Moxidectin

What it is used for

• Prevention of heartworm disease, adult fleas, ear mites, hookworms, and roundworms (Advantage Multi)
• Feline Aelurostrongylosis (Aelurostrongylus abstrusus)
• Flea, mite, nematode treatment and heartworm prevention
• Flea/tick control and heartworm/nematode prevention (Bravecto Plus)
• Internal parasites
• Gastrointestinal helminthes in Camelids (NWC)
• Gastrointestinal parasites (Oral Gel)
• Mucosal stages of small strongyles
• Internal and external parasites (Pour-On)
• Internal and external parasites (Injectable)
• Internal parasites
• Prevention of heartworm disease, adult fleas, hookworms, roundworms, and whipworms (Advantage Multi)

How it is given

Possible side effects

• Dogs: Lethargy, vomiting, ataxia, anorexia, diarrhea, nervousness, weakness, polydipsia, pruritus
• Dogs (Injectable): Rare but serious reports of anaphylaxis, liver disease, autoimmune hemolytic disease, convulsions
• Cats: Recumbency (rare)
• Horses: Minimal at labeled doses; CNS depression and coma reported in foals at high doses
• Cattle: Minimal to nonexistent at labeled doses
• Transient pruritus at application site
• Erythema at application site
• Hypersalivation (if licked)
• Emesis and haematemesis
• Diarrhoea
• Lethargy
• Pyrexia
• Tachypnoea

Cautions & contraindications

• Hypersensitivity to the drug
• Dogs not tested for heartworm infection prior to use
• Sick, debilitated, or underweight dogs (specifically for the 6-month injectable)
• Female dairy cattle of breeding age
• Horses intended for food purposes
• Foals younger than 4 months of age
• Kittens < 9 weeks of age
• Dogs < 7 weeks of age
• Dogs with Class 4 heartworm disease
• Cats < 1.2 kg (for fluralaner combination)
• Breeding males (for fluralaner combination)
• > **Heartworm Testing**: Always test dogs for existing heartworm infections before initiating moxidectin therapy. Adult heartworms and microfilariae should be removed prior to therapy. * **ABCB1 (MDR1) Mutants**: Safe at standard labeled preventative doses. However, off-label high doses (e.g., for demodicosis or scabies) can cause severe neurotoxicity in herding breeds with this mutation. * **Body Condition**: Animals with very low body fat (neonates, cachexia) may experience significantly higher serum levels due to the drug's extreme lipophilicity, making them more prone to adverse reactions. * **Vaccinations**: Caution is advised when administering the 6-month sustained-release injection concurrently with vaccinations, as anaphylaxis has been reported.

Drug interactions

• Benzodiazepines: Effects may be potentiated by moxidectin; concurrent use is generally not advised.
• P-glycoprotein Inhibitors (Amiodarone, Carvedilol, Clarithromycin, Cyclosporine, Diltiazem, Erythromycin, Itraconazole, Ketoconazole, Quinidine, Spironolactone, Tamoxifen, Verapamil): May inhibit the efflux pump at the blood-brain barrier, potentially increasing the risk of moxidectin neurotoxicity, especially in dogs with the ABCB1-1∆ mutation.
• P-glycoprotein substrates: Increased risk of neurological toxicity due to competitive inhibition at the blood-brain barrier
• Other macrocyclic lactones: Additive toxicity and increased risk of adverse neurological effects

Frequently asked questions