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Use every month. Never had a problem with any of the pests it treats. Cats seem sleepy for a few hours afterwards, that's the only side effect I've noticed.
First gave this as a treatment to our old, 8kg indoor-outdoor family cat for fleas. Pleasantly surprised to discover that it treats other nasties as well (mites, worms etc.). Haven't had any issues with fleas since we started using it. Recently bought to use on my new 2-year old indoor domestic medium hair (as a preventative, as we were about to adopt a new kitten), and despite the fact that he's very wriggly, it went on fairly easily and it's good to know that he's protected against anything that may be introduced to the house (particularly as I, my roommate and our friends are Animal Science students at University, and come into contact with animals all the time and could catch things from them to bring home).