moxidectin

Small moleculeapprovedOrphan Drug FDA

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

Phase 1
5
Phase 2
16
Phase 3
9
Phase 4
2

Earliest trial started Sep 1, 2006 (NCT00300768)

Timeline

2000s

  1. Jan 1, 2006

    Earliest Phase 2 Sponsor(trial)

  2. Jan 1, 2008

    Earliest Phase 1 Sponsor(trial)

  3. Jan 1, 2009

    Earliest Phase 3 Sponsor(trial)

2010s

  1. Sep 29, 2010

    Orphan Drug Designation

  2. Jun 13, 2018

    Medicines Development for Global Health — Earliest FDA Approval

  3. Jun 13, 2018

    Medicines Development for Global Health — NDA Secondary Org

  4. Jun 13, 2018

    Medicines Development for Global Health — NDA Organization

Indications

Mechanism of action

  • 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

Loading structure…

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

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 IDPhaseStart dateSponsor(s)
NCT07159373Phase 3Mar 31, 2026Medicines Development for Global Health, Murdoch University, University of New South Wales
NCT07145736Phase 4Aug 4, 2025Emory 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
NCT06795165Phase 4Feb 15, 2025Eye Research Foundation
NCT06188715Phase 3May 14, 2024University of Basel
NCT06070116Phase 2Jan 15, 2024Washington University in St. Louis
NCT05875441Phase 2Nov 23, 2023Medicines Development for Global Health, West Houston Clinical Research Services
NCT04848688Phase 3Dec 1, 2021National Centre for Parasitology, Entomology and Malaria Control, Cambodia, University of Basel
NCT04700423Phase 2/Phase 3 (Phase 3)Sep 30, 2021University of Basel
NCT04726969Phase 3Jun 15, 2021Centre Suisse de Recherches Scientifiques en Côte d'Ivoire (CSRS), University of Basel
NCT04311671Phase 3Oct 9, 2020Centre de Recherche en Maladies Tropicales de l'Ituri, Medicines Development for Global Health
NCT04410406Phase 3Jul 1, 2020Case Western Reserve University, Regional Hospital of Agboville, Southern Cote d'Ivoire, Washington University in St. Louis
NCT04049851Phase 2Jan 15, 2020Institut National de la Santé Et de la Recherche Médicale, France
NCT03876262Phase 3Nov 30, 2019Centre de Recherche en Maladies Tropicales de l'Ituri, Medicines Development for Global Health
NCT03962062Phase 1Sep 30, 2019Medicines Development for Global Health
NCT04056325Phase 2Sep 1, 2019Government of Laos, National Centre for Parasitology, Entomology and Malaria Control, Cambodia, University of Basel
NCT03905265Phase 2May 31, 2019Medicines Development for Global Health
NCT03501251Phase 2Jul 3, 2018University of Basel
NCT03012828Phase 1Jan 1, 2017Medicines Development for Global Health, Sponsor GmbH
NCT01035619Phase 2Apr 1, 2011Pfizer, World Health Organization
NCT00790998Phase 3Apr 1, 2009World Health Organization
Showing 20 of 24 trials
Page 1 / 2

Organizations

Research & Development (25)

OrganizationOrg typeTrialsAs lead sponsorPhasesEarliest year
Medicines Development for Global HealthFor profit8742017
University of BaselAcademic/Hospital7632018
PfizerFor profit4422008
World Health OrganizationGovernment4232006
WyethFor profit3012008
Centre de Recherche en Maladies Tropicales de l'IturiAcademic/Hospital2012019
Murdoch UniversityAcademic/Hospital2022025
National Centre for Parasitology, Entomology and Malaria Control, CambodiaAcademic/Hospital2022019
University of New South WalesAcademic/Hospital2122025
Washington University in St. LouisAcademic/Hospital2222020
Case Western Reserve UniversityAcademic/Hospital1012020
Centre Suisse de Recherches Scientifiques en Côte d'Ivoire (CSRS)Academic/Hospital1012021
Emory UniversityAcademic/Hospital1012025
Erasmus University RotterdamAcademic/Hospital1012025
Eye Research FoundationAcademic/Hospital1112025
Government of LaosGovernment1012019
Institut National de la Santé Et de la Recherche Médicale, FranceAcademic/Hospital1112020
La Trobe UniversityAcademic/Hospital1012025
Regional Hospital of Agboville, Southern Cote d'IvoireAcademic/Hospital1012020
Sponsor GmbHAcademic/Hospital1012017
25 organizations
Page 1 / 2

Marketing (2)

OrganizationOrg typeRelationshipDate
Medicines Development for Global HealthFor profitNDA2Jun 13, 2018
Medicines Development for Global HealthFor profitNDAJun 13, 2018