Moxidectin was approved foronchocerciasis (river-blindness) in 2018 for people over the age of 11 in the United States based on two studies.[5] There is a need for additional trials, with long-term follow-up, to assess whether moxidectin is safe and effective for treatment of nematode infection in children and women of childbearing potential.[6] Moxidectin is predicted to be helpful to achieve elimination goals of this disease.[7]
Nematodes can develop cross-resistance between moxidectin and other similar parasiticides, such asivermectin,doramectin andabamectin.[11] The ways in which the parasites evolve resistance to this drug include mutations in glutamate-gated chloride channel genes,GABA-R genes,[12] or increased expression of p-glycoprotein, which is a transmembrane drug efflux pump.[13] Allele frequency changes corresponding to resistance to moxidectin and/or other macrocyclic lactone-class drugs have been observed in the glutamate-gated chloride channel α-subunit gene ofHaemonchus contortus andCooperia oncophora, as well as in theH. contortus genes coding for p-glycoprotein and the GABA-R gene.[13]
Moxidectin is being evaluated as a treatment to eradicatescabies in humans, especially when resistant to other treatments.[14]
Studies of moxidectin show the side effects vary by animal and may be affected by the product's formulation, application method and dosage.[citation needed]. It is however regarded as relatively safe.[15]
If a dog licks moxidectin from the skin which was applied as a "spot-on" (topical) treatment, this has the same effect as an overdose, and may cause vomiting, salivation and neurological signs such asataxia, tremor, andnystagmus.[8] SomeCollie dogs can tolerate moxidectin, but other individuals are sensitive and upon ingestion, experience vomiting, salivation or transient neurological signs.[8]
Moxidectin is verylipophilic, which causes it to have a highvolume of distribution.[17] Moxidectin concentrates in the animal'sadipose tissue, from where it is released for up to two months following administration.[17]
In goats, the oral bioavailability of moxidectin is 2.7 times lower, and the half-life is 1.8 times shorter than in sheep.[18]
For human use, moxidectin was approved by the United States Food and Drug Administration in June 2018 for the treatment of onchocerciasis in adults and adolescents aged 12 and older. This is the first human approval worldwide. The license holder is the nonprofit biopharmaceutical companyMedicines Development for Global Health.[20]
^abcdeAwasthi A, Razzak M, Al-Kassas R, Harvey J, Garg S (2013). "Chapter 7: Analytical profile of moxidectin". In Brittain H (ed.).Profiles of drug substances, excipients and related methodology: Volume 38. Amsterdam: Academic Press. pp. 315–366.ISBN9780124078284.
^Old JM, Skelton C, Stannard HJ (2021). "The use of Cydectin® by wildlife carers to treat sarcoptic mange in free-ranging bare-nosed wombats (Vombatus ursinus)".Parasitology Research.120 (3):1077–1090.doi:10.1007/s00436-020-07012-8.PMID33438043.
^Papich MG (2011). "Moxidectin".Saunders handbook of veterinary drugs small and large animal (3rd ed.). Philadelphia, PA: Elsevier/Saunders. pp. 525–526.ISBN9781437701920.
^Sargison N (2008). "Moxidectin".Sheep flock health a planned approach. Oxford: Blackwell Publishing. pp. 180–181.ISBN9781444302608.
^Rugg D, Buckingham SD, Sattelle DB, Jansson RK (2010). "The insecticidal macrocyclic lactones". In Gilbert GI, Gill SS (eds.).Insect pharmacology channels, receptors, toxins and enzymes. London: Academic Press.ISBN9780123814487.
^Wolstenholme AJ, Fairweather I, Prichard R, von Samson-Himmelstjerna G, Sangster NC (October 2004). "Drug resistance in veterinary helminths".Trends in Parasitology.20 (10):469–476.doi:10.1016/j.pt.2004.07.010.PMID15363440.
^abBlackhall WJ, Prichard RK, Beech RN (March 2008). "P-glycoprotein selection in strains of Haemonchus contortus resistant to benzimidazoles".Veterinary Parasitology.152 (1–2):101–107.doi:10.1016/j.vetpar.2007.12.001.PMID18241994.
^Schraven AL, Stannard HJ, Old JM (2021). "A systematic review of moxidectin as a treatment for parasitic infections in mammalian species".Parasitology Research.120 (4):1167–1181.doi:10.1007/s00436-021-07092-0.PMID33615411.
^abDowling PM (2012). "Ivermectin and moxidectin toxicosis". In Wilson DA (ed.).Clinical veterinary advisor: The horse. St. Louis, MO: Elsevier Saunders. pp. 307–308.ISBN9781437714494.
^abLanusse CE, Lifschitz AL, Imperiale FA (2013). "Chapter 42: Macrocyclic lactones: Endectocide compounds". In Riviere JE, Papich MG (eds.).Veterinary Pharmacology and Therapeutics (9th ed.). John Wiley & Sons. p. 1126.ISBN978-1118685907.
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