MOXIDECTIN TABLETS

Indications

• Onchocerciasis
• River blindness

Dosage

Children: Refer to the BNF for Children for specific dosing guidelines.

Adults: Refer to the BNF for specific dosing guidelines.

Mechanism of action

Moxidectin selectively binds to the parasite's GABA-A and glutamate-gated chloride ion channels, essential for the functioning of invertebrate nerve and muscle cells. This binding increases the permeability of the cell membranes, allowing an influx of chloride ions, which results in flaccid paralysis of the parasite without directly killing it.

Pharmacodynamics

Moxidectin has shown remarkable efficacy against _Onchocerca volvulus_, demonstrating a superior ability to reduce microfilarial loads in infected individuals compared to ivermectin. The administration of moxidectin leads to a significant decrease in microfilariae levels to undetectable amounts, making it suitable for mass drug administration, while maintaining safety.

Pharmacokinetics

Moxidectin is well absorbed after oral administration with a long half-life, allowing for less frequent dosing compared to other treatments. Its pharmacokinetic profile supports its use in mass treatment strategies for onchocerciasis, although specific parameters such as absorption rate, distribution volume, and elimination route require detailed clinical studies for comprehensive understanding.

Pregnancy

There are no adequate data from the use of moxidectin in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is unknown whether moxidectin is excreted in human breast milk. Caution should be exercised when moxidectin is administered to a nursing woman.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.

Mechanism of action

Moxidectin selectively binds to the parasite's GABA-A and glutamate-gated chloride ion channels which are vital for the function of invertebrate nerve and muscle cells. It presents activity against the parasite but it does not kill him. Once moxidectin is bound, there is an increased permeability leading to an influx of chloride ions and flaccid paralysis of the parasite.

Pharmacodynamics

Moxidectin has been reported to be highly effective against _Onchocerca volvulus_ when compared to ivermectin. When moxidectin was administered in infected individuals, the microfilarial load in the skin was lower even when compared to the current therapy, ivermectin. The levels of microfilarial got reduced to an undetectable level while being safe to be used in mass drug administration.