Contra-indications, warnings, etc
Do not use in cats that are suffering from concomitant disease, or are debilitated and underweight (for size and age).
Do not use in cases of hypersensitivity to the active substances or to any of the excipients.
It is recommended, in accordance with good veterinary practice, that all animals 6 months of age or more, living in countries where a vector exists, should be tested for existing adult heartworm infections before beginning preventive use with Stronghold Plus.
Stronghold Plus is not effective against adult D. immitis. The administration to animals with adult heartworm infection did not pose safety concerns.
Whilst not routinely indicated, the potential benefits of performing periodic testing for heartworm infection in individual cases should be considered by the responsible veterinarian.
Ticks need to start feeding on the host to become exposed to sarolaner; therefore, the transmission of infectious tick-borne diseases cannot be excluded.
Use of Stronghold Plus is indicated in cats aged at least 8 weeks old and weighing at least 1.25 kg bodyweight.
Stronghold Plus is to be applied to the skin surface only. Do not administer orally or parenterally.
Do not apply when the animal's hair coat is wet.
For ear mite treatment, do not apply directly to the ear canal.
It is important to apply the dose as indicated to prevent the animal from licking and ingesting the product. If significant ingestion occurs, transient gastrointestinal effects such as hypersalivation, emesis, soft faeces or reduced food consumption may be observed and should normally resolve without treatment.
Keep treated animals away from fires and other sources of ignition for at least 30 minutes or until the hair coat is dry.
Use of the veterinary medicinal product may result in mild and transient pruritus at the application site. Mild to moderate alopecia at the application site, erythema and drooling have been uncommonly (more than 1 but less than 10 animals in 1,000 animals) observed.

User warnings:
The product is harmful after ingestion. Keep the product in the original packaging until use, in order to prevent children from getting direct access to the product. Used pipettes should be disposed of immediately. In case of accidental ingestion, seek medical advice immediately and show the package leaflet or the label to the physician.
The product may cause eye irritation. Avoid eye contact including hand-to-eye-contact. Avoid direct contact with treated animals until the application area is dry. Wash hands after use and wash off any product in contact with the skin immediately with soap and water. If accidental eye exposure occurs, flush the eyes immediately with water and seek medical attention.
Children are not allowed to play with treated cats for 4 hours after treatment. It is recommended to treat animals in the evening. On the day of treatment, treated animals should not be permitted to sleep in the same bed as their owner, especially children.
People with sensitive skin or known allergy to veterinary medicinal products of this type should handle the veterinary medicinal product with caution. The product is highly flammable. Keep away from heat, sparks, open flame or other sources of ignition.

Further information
For fleas, the onset of efficacy is within 24 hours for 5 weeks after product application.
For ticks (I.ricinus), the onset of efficacy is within 24 hours of attachment for one month after product application.
The safety of the veterinary medicinal product has not been established during pregnancy and lactation or in animals intended for breeding. However, selamectin is considered safe for use in breeding, pregnant and lactating cats. While the safety of sarolaner has not been evaluated in breeding, pregnant or lactating cats, laboratory studies with sarolaner in rats and rabbits have not produced any evidence of teratogenic effects. Use only according to the benefit-risk assessment by the prescribing veterinarian.
During clinical field testing, no interactions between this veterinary medicinal product and routinely used veterinary medicinal products were observed.
No clinically significant adverse reactions were observed in kittens from 8 weeks of age treated with up to 5 times the maximum recommended dose of the product for up to 8 consecutive treatments at 28 day intervals, apart from a single cat administered 5 times the maximum dose that displayed transient hypersensitivity to touch, piloerection, mydriasis and mild tremor which resolved without treatment.
After accidental ingestion of a full product dose, transient gastrointestinal effects such as salivation, soft faeces, emesis, and reduced food consumption may occur, however these should resolve without treatment.