Nurses Compass
Drug Guide
Moxidectin
Classification
Therapeutic: Antiparasitic agent
Pharmacological: macrocyclic lactone
FDA Approved Indications
- Treatment of onchocerciasis (river blindness) in adults and children over 12 years of age
Mechanism of Action
Moxidectin binds to invertebrate glutamate-gated chloride channels, causing increased permeability to chloride ions, leading to hyperpolarization of nerve or muscle cells, resulting in paralysis and death of the parasite.
Dosage and Administration
Adult: Single oral dose of 8-8.6 mg, as per specific product instructions.
Pediatric: Not FDA approved for children under 12; use in pediatric populations not well established.
Geriatric: No specific adjustments recommended, but caution in patients with hepatic or renal impairment.
Renal Impairment: No specific dose adjustments; monitor patients closely.
Hepatic Impairment: No specific dose adjustments; use with caution, as hepatic function may affect drug metabolism.
Pharmacokinetics
Absorption: Well absorbed orally.
Distribution: Widely distributed in body tissues, including skin and fat.
Metabolism: Primarily metabolized in the liver.
Excretion: Excreted mainly in feces, with minimal urinary excretion.
Half Life: Approximately 16-31 days, supporting a once-only dose for treatment.
Contraindications
- Hypersensitivity to moxidectin or other macrocyclic lactones.
- Pregnancy and lactation: insufficient data; use with caution.
Precautions
- Use with caution in patients with severe hepatic impairment.
- Monitoring for adverse effects in pediatric populations.
Adverse Reactions - Common
- Mild gastrointestinal symptoms (nausea, diarrhea) (Rare)
Adverse Reactions - Serious
- Hypersensitivity reactions, including rash, swelling, difficulty breathing (Very rare)
Drug-Drug Interactions
- May increase the risk of adverse effects when combined with other CNS depressants or medications affecting the blood-brain barrier.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor for signs of allergic reactions, neurological symptoms, and gastrointestinal symptoms.
Diagnoses:
- Risk for allergic reaction
- Risk for neurological side effects
Implementation: Administer as a single oral dose with food or as directed. Educate patient on potential side effects.
Evaluation: Assess for clinical improvement and adverse effects, ensure patient understanding of medication purpose and side effects.
Patient/Family Teaching
- Take medication exactly as prescribed.
- Report any allergic reactions or neurological symptoms immediately.
- Avoid driving or operating machinery if affected.
- Complete the full course if multiple doses are prescribed, even if symptoms resolve.
Special Considerations
Black Box Warnings:
- No black box warnings currently issued for moxidectin.
Genetic Factors: N/A
Lab Test Interference: N/A
Overdose Management
Signs/Symptoms: Potential neurological toxicity, such as ataxia, confusion, somnolence.
Treatment: Supportive care; no specific antidote. Consult poison control.
Storage and Handling
Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).
Stability: Stable for the duration of the shelf life as per manufacturer instructions.