What is NexGard Combo? The Next-Generation Parasite Control Solution for Cats

What Is NexGard Combo and How Does It Work?

NexGard Combo is a next-generation broad-spectrum antiparasitic spot-on treatment developed specifically for cats. It provides simultaneous protection against external parasites (such as fleas, ticks, and mites) and internal parasites (including roundworms, hookworms, and tapeworms).

Manufactured by Boehringer Ingelheim, NexGard Combo combines cutting-edge chemistry with ease of use, offering pet owners a single, monthly solution for nearly all major feline parasite threats. The medication is applied directly to the cat’s skin, where it spreads through the sebaceous glands and bloodstream to provide long-lasting protection.

Unlike traditional flea and tick treatments that target only external parasites, NexGard Combo works systemically — killing parasites through both direct contact and ingestion. It represents one of the most comprehensive feline parasite control options available today.

Key Highlights of NexGard Combo

• Kills fleas within 24 hours and ticks within 48 hours.

• Prevents heartworm disease (Dirofilaria immitis).

• Eliminates intestinal worms and tapeworms with a single monthly dose.

• Easy-to-apply topical pipette — no tablets required.

• Provides one-month protection with a single application.

By combining multiple active ingredients, NexGard Combo ensures multi-level defense, addressing both immediate infestations and long-term prevention in cats of all lifestyles — from indoor-only cats to outdoor explorers.

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Active Ingredients and Mechanism of Action

NexGard Combo contains three active ingredients — Esafoxolaner, Eprinomectin, and Praziquantel — each targeting a specific group of parasites. Together, they form a synergistic formula that covers almost all major external and internal parasites in cats.

Active Ingredient	Class	Main Target	Mechanism of Action
Esafoxolaner	Isoxazoline	Fleas, ticks, and mites	Blocks GABA- and glutamate-gated chloride channels in parasites, causing paralysis and death. Highly selective for arthropods, ensuring safety in mammals.
Eprinomectin	Macrocyclic lactone (Avermectin)	Roundworms, hookworms, heartworm larvae	Increases chloride ion permeability in parasite neurons, leading to paralysis and expulsion. Effective against both adult and larval stages.
Praziquantel	Pyrazinoisoquinoline	Tapeworms (Dipylidium, Taenia, Echinococcus)	Damages the worm’s outer membrane, causing calcium imbalance, paralysis, and disintegration within the digestive tract.

How It Works

• Topical Absorption: After being applied to the skin, Esafoxolaner spreads across the surface while Eprinomectin and Praziquantel are absorbed transdermally into the bloodstream.

• Systemic Protection: The ingredients work both on contact (external parasites) and internally (intestinal and blood-borne parasites).

• Continuous Efficacy: Active compounds remain stored in the sebaceous glands, providing steady release and sustained protection for one month.

Why NexGard Combo Is Different

Most spot-on treatments target either fleas and ticks or intestinal worms, but rarely both. NexGard Combo’s triple-action formula provides complete parasite coverage in a single, easy-to-use dose — simplifying feline parasite control for pet owners and veterinarians alike.

Which Parasites Is NexGard Combo Effective Against?

NexGard Combo provides broad-spectrum protection against nearly all common feline parasites — both external and internal. Its triple-action formulation targets multiple parasite species in different life stages, breaking infestation cycles and preventing re-infection.

1. External Parasites (Ectoparasites)

NexGard Combo eliminates parasites that live on the skin or fur and feed on the cat’s blood.

Parasite Type	Scientific Name	Effectiveness
Fleas	Ctenocephalides felis	Kills adult fleas within 24 hours and prevents egg laying for one month. Stops flea allergy dermatitis (FAD) by killing fleas before they bite.
Ticks	Ixodes ricinus, Rhipicephalus sanguineus, Dermacentor reticulatus	Kills and repels ticks within 48 hours, reducing the risk of disease transmission such as hemoplasmosis and cytauxzoonosis.
Mites	Otodectes cynotis (ear mites), Notoedres cati (feline scabies)	Effective against ear mite infestations and mange, relieving itching and inflammation.

2. Internal Parasites (Endoparasites)

NexGard Combo also provides strong protection against worms and internal parasites that affect a cat’s digestive and circulatory systems.

Parasite Group	Species Controlled	Action
Roundworms (Nematodes)	Toxocara cati, Toxascaris leonina	Eliminates adult and larval stages; prevents transmission to kittens or humans (zoonotic risk).
Hookworms	Ancylostoma tubaeforme	Kills adult and immature stages that cause intestinal bleeding and anemia.
Tapeworms (Cestodes)	Dipylidium caninum, Taenia taeniaeformis, Echinococcus multilocularis	Destroys adult tapeworms through disruption of the worm’s cell membrane.
Heartworm (Prevention)	Dirofilaria immitis larvae (L3, L4 stages)	Prevents development of heartworm disease by killing larval forms before they reach the heart.

Full Protection Spectrum

NexGard Combo effectively prevents:

• Flea and tick infestations.

• Feline scabies and ear mites.

• Intestinal worms and tapeworms.

• Heartworm infections.

With one monthly dose, it offers complete, multi-parasite coverage that protects cats from both visible and hidden threats, reducing the need for multiple separate medications.

Areas of Use and Key Advantages

NexGard Combo was created for comprehensive parasite prevention and control. It’s suitable for cats of all lifestyles, ages (above 8 weeks), and environments — from city apartments to outdoor rural settings.

Primary Areas of Use

• Routine monthly parasite prevention for indoor and outdoor cats.

• Treatment of active flea and tick infestations with simultaneous environmental control.

• Management of ear mite and scabies infections caused by Otodectes and Notoedres species.

• Elimination of intestinal worms and tapeworms in adult and young cats.

• Heartworm prevention in endemic regions or areas with mosquito exposure.

Key Advantages of NexGard Combo

1. All-in-One Protection: Covers fleas, ticks, mites, and both round and tapeworms — replacing the need for multiple separate treatments.

2. Fast-Acting and Long-Lasting: Begins killing fleas within 24 hours and ticks within 48 hours, maintaining full effectiveness for 30 days.

3. Easy Topical Application: Single pipette application makes it simple for pet owners to administer monthly doses.

4. Suitable for Multi-Pet Homes: Safe for households with dogs and cats when species-appropriate formulations are used.

5. Clinically Proven Efficacy: Tested across various parasite species under international veterinary supervision.

6. High Safety Profile: Low systemic absorption and selective parasite targeting ensure safety even in sensitive cats.

7. Water-Resistant Formula: Maintains efficacy after light exposure to water or bathing (post 48 hours).

8. Ideal for Travel and Boarding: Reduces risk of parasite transmission in multi-animal environments.

NexGard Combo offers complete parasite protection in a single monthly application, making it one of the most convenient and effective choices for feline health management.

Benefits of NexGard Combo for Cats

NexGard Combo is one of the most advanced and convenient parasite control solutions available for cats today. By combining three scientifically proven active ingredients — esafoxolaner, eprinomectin, and praziquantel — it provides broad-spectrum protection in a single topical dose.

1. All-in-One Solution

NexGard Combo eliminates the need for multiple separate treatments. A single pipette provides complete protection against:

• External parasites such as fleas, ticks, and mites.

• Internal parasites like roundworms, hookworms, and tapeworms.

• Heartworm prevention, which is essential in regions where mosquitoes transmit this disease.

2. Rapid Parasite Elimination

• Kills fleas within 24 hours and ticks within 48 hours of application.

• Interrupts the flea life cycle, preventing re-infestation and allergic reactions such as Flea Allergy Dermatitis (FAD).

3. Long-Lasting Protection

One dose protects cats for up to one full month against fleas, ticks, and internal worms. The sustained-release mechanism from sebaceous glands ensures constant coverage.

4. Safe and Easy Application

NexGard Combo is a spot-on topical treatment, eliminating the stress of pills or injections. Its small pipette size allows accurate, mess-free dosing.

5. Suitable for Indoor and Outdoor Cats

Whether your cat stays indoors or roams outdoors, NexGard Combo is formulated to handle all common parasite risks in both environments.

6. Water and Bath Resistant

Once the solution dries, it remains effective even if your cat is exposed to water, rain, or light bathing.

7. Veterinary-Approved and Scientifically Tested

NexGard Combo has undergone extensive clinical testing for efficacy and safety in cats of various breeds, ages, and health conditions.

8. Reduces Zoonotic Risk

By eliminating intestinal worms and external parasites, NexGard Combo helps reduce zoonotic transmission — protecting both pets and their human family members.

In short, NexGard Combo offers convenience, safety, and comprehensive protection — making it an ideal choice for long-term parasite prevention in cats.

Possible Side Effects and Safety Guidelines

NexGard Combo has a high safety margin when used correctly; however, as with all veterinary medicines, mild reactions may occasionally occur. Understanding these effects ensures safe, confident use.

Common Mild Reactions

• Temporary itching or mild redness at the application site.

• Slight greasiness or clumping of fur where the product was applied.

• Short-term lethargy or decreased appetite, typically resolving within 24 hours.

These effects are generally minor and self-limiting.

Less Common Reactions

• Drooling or excessive salivation, usually caused by licking the application area before it dries.

• Vomiting or soft stool due to mild gastrointestinal sensitivity.

• Transient restlessness or excessive grooming after treatment.

Rare but Serious Reactions

• Neurological signs such as tremors, uncoordinated movement, or hypersensitivity (very rare).

• Allergic swelling or severe skin irritation.If any of these occur, wash the area with mild soap and water and contact your veterinarian immediately.

Safety Guidelines

• Apply only on cats older than 8 weeks and weighing at least 0.8 kg.

• Do not use on sick, debilitated, or underweight cats without veterinary supervision.

• Keep the treated cat away from other pets until the product has fully dried to prevent ingestion during grooming.

• Wash your hands thoroughly after application and avoid contact with the treated area for several hours.

• Avoid combining with other topical or oral antiparasitic products unless prescribed by your vet.

Veterinary Testing and Tolerance

Extensive trials show NexGard Combo is well tolerated in cats, including those receiving routine vaccinations and deworming treatments. The active ingredients act selectively on parasites, minimizing any adverse effects on the cat’s nervous system or organs.

When used according to instructions, NexGard Combo offers a strong safety profile with exceptional efficacy, making it one of the most trusted all-in-one antiparasitic treatments for cats.

Comparison Between NexGard Combo and Similar Parasite Treatments

NexGard Combo stands out among modern feline antiparasitic products thanks to its three active ingredients and comprehensive coverage against both internal and external parasites. The table below compares NexGard Combo with other leading parasite control medications commonly used in cats.

Product Name	Active Ingredients	Parasites Covered	Protection Duration	Key Features
NexGard Combo	Esafoxolaner, Eprinomectin, Praziquantel	Fleas, ticks, mites, roundworms, hookworms, tapeworms, heartworm larvae	1 month	All-in-one topical solution; kills internal and external parasites; heartworm prevention.
Bravecto Plus	Fluralaner, Moxidectin	Fleas, ticks, roundworms, hookworms, heartworm	3 months	Long-lasting spot-on; extended flea and tick coverage; partial internal protection.
Stronghold (Revolution)	Selamectin	Fleas, mites, roundworms, hookworms, heartworm	1 month	Effective against common external and internal parasites; no tapeworm protection.
Advocate	Imidacloprid, Moxidectin	Fleas, mites, roundworms, hookworms, heartworm	1 month	Trusted for internal and external control; limited tick coverage.
Frontline Combo	Fipronil, (S)-Methoprene	Fleas, ticks, lice	1 month	Excellent flea and tick protection; no internal parasite coverage.
Profender	Emodepside, Praziquantel	Roundworms, hookworms, tapeworms	1 month	Internal deworming spot-on only; no flea or tick coverage.

Key Differences

• Spectrum of Protection: NexGard Combo is the most comprehensive, covering external parasites (fleas, ticks, mites) and internal ones (worms and heartworm).

• Convenience: Combines multiple effects into one dose—replacing the need for both dewormers and flea/tick products.

• Frequency: Monthly application maintains consistent parasite control with minimal owner effort.

• Safety: Low systemic absorption and extensive clinical testing ensure excellent tolerance in cats of different breeds and weights.

In summary, NexGard Combo represents the next generation of feline parasite protection, merging innovation, convenience, and broad-spectrum efficacy into one easy application.

How to Apply NexGard Combo Correctly (Step-by-Step Guide)

Proper application ensures NexGard Combo provides maximum protection. Follow these steps carefully to guarantee safety and full parasite control.

Step 1 – Prepare the Pipette

• Remove one pipette from its packaging immediately before use.

• Hold it upright and tap the narrow part to ensure the liquid settles at the bottom.

• Twist and break off the seal at the top.

Step 2 – Choose the Right Application Site

• Part the fur at the base of your cat’s neck (between the shoulder blades) until the skin is visible.

• This location prevents your cat from licking the product and ensures optimal absorption.

Step 3 – Apply the Product

• Place the tip of the pipette directly on the exposed skin.

• Squeeze the entire contents onto the skin in one spot.

• Avoid rubbing or spreading the solution with your hands; it will naturally disperse through skin oils.

Step 4 – Post-Application Care

• Keep your cat indoors for 24 hours after treatment.

• Prevent other cats or dogs from licking the treated area until it’s fully dry.

• Wash your hands thoroughly after application and discard the empty pipette safely.

Step 5 – Monitor for Reactions

• Mild itching or greasiness may appear briefly but should subside within 24 hours.

• If redness, swelling, or unusual behavior occurs, contact your veterinarian.

Additional Tips

• Do not bathe your cat or use grooming sprays within 48 hours before or after application.

• Apply NexGard Combo once every month for continuous protection.

• Treat all cats and dogs in your household to prevent re-infestation.

When used correctly, NexGard Combo delivers comprehensive protection against fleas, ticks, mites, and internal worms, ensuring your cat remains healthy, parasite-free, and comfortable all year long.

Frequency of Use and Duration of Protection

NexGard Combo provides a full month of protection against fleas, ticks, mites, and internal worms after a single topical application. Regular monthly use ensures your cat stays continuously protected, preventing new infestations and maintaining parasite-free health throughout the year.

1. Recommended Frequency

• Apply once every 4 weeks (monthly) for ongoing protection.

• For cats living in parasite-prone environments or warm climates, year-round treatment is strongly recommended.

• Skipping a monthly dose can allow immature parasite stages (eggs or larvae) to mature and re-infect your cat and its surroundings.

2. Duration of Effectiveness

Parasite Type	Duration of Protection	Action
Fleas	Up to 1 month	Kills adult fleas within 24 hours and prevents re-infestation by stopping egg-laying.
Ticks	Up to 1 month	Kills and repels ticks within 48 hours of contact.
Mites	Up to 1 month	Eliminates ear mites (Otodectes cynotis) and mange mites (Notoedres cati).
Roundworms & Hookworms	1 month	Removes adult and larval intestinal worms.
Tapeworms	1 month	Kills common feline tapeworm species (Dipylidium caninum, Taenia taeniaeformis).
Heartworm Prevention	1 month	Prevents development of heartworm larvae into adult worms.

3. Continuous Protection Principle

Parasites reproduce quickly and can persist in the environment. Continuous monthly use of NexGard Combo ensures:

• Flea life cycles are disrupted before re-infestation occurs.

• Internal parasite loads are kept at zero.

• Environmental contamination by eggs and larvae is minimized.

For consistent effectiveness, mark your calendar or set a phone reminder for monthly reapplication. Maintaining strict intervals guarantees maximum safety and efficacy for your cat.

Use in Kittens, Pregnant, and Nursing Cats

NexGard Combo is formulated to be safe for cats across various life stages, including kittens, pregnant queens, and nursing mothers — when used under veterinary supervision.

1. Use in Kittens

• NexGard Combo is approved for kittens over 8 weeks of age and weighing at least 0.8 kg.

• For kittens younger than 8 weeks or underweight, consult a veterinarian for alternative treatments.

• Dosage must match the kitten’s weight category; use the smallest pipette size recommended.

• Monitor kittens for mild irritation or hypersensitivity after the first use — effects usually subside within 24 hours.

2. Use in Pregnant Cats

• NexGard Combo has undergone reproductive safety studies and is considered safe for use in pregnant cats.

• Always consult your veterinarian before treatment during pregnancy to ensure the cat’s health status supports topical medication use.

• Apply the product in a well-ventilated area and avoid stress during handling.

3. Use in Nursing (Lactating) Cats

• Safe for use during lactation.

• Apply after feeding to prevent kittens from coming into direct contact with the treated area.

• Keep the mother cat and kittens separated until the application site has fully dried (usually 2–3 hours).

4. Precautions

• Avoid treating very young kittens directly; instead, focus on controlling the environment and treating the nursing mother.

• For multi-cat households, ensure that only one topical product is used per animal to avoid accidental overdosing.

• If adverse reactions such as excessive drooling, skin irritation, or lethargy occur, contact your veterinarian immediately.

NexGard Combo’s proven safety profile makes it one of the few broad-spectrum products suitable for cats in all life stages, ensuring continuous protection for both mothers and their kittens.

Veterinary Advice and Precautions Before Use

Although NexGard Combo is designed for convenience and safety, consulting a veterinarian before starting any parasite treatment is strongly recommended — especially for cats with pre-existing conditions or complex medical histories.

When to Seek Veterinary Advice

• First-time users: A vet should confirm the correct dosage and ensure the cat’s age, weight, and health meet the requirements.

• Cats with chronic illness: Cats suffering from liver, kidney, or neurological diseases may require adjusted treatment schedules or alternative products.

• Concurrent medication use: Combining NexGard Combo with other flea, tick, or deworming products should only be done under veterinary supervision to prevent drug interactions.

• History of allergic reactions: Cats that previously reacted to topical medications should be evaluated for sensitivity before reapplication.

Before Application

1. Weigh your cat accurately to ensure the correct pipette size is used.

2. Inspect the skin and coat for open wounds, irritation, or excessive dandruff — avoid applying on broken or inflamed skin.

3. Avoid washing or bathing within 48 hours before application, as oils in the skin are essential for the product’s distribution.

4. Do not use on sick, underweight, or debilitated cats without a veterinarian’s approval.

5. Prevent stress: Apply in a calm, familiar environment to keep your cat relaxed and reduce post-application grooming.

Precautions for Multi-Pet Households

• Ensure each cat receives a species-specific dose (never use the dog version).

• Separate cats for a few hours post-application to prevent licking each other’s treatment site.

• Treat all cats and dogs in the household simultaneously to stop cross-infestation.

Following veterinary and safety guidelines guarantees maximum efficacy and reduces the chance of adverse reactions.

Post-Application Monitoring and Efficacy Evaluation

Monitoring your cat after applying NexGard Combo helps confirm effectiveness and ensures early detection of any unwanted side effects.

1. Immediate Monitoring (First 24 Hours)

• Observe behavior: Mild lethargy, itching, or grooming at the site may occur and typically resolves quickly.

• Check for skin reactions: Slight redness or hair clumping is normal. Persistent irritation beyond 48 hours warrants a vet visit.

• Prevent licking: Keep your cat from grooming or interacting with other animals until the application site has fully dried.

2. Effectiveness Assessment

• Fleas: Expect visible reduction within 24 hours; fleas die quickly upon contact.

• Ticks: Removed or dead ticks should be seen within 48 hours.

• Worms: For internal parasites, improvements in stool consistency and appetite are seen within a few days.

• Heartworm Prevention: Efficacy is preventive and not visually detectable — continue monthly doses without interruption.

3. Environmental Control

Reinfestation is often due to untreated surroundings. For maximum efficacy:

• Wash bedding weekly in hot water.

• Vacuum carpets, sofas, and pet resting areas.

• Treat all other pets in the household with appropriate parasite control.

4. Signs of Ineffectiveness

If fleas or ticks persist after two consecutive treatments:

• Recheck dosing and application technique.

• Inspect for environmental parasite sources.

• Consult a veterinarian to rule out resistance or secondary infections.

5. Long-Term Monitoring

Maintain a monthly schedule for applications. Keeping a record of application dates and observed results helps track efficacy and ensures uninterrupted protection.

When applied correctly and paired with environmental hygiene, NexGard Combo delivers full-spectrum, lasting protection, making it one of the most reliable parasite management tools for cats worldwide.

Frequently Asked Questions (FAQ)

What is NexGard Combo for cats used for?NexGard Combo is a broad-spectrum monthly treatment that protects cats against fleas, ticks, mites, intestinal worms, tapeworms, and heartworm larvae. It provides complete internal and external parasite protection in one easy-to-use spot-on dose.

How does NexGard Combo for cats work?It contains esafoxolaner, eprinomectin, and praziquantel, which act together to paralyze and kill parasites. Esafoxolaner targets fleas and ticks, eprinomectin removes roundworms and hookworms, and praziquantel eliminates tapeworms.

Is NexGard Combo safe for my cat?Yes. NexGard Combo is tested and proven safe for cats older than 8 weeks and weighing at least 0.8 kg, when used according to the label instructions.

How often should NexGard Combo be applied?It should be applied once a month (every 4 weeks) to ensure continuous protection from all internal and external parasites.

Does NexGard Combo kill fleas and ticks already on my cat?Yes. It kills existing fleas within 24 hours and ticks within 48 hours, providing rapid relief from infestations.

Can NexGard Combo prevent future flea infestations?Absolutely. It kills adult fleas before they can lay eggs, effectively breaking the flea life cycle and preventing re-infestation.

Does NexGard Combo also treat worms?Yes. The combination of eprinomectin and praziquantel kills roundworms, hookworms, and tapeworms in a single dose, offering complete internal deworming protection.

Is NexGard Combo effective against mites and mange?Yes. It treats ear mites (Otodectes cynotis) and mange mites (Notoedres cati), relieving itching and preventing secondary infections.

Can NexGard Combo prevent heartworm disease?Yes. Monthly application kills the larval stages (L3, L4) of heartworm before they reach the heart, preventing serious and often fatal infections.

Can I use NexGard Combo on kittens?Yes, but only for kittens older than 8 weeks and weighing at least 0.8 kg. For younger or smaller kittens, consult your veterinarian for safe alternatives.

Can pregnant or nursing cats use NexGard Combo?Yes. NexGard Combo has been tested and found safe for use in pregnant and lactating queens, under veterinary guidance.

Where should I apply NexGard Combo?Part your cat’s fur at the base of the neck (between the shoulder blades) until the skin is visible, then apply the entire contents of one pipette directly to the skin.

What happens if my cat licks the application site?If your cat licks the area before it dries, temporary drooling or salivation may occur. It’s harmless and resolves within hours. Prevent grooming by separating pets for a few hours after application.

Are there side effects to NexGard Combo for cats?Most cats tolerate it very well. Mild itching, temporary hair clumping, or slight redness may appear at the application site and typically resolve within 24–48 hours.

Can I use NexGard Combo with other flea or worm medications?It’s not necessary, as NexGard Combo already covers nearly all major parasites. Only combine treatments if advised by your veterinarian.

Is NexGard Combo waterproof?Once dry, NexGard Combo is water-resistant and remains effective after light exposure to water or rain. Avoid bathing your cat for 48 hours before and after use.

Can NexGard Combo be used year-round?Yes. Monthly, year-round treatment ensures continuous protection, as fleas, ticks, and worm eggs can survive indoors even in winter.

How long does NexGard Combo last after application?Each dose protects against fleas, ticks, and internal parasites for 30 days. To maintain effectiveness, reapply monthly.

What should I do if I miss a dose?Apply the missed dose as soon as you remember, then continue with your regular monthly schedule. Do not double-dose to compensate for missed treatment.

Can NexGard Combo be used on dogs?No. NexGard Combo is formulated specifically for cats. Using it on dogs or other species can cause toxicity.

How should I handle NexGard Combo safely?Wash your hands thoroughly after use and avoid touching the treated area until it’s completely dry. Keep pipettes away from children and food.

Can NexGard Combo replace traditional deworming?Yes. It covers both intestinal worms and tapeworms, replacing the need for separate oral dewormers when used regularly.

Why is NexGard Combo considered an advanced treatment?Because it provides broad-spectrum, all-in-one protection against external and internal parasites — including heartworm — in a single monthly dose.

Where can I buy NexGard Combo for cats?It’s available at veterinary clinics and licensed pharmacies. In many countries, it may require a veterinary prescription due to its wide-spectrum activity.

How can I ensure NexGard Combo works effectively?Apply it correctly, treat all pets in your household, maintain monthly dosing, and keep your home environment clean. Consistency is key to full parasite prevention.

Sources

• Boehringer Ingelheim – NexGard Combo Product Monograph and Clinical Trials

• European Medicines Agency (EMA) – NexGard Combo Assessment Report (2023)

• World Small Animal Veterinary Association (WSAVA) – Guidelines on Feline Parasite Prevention

• American Veterinary Medical Association (AVMA) – Topical Antiparasitic Safety and Efficacy Data

• Mersin Vetlife Veterinary Clinic – Haritada Aç: https://share.google/XPP6L1V6c1EnGP3Oc