Medically reviewed by Drugs.com. Last updated on May 26, 2020.
(mox i DEK tin)
Generic: 2 mg [500s] [contains lactose, sodium lauryl sulfate]
Moxidectin, an anthelminthic agent, is active against the microfilariae of O. volvulus, but not effective in killing the adult worms. Studies with other nematodes suggest moxidectin binds to glutamate-gated chloride ions channels, gamma-aminobutyric acid (GABA) receptors, and/or APT-binding cassette transporters. This leads to increased permeability, influx of chloride ions, hyperpolarization, and muscle paralysis. There is also a reduction in motility of all stages of the parasite, excretion of immunomodulatory proteins, and the fertility of both male and female adult worms.
Vd: 2,421 ± 1,658 L
Feces: 2% (as unchanged drug)
Time to Peak
23.3 days (559 hours)
Use: Labeled Indications
Onchocerciasis: Treatment of onchocerciasis due to Onchocerca volvulus in patients ≥12 years of age.
Limitations of use: Moxidectin does not kill adult O. volvulus; follow-up evaluation is advised. Safety and efficacy of repeat administration of moxidectin in patients with O. volvulus has not been studied.
There are no contraindications listed in the manufacturer’s labeling.
Onchocerciasis: Oral: 8 mg as a single dose
Refer to adult dosing.
Onchocerciasis: Children ≥12 years and Adolescents: Oral: 8 mg as a single dose
Oral: Administer without regard to meals.
Store below 30°C (86°F). Protect from light. Once opened, administer within 24 hours. Discard unused tablets.
There are no known significant interactions.
Cardiovascular: Tachycardia (39%), postural orthostatic tachycardia (34%), hypotension (30%), orthostatic hypotension (22%), peripheral edema (11%)
Central nervous system: Headache (58%), chills (≤27%), lymph node pain (13%), dizziness (12%)
Dermatologic: Pruritus (65%), skin rash (37%)
Endocrine & metabolic: Hyponatremia (12%)
Gastrointestinal: Abdominal pain (31%), diarrhea (≤15%), enteritis (≤15%), gastroenteritis (≤15%)
Hematologic & oncologic: Eosinophilia (18% to 74%; severe: 18%), lymphocytopenia (48%: grade 3: 23%), leukocytosis (25%), neutropenia (20%: grade 4: 7%)
Neuromuscular & skeletal: Musculoskeletal pain (64%)
Respiratory: Flu-like symptoms (23%), cough (17%)
Miscellaneous: Fever (≤27%)
1% to 10%:
Cardiovascular: Symptomatic orthostatic hypotension (5%)
Endocrine & metabolic: Increased gamma-glutamyl transferase (3%)
Hematologic & oncologic: Eosinopenia (5%)
Hepatic: Hyperbilirubinemia (3%), increased serum alanine aminotransferase (1%), increased serum aspartate aminotransferase (1%)
Ophthalmic: Eye pain (8%), eye pruritus (7%), visual impairment (3%; including blurred vision, low vision acuity), allergic conjunctivitis (2%), eyelid edema (2%), conjunctival hyperemia (≤2%), ocular hyperemia (≤2%), increased lacrimation (1%)
Frequency not defined: Dermatologic: Mazzotti reaction
Concerns related to adverse effects:
• Mazzoti reaction: Moxidectin treatment may cause cutaneous, ophthalmological, and/or systemic reactions (Mazzoti reaction) of varying severity, due to allergic and inflammatory host responses to the death of microfilariae. These reactions generally occur and resolve in the first week post-treatment. Risk may be increased in patients with higher microfilarial burden. Treatment of severe Mazzoti reactions is not definitive, but includes supportive care (eg, hydration and/or parenteral corticosteroids) to treat postural hypotension. Antihistamines and/or aspirin have been used for most mild to moderate reactions.
• Orthostatic hypotension: Orthostatic hypotension may occur, most commonly on the first 1 to 2 days after treatment. Decrease in blood pressure was transient and managed by resuming recumbency.
• Loiasis: Pretreatment assessment for loiasis is recommended in any patient with exposure to Loa loa-endemic areas; serious, sometimes fatal, encephalopathy may occur following treatment with moxidectin in onchocerciasis patients with concomitant loiasis.
• Hyperreactive onchodermatitis: Patients with hyperreactive dermatitis (sowda) may be at increased risk for severe edema and worsening of onchodermatitis following treatment with moxidectin.
Skin microfilarial counts; screening for loiasis prior to treatment in patients exposed to Loa loa-endemic areas; signs and symptoms of Mazzotti reaction, including symptomatic orthostatic hypotension
Females of reproductive potential were required to use long acting contraception during clinical studies (Awadzi 2014; Korth-Bradley 2011) likely due to the long terminal half-life of moxidectin.
Adverse events were observed in some animal reproduction studies.
What is this drug used for?
• It is used to treat eye and skin disease caused by certain worms (O. volvulus).
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
• Abdominal pain
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
• Low sodium like headache, trouble focusing, trouble with memory, confusion, weakness, seizures, or change in balance.
• Flu-like symptoms
• Passing out
• Fast heartbeat
• Swollen glands
• Muscle pain
• Joint pain
• Burning or numbness feeling
• Eye redness
• Eye pain
• Eye itching
• Eye swelling
• Blurred vision
• Watery eyes
• Light sensitivity
• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.
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