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No, it can be taken on its own
But the trifecta plus D3 is better
Interesting, everything in that is OTC except the Ivermectin. I already take a C, D, and E supplement... I would far rather take Ivermectin prophylactic treatment than experimental vaccines.
A look at the various ivermectin products illustrates extreme differences in price and difficulties inherent in transferring products between species. Six doses of one name-brand heartworm-prevention product (containing ivermectin and pyrantel) for a 50-pound dog costs roughly 15 times the price of a tube of generic ivermectin paste dewormer dosed for a 1,280-pound horse. Figuring out how much of that tube to give to a dog is fraught with risk.
For example, one type of equine paste contains 1.87 percent ivermectin in 6.08 grams of product. The ivermectin dose for dogs is measured in micrograms (millionths of a gram). Translating a percentage concentration into micrograms of ivermectin per tube and then determining and measuring out the volume of paste to give to a dog of a certain weight involves multiple calculations that could make most heads spin — and easily result in critical errors.
https://news.vin.com/default.aspx?pid=210&Id=6018472