addictive in the classical sense. However, unnecessary and frequent use can create a feeling of "I have to keep giving them." Effective and conscious use is a healthier approach in the long run.
Is there a single answer to the question of how many months of consecutive use is safe?
No. There is no single answer to this question. The product used, the cat's age, lifestyle, parasite control, and the properties of the active ingredient determine the answer. Therefore, each product and each cat should be evaluated separately.
Sources
European Scientific Counsel Companion Animal Parasites (ESCCAP) – Feline Parasite Control Guidelines
Companion Animal Parasite Council (CAPC) – Feline Parasite Prevention Recommendations
European Medicines Agency (EMA) – Veterinary Antiparasitic Products Summaries
Merck Veterinary Manual – Feline Parasitology and Antiparasitic Drugs
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