moxidectin
Approved
Jun 13, 2018
Moxidectin is a semi-synthetic methoxime derivative of LL F-2924α, commonly referred as F-alpha or nemadectin F-alpha is a product of fermentation of Streptomyces cyaneogriseus subsp. noncyanogenus, a bacterial organism isolated in 1983 from a sample of sand from Victoria, Australia. Moxidectin is a potent, broad-spectrum endectocide with activity against a wide range of nematodes, insects and acari. The compound acts by binding to ligand-gated chloride channels, more specifically the subtypes that are gamma-aminobutyric (GABA) mediated and glutamate-gated. The consequence of Moxidectin binding and activation is an increased permeability, leading to an influx of chloride ions and flaccid paralysis of the parasite leading to death. The macrocyclic lactones probably act by binding to and opening glutamate-gated chloride channels found only in neurons and myocytes of invertebrates. Because moxidectin is very lipophilic, it becomes highly concentrated in the serum. When the concentration of moxidectin in the serum is high, moxidectin is able to cross the blood-brain barrier. Once it is in the central nervous system, a macrocyclic lactone stimulates the synaptic secretion of the inhibitory neurotransmitter, GABA. By binding at the receptor site, GABA causes influx of chloride ions into neurons, causing the neurons to become hyperpolarised, which in turn, causes diminution in neuronal activity, resulting in sedation and relaxation of the skeletal muscles. Signs displayed by foals with moxidectin toxicity included dyspnoea, depression, ataxia, weakness, coma and seizures. In a Phase 3 study compared the efficacy, safety and tolerability of moxidectin and ivermectin in subjects infected with Onchocerca volvulus, which is the parasite that causes river blindness. — NCATS
Clinical trial activity
24 trials · 25 clinical orgs · 1 marketing orgs
Earliest trial started Sep 1, 2006 (NCT00300768)
Timeline
2000s
2010s
- Sep 29, 2010
Orphan Drug Designation
- Jun 13, 2018
Medicines Development for Global Health — Earliest FDA Approval
- Jun 13, 2018
Medicines Development for Global Health — NDA Secondary Org
- Jun 13, 2018
Medicines Development for Global Health — NDA Organization
Indications
Approved for
Studied for
- Ascariasis · Phase 4
- Blepharitis · Phase 4
- Elephantiasis, Filarial · Phase 3
- Healthy Volunteers · Phase 1
- Helminthiasis · Phase 2/Phase 3
- Hookworm Infections · Phase 4
- Infections · Phase 2
- Loiasis · Phase 2
- Onchocerca · Phase 2
- Onchocerciasis · Phase 3
- Onchocerciasis, Ocular · Phase 2
- Scabies · Phase 4
- Strongyloides · Phase 3
- Strongyloidiasis · Phase 3
- Trichuriasis · Phase 4
Mechanism of action
- Nematode GABA-A receptorANTAGONIST
Nematode GABA-A receptor antagonist
- Unspecified targetOTHER
Unknown
Antihelmintic. Based on other nematode studies, the mechanism may be through binding glutamate-gate chloride channels, GABA receptors and/or ABC transporters impacting cell permeability, polarisation and parasite motility.
Active against Onchocerca volvulus microfilariae.
Approval history
- approvedPriority reviewJun 13, 2018
Chemistry & pharmacology
SMILES
CO\N=C1/C[C@]2(C[C@@H]3C[C@@H](C\C=C(C)\C[C@@H](C)\C=C\C=C4/CO[C@@H]5[C@H](O)C(C)=C[C@@H](C(=O)O3)[C@]45O)O2)O[C@@H]([C@H]1C)C(\C)=C\C(C)C- Mol. weight
- 639.8186 g/mol
- Lipinski Ro5
- 2 violation(s)
- Rule of 3
- No
- Chirality
- Single Stereoisomer
- Inorganic
- No
- Polymer
- No
- Delivery
- Oral
- Availability
- Prescription Only
Oral
Yes
Parenteral
No
Topical
No
Sources
- WikipediaMoxidectin ↗
- NCATSNGU5H31YO9 ↗
- ChEMBLCHEMBL2104415 ↗
- WikipediaMilbemycin ↗
Also known as
- 5-hydroxymilbemycin beta7
- cl 301423
- cl 301,423
- cl-301423
- cl-301423
- cydectin
- milbemectin
- milbemycin
- milbemycin a3
- milbemycin a3
- milbemycin a4
- milbemycin alpha1
- milbemycin alpha10
- milbemycin alpha11
- milbemycin alpha13
- milbemycin alpha14
- milbemycin alpha15
- milbemycin alpha2
- milbemycin alpha3
- milbemycin alpha4
- milbemycin alpha5
- milbemycin alpha6
- milbemycin alpha7
- milbemycin alpha8
- milbemycin alpha9
- milbemycin b
- milbemycin beta1
- milbemycin beta12
- milbemycin beta2
- milbemycin beta3
- milbemycin d
- milbemycins
- moxidectin
- moxidectin
- moxidectin
- moxidectin
- moxidectin
Clinical trials
| NCT ID | Phase | Start date | Sponsor(s) |
|---|---|---|---|
| NCT07159373 | Phase 3 | Mar 31, 2026 | Medicines Development for Global Health, Murdoch University, University of New South Wales |
| NCT07145736 | Phase 4 | Aug 4, 2025 | Emory University, Erasmus University Rotterdam, La Trobe University, Medicines Development for Global Health, Murdoch University, The Mentor Initiative, University of Basel, University of Melbourne, University of New South Wales, University of Ottawa, World Health Organization |
| NCT06795165 | Phase 4 | Feb 15, 2025 | Eye Research Foundation |
| NCT06188715 | Phase 3 | May 14, 2024 | University of Basel |
| NCT06070116 | Phase 2 | Jan 15, 2024 | Washington University in St. Louis |
| NCT05875441 | Phase 2 | Nov 23, 2023 | Medicines Development for Global Health, West Houston Clinical Research Services |
| NCT04848688 | Phase 3 | Dec 1, 2021 | National Centre for Parasitology, Entomology and Malaria Control, Cambodia, University of Basel |
| NCT04700423 | Phase 2/Phase 3 (Phase 3) | Sep 30, 2021 | University of Basel |
| NCT04726969 | Phase 3 | Jun 15, 2021 | Centre Suisse de Recherches Scientifiques en Côte d'Ivoire (CSRS), University of Basel |
| NCT04311671 | Phase 3 | Oct 9, 2020 | Centre de Recherche en Maladies Tropicales de l'Ituri, Medicines Development for Global Health |
| NCT04410406 | Phase 3 | Jul 1, 2020 | Case Western Reserve University, Regional Hospital of Agboville, Southern Cote d'Ivoire, Washington University in St. Louis |
| NCT04049851 | Phase 2 | Jan 15, 2020 | Institut National de la Santé Et de la Recherche Médicale, France |
| NCT03876262 | Phase 3 | Nov 30, 2019 | Centre de Recherche en Maladies Tropicales de l'Ituri, Medicines Development for Global Health |
| NCT03962062 | Phase 1 | Sep 30, 2019 | Medicines Development for Global Health |
| NCT04056325 | Phase 2 | Sep 1, 2019 | Government of Laos, National Centre for Parasitology, Entomology and Malaria Control, Cambodia, University of Basel |
| NCT03905265 | Phase 2 | May 31, 2019 | Medicines Development for Global Health |
| NCT03501251 | Phase 2 | Jul 3, 2018 | University of Basel |
| NCT03012828 | Phase 1 | Jan 1, 2017 | Medicines Development for Global Health, Sponsor GmbH |
| NCT01035619 | Phase 2 | Apr 1, 2011 | Pfizer, World Health Organization |
| NCT00790998 | Phase 3 | Apr 1, 2009 | World Health Organization |
Organizations
Research & Development (25)
Marketing (2)
| Organization | Org type | Relationship | Date |
|---|---|---|---|
| Medicines Development for Global Health | For profit | NDA2 | Jun 13, 2018 |
| Medicines Development for Global Health | For profit | NDA | Jun 13, 2018 |