Choosing the Best Heartworm and Flea Prevention

Combination heartworm and flea prevention medications make it possible to prevent heartworms along with protection from common pests including fleas, and in some products, ticks, mites and intestinal parasites — all in one medication.

The importance of heartworm prevention is undeniable. The American Heartworm Society recommends year-round heartworm prevention for cats and dogs, without missing even one dose.

As a responsible pet parent, parasite prevention including heartworm protection may seem overwhelming. However, recent innovations in the science of heartworm prevention have made it easier than ever to protect your pet from harmful parasites with a single heartworm and flea pill or application.

Combination heartworm preventatives offer comprehensive protection

Administering a once-a-month combination product will protect your pet from heartworms, fleas and several types of intestinal worms in a single dose! That's a lot easier than remembering to use several products at different times, helping reduce the chances of missing a dose. Taking a single medication to prevent multiple parasites is easier on your pet, too. Compare: Trifexis, Revolution, Sentinel, Advantage Multi, and Sentinel Spectrum.

Compare combination heartworm and flea prevention medications

Sentinel Spectrum, Opens in New Window Advantage Multi, Opens in New Window Trifexis, Opens in New Window Revolution, Opens in New Window Sentinel, Opens in New Window


Combination heartworm medications are available in several forms, including tablets and topically applied formulas. This variety of administration options makes it easier and more convenient to choose the right one for your pet. Those pets that do not take tablets well will likely be more co-operative if given heartworm prevention topically.

Benefits of all-in-one heartworm and flea prevention

Before the development of combination heartworm medicine, pet parents' only choice was to give their pets separate products for the prevention of heartworms, fleas, ticks and intestinal parasites. This can be inconvenient, confusing and expensive, especially for multiple-pet homes.

These innovative all-in-one protection options now available are:

  • Affordable
  • Convenient
  • Fast-acting
  • Easy to administer
  • Long-lasting
  • Effective in the prevention of multiple pests

Trifexis is one of the leading oral combination heartworm preventatives. It is a once a month chewable tablet that prevents heartworms, kills adult fleas and also prevents hookworms, roundworms and whipworms. Sentinel Spectrum does the same, with the added benefit of preventing tapeworms.

Choosing the best heartworm and flea prevention for your pet

When choosing a combination heartworm preventative, consider your pet's lifestyle and what you want to protect your pet against most.

Choosing a heartworm and flea medicine for dogs will depend on if your dog spends most of the time indoors or outdoors. If it's unlikely that your pet could be exposed to ticks, Trifexis (a very popular flea heartworm pill for dogs) or Sentinel Spectrum may be your two best heartworm and flea prevention options. If you're concerned about ticks, Revolution provides heartworm protection and will kill ticks, along with fleas and their eggs, roundworms and hookworms.

Choosing a heartworm and flea prevention medication for cats will also depend on if your cat is primarily a housecat or spends some time outside. If you're looking for a comprehensive combination heartworm and flea protection that will also protect your cat from roundworms, hookworms and whipworms Advantage Multi is the ideal choice. However, if your cat also requires protection from ticks, Revolution is a combination heartworm preventative that kills fleas and flea eggs, ticks, roundworms and hookworms in a single topical application.

All of these combination heartworm preventatives are available by prescription only, so when seeing your veterinarian for your pet's yearly checkup, be sure to ask about your options. Your vet will be able to help you choose one based on your pet's specific needs, and will perform a heartworm test prior to writing a prescription.

What if my pet has heartworms?

If your pet is diagnosed with heartworms, your veterinarian will prescribe a treatment protocol that must be completed before giving your pet any type of heartworm preventative. Unfortunately, there is no definitive treatment protocol available for cats, but there are several palliative options including surgery in extreme cases. Heartworm treatment can be harsh, expensive and traumatic to your pet's health. This is why comprehensive heartworm prevention is so very important.

Pharmacy Tip

Still have questions about heartworms and the different treatment options available for your pet? Read our article covering heartworm disease FAQ.