[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Anthelmintics](https://durgical.com/en/pharmacology/classes/anthelmintics/) › Moxidectin

# Moxidectin

## Anthelmintics?

Anthelmintics

Long-acting macrocyclic lactone related to ivermectin; a single oral dose clears Onchocerca microfilariae from the skin for months.

Updated Nov 12, 2026

## Quick facts

**Group**
[Anthelmintics](https://durgical.com/en/pharmacology/classes/anthelmintics/)

**Target**
Nematode glutamate-gated chloride channel (GluCl)

**Used for**
Onchocerciasis

**Key effects**
Itching · Headache · Eosinophilia

**Monitor**
Itching · Blood pressure and dizziness on standing

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

⇅**Nematode glutamate-gated chloride channel (GluCl)**Moxidectin

ⓘ No structure with moxidectin is published; the figure shows ivermectin, a related macrocyclic lactone, in the GluCl channel of the nematode Caenorhabditis elegans.

**Target in 3D:** Nematode glutamate-gated chloride channel (GluCl). PDB structure 3RHW (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/3RHW) · Drag to rotate · pinch to zoom

Moxidectin belongs to the same family as ivermectin. In nematodes it is thought to act on glutamate-gated chloride channels (and possibly GABA receptors and ABC transporters), opening them so the worm's nerve and muscle cells are paralysed. It kills Onchocerca volvulus microfilariae and also stops adult females from releasing new ones for a time, but it does not kill the adult worms.

- Binds glutamate-gated chloride channels of the worm
- Chloride enters and nerve and muscle cells stop firing
- Microfilariae are paralysed and cleared from the skin
- Adult females release fewer microfilariae for months

## Indications

- Onchocerciasis (river blindness) by Onchocerca volvulus in adults and children from four years [Onchocerciasis (river blindness) →](https://durgical.com/en/conditions/onchocerciasis/)
- WHO lists it as a therapeutic equivalent of ivermectin for onchocerciasis and lymphatic filariasis [Lymphatic filariasis →](https://durgical.com/en/conditions/lymphatic-filariasis/)

## Adverse effects

### Common

- Itching, rash and skin swelling (Mazzotti-type reaction)
- Headache, fever, muscle and joint pain
- Eosinophilia, fast heart rate and low blood pressure
- Abdominal pain

### Serious (rare, important)

- Symptomatic orthostatic hypotension (dizziness or fainting on standing)
- Worsening oedema and skin disease in hyper-reactive onchodermatitis (sowda)
- Serious or fatal encephalopathy in people co-infected with Loa loa

## Contraindications

- None absolute on the label; Loa loa is ruled out first in areas where it is common

## Key interactions

**CYP3A4 substrates such as midazolam**
No relevant change: moxidectin does not affect CYP enzymes or P-glycoprotein.

**Food**
A fatty meal raises exposure a little; not clinically important.

## What is monitored

- Itching, rash, fever and eye symptoms in the days after the dose
- Blood pressure and dizziness on standing
- Loa loa screening before treatment in endemic areas

## Administration and safety

- Oral, single dose
- Repeat dosing has not been fully studied; follow-up is planned because adult worms survive

## Pregnancy and breastfeeding

Human data are insufficient; rats showed fetal effects only at doses toxic to the mother. A clinician weighs the benefit.

## Nursing care

- Ask about residence in areas where Loa loa is common
- Teach the patient to lie down if dizzy or faint, and to rise slowly
- Warn that itching and rash may appear as microfilariae die
- Breastfeeding is paused during treatment and for one week after the dose

## Pharmacokinetics

**Absorption**
Oral; a high-fat meal raises exposure somewhat, but it can be taken with or without food.

**Metabolism**
Minimal metabolism in the liver; it is not a CYP3A4 substrate or inhibitor.

**Half-life**
Very long: about 23 days in people with onchocerciasis.

## Memory aid

«MOXidectin = MOre eXtended ivermectin»: same family and channel, longer in the body, longer clearance of skin microfilariae.

## Test yourself

Think of the answer, then tap the question to see it.

## Which disease is moxidectin approved for?

Onchocerciasis (river blindness) caused by Onchocerca volvulus.

## Does moxidectin kill adult Onchocerca worms?

No. It kills microfilariae and temporarily stops adult females from releasing them, so follow-up is needed.

## Why is Loa loa ruled out before moxidectin in endemic areas?

In co-infected people, killing Loa loa microfilariae can cause serious or fatal encephalopathy.

## Which blood-pressure effect should patients be warned about after moxidectin?

Symptomatic orthostatic hypotension: dizziness or fainting on standing; they should lie down if it happens.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/pharmacology/moxidectin/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Ivermectin](https://durgical.com/en/pharmacology/ivermectin/)
- [Diethylcarbamazine](https://durgical.com/en/pharmacology/diethylcarbamazine/)
- [Albendazole](https://durgical.com/en/pharmacology/albendazole/)

## Related conditions 2

- [Onchocerciasis (river blindness)](https://durgical.com/en/conditions/onchocerciasis/)
- [Lymphatic filariasis](https://durgical.com/en/conditions/lymphatic-filariasis/)

[← Back to the class: Anthelmintics](https://durgical.com/en/pharmacology/classes/anthelmintics/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - MOXIDECTIN tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6eb02ae9-9065-176f-e053-2991aa0ac891) (DailyMed (U.S. National Library of Medicine), 2026); [Onchocerciasis](https://www.who.int/news-room/fact-sheets/detail/onchocerciasis) (World Health Organization (WHO), 2025); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/?query=moxidectin) (World Health Organization (WHO), 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/moxidectin/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/moxidectin/