Your furry friend must have a current heartworm test result on file with your veterinarian in order to be prescribed heartworm medication. Please visit your veterinarian to have this test performed annually to protect your four-legged friend. This combo purchase has what it takes to protect your pet from pesky pests! It includes Heartgard Plus Chews for Dogs and NexGard Chews for Dogs. Each item in this bundle will require its own prescription approval.Heartgard Plus Chews is a heartworm preventative that kills heartworms and also helps treat and control roundworms and hookworms. It comes in a delicious once-a-month, real-beef chew that dogs love and is safe for puppies 6 weeks and older.NexGard Chews are vet-recommended and FDA-approved to kill adult fleas fast before they have a chance to lay eggs. This product is also FDA-approved to help prevent Lyme infections as a direct result of killing black-legged ticks. Each fast-acting chew provides safe and effective protection, killing fleas and ticks for a full month. Each NexGard bite-sized monthly dose is gentle enough to give to puppies and dogs as young as 8 weeks.We directly source prescription medications from manufacturers and wholesale distributors registered with the FDA and licensed by applicable state boards. Guaranteed genuine, and where applicable, backed by the manufacturer. Heartgard Plus product may arrive in new and updated packaging, prompted by the manufacturer.