목시덱틴
Moxidectin
Semi-synthetic methoxime derivative of nemadectin
다른 이름: Cydectin · ProHeart · Advantage Multi · Quest · ComboCare · Advocate · Bravecto Plus · Endectrid · Moxiclear · Prinovox · CL-301423 · Moxidectina · Moxidectinum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Prevention of heartworm disease, adult fleas, hookworms, roundworms, and whipworms (Advantage Multi) | 10 mg/kg imidacloprid with 2.5 mg/kg moxidectin once a month by topical administration | topical | q30d | — | 🌎 NA |
| Heartworm prevention, hookworms (ProHeart 6) | 0.05 mL of the constituted suspension/kg body weight (provides 0.17 mg moxidectin/kg) | SC | q6mo | — | 🌎 NA |
| Scabiocidal therapy | 0.25 mg/kg SC every 7 days for three treatments OR 0.4 mg/kg PO every 3-4 days for 3-6 weeks | SC/PO | q7d or q3-4d | 3-6 weeks | 🌎 NA |
| Generalized demodicosis | 0.2-0.4 mg/kg PO once a day | PO | q24h | Until parasitic cure (averages 112 days) | 🌎 NA |
| Treatment of canine sarcoptic mange | 10 mg/kg body weight imidacloprid and 2.5 mg/kg body weight moxidectin | topical | q14d | 3 occasions | 🌍 EU |
| Flea, lice, mite, nematode treatment and heartworm/angiostrongylosis prevention | 10 mg/kg body weight imidacloprid and 2.5 mg/kg body weight moxidectin | topical | monthly | Ongoing for prevention | 🌍 EU |
- Prevention of heartworm disease, adult fleas, hookworms, roundworms, and whipworms (Advantage Multi): For dogs 3-9 lb = 0.4 mL; 9.1-20 lb = 1 mL; 20.1-55 lb = 2.5 mL, 55.1-88 lb = 4 mL.
- Heartworm prevention, hookworms (ProHeart 6): Do not overdose growing puppies. Mix at least 30 minutes prior to use.
- Scabiocidal therapy: May cause toxicity in ABCB1 mutant genotype dogs.
- Generalized demodicosis: May cause toxicity in ABCB1 mutant genotype dogs.
- Treatment of canine sarcoptic mange: Apply via spot-on pipette.
- Flea, lice, mite, nematode treatment and heartworm/angiostrongylosis prevention: Frequent shampooing may reduce efficacy.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Prevention of heartworm disease, adult fleas, ear mites, hookworms, and roundworms (Advantage Multi) | 10 mg/kg imidacloprid/1 mg/kg moxidectin once a month by topical administration | topical | q30d | — | 🌎 NA |
| Feline Aelurostrongylosis (Aelurostrongylus abstrusus) | One to three topical applications of 1 mg/kg moxidectin (in combination with imidacloprid) | topical | 1-3 applications | — | 🌎 NA |
| Flea, mite, nematode treatment and heartworm prevention | 10 mg/kg body weight imidacloprid and 1.0 mg/kg body weight moxidectin | topical | monthly | Ongoing for prevention | 🌍 EU |
| Flea/tick control and heartworm/nematode prevention (Bravecto Plus) | 280 mg/ml fluralaner and 14 mg/ml moxidectin (volume based on weight) | topical | q12w for flea/tick control, q8w for heartworm prevention | Ongoing | 🌍 EU |
- Prevention of heartworm disease, adult fleas, ear mites, hookworms, and roundworms (Advantage Multi): For cats 2-5 lb = 0.23 mL; 5.1-9 lb = 0.4 mL; 9.1-18 lb = 0.8 mL.
- Flea, mite, nematode treatment and heartworm prevention: Apply via spot-on pipette. Severe effects may be seen if applied to cats with adult heartworm disease.
- Flea/tick control and heartworm/nematode prevention (Bravecto Plus): Not for use in kittens <9 weeks or cats <1.2 kg.
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Gastrointestinal parasites (Oral Gel) | Dial in the weight of the animal on the syringe | PO | single dose | — | 🌎 NA |
| Mucosal stages of small strongyles | 400 micrograms/kg PO | PO | single dose | — | 🌎 NA |
- Gastrointestinal parasites (Oral Gel): Horses weighing more than 1250 lb require additional gel from a second syringe.
소
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Internal and external parasites (Pour-On) | 1 mL (5 mg)/10 kg (22 lb) bodyweight applied directly to the hair and skin along the top of the back | topical | single dose | — | 🌎 NA |
| Internal and external parasites (Injectable) | 0.2 mg/kg [1 mL for each 110 lb (50 kg) of bodyweight] subcutaneously | SC | single dose | — | 🌎 NA |
양
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Internal parasites | 0.2 mg/kg [1 mL per 11 lb (1 mL per 5 kg) bodyweight] PO (drench) | PO | single dose | — | 🌎 NA |
| Gastrointestinal helminthes in Camelids (NWC) | 0.2 mg/kg | PO | single dose | — | 🌎 NA |
- Gastrointestinal helminthes in Camelids (NWC): Regimen of choice for camelids.
염소
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Internal parasites | Twice the sheep dose (0.4 mg/kg) | PO | single dose | — | 🌎 NA |
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
목시덱틴(Moxidectin)은 소동물 및 대동물 수의학에서 광범위하게 사용되는 강력한 2세대 매크로라이드계(아버멕틴/밀베마이신 하위 클래스) 항기생충 약물입니다.
주요 약리학적 특징은 다음과 같습니다:
- 광범위한 효능: 다양한 체내 선충(회충, 구충, 편충, 심장사상충 유충) 및 체외 절지동물(벼룩, 진드기, 이, 소파리 유충)에 효과적입니다.
- 높은 지용성: 목시덱틴은 이버멕틴보다 약 100배 더 높은 지용성을 가집니다. 이로 인해 조직에 광범위하게 분포하고 반감기가 연장되며, 서방형 제제(예: 6개월 지속형 심장사상충 예방 주사)의 개발이 가능합니다.
- ABCB1 (MDR1) 안전성: ABCB1-1∆ 유전자 돌연변이가 있는 개는 매크로라이드계 약물에 민감하지만, FDA 승인을 받은 표준 라벨 용량(바르는 약 및 경구용 심장사상충 예방)의 목시덱틴은 이러한 품종에도 일반적으로 안전한 것으로 간주됩니다. 그러나 라벨 외 고용량 사용(예: 모낭충증 치료)은 심각한 신경 독성을 유발할 수 있습니다.
바르는 스팟온(주로 이미다클로프리드와 혼합), 서방형 주사제, 경구용 겔, 푸어온(등에 붓는) 용액 등 다양한 제형으로 제공됩니다.
작용 기전
Moxidectin exerts its antiparasitic effects by disrupting the neurological function of invertebrates:
- Glutamate-Gated Chloride Channels (GluCl): Moxidectin binds selectively and with high affinity to GluCl channels present in invertebrate nerve and muscle cells → increases membrane permeability to chloride ions → causes cellular hyperpolarization → results in flaccid paralysis and death of the parasite.
- GABA Receptors: It also enhances the release of gamma-aminobutyric acid (GABA) at presynaptic neurons, further blocking post-synaptic stimulation.
Mammalian Safety: Mammals do not possess GluCl channels. Furthermore, the P-glycoprotein (P-gp) efflux pump at the mammalian blood-brain barrier actively prevents moxidectin from entering the central nervous system, protecting mammalian GABA receptors from exposure.
안전성·주의사항
금기사항
- 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)
부작용
- 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
- Pyrexia
- Tachypnoea
- Mydriasis
- Severe systemic reactions in cats with adult heartworm disease
주의
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.
약물 상호작용
Effects may be potentiated by moxidectin; concurrent use is generally not advised.
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.
Increased risk of neurological toxicity due to competitive inhibition at the blood-brain barrier
Additive toxicity and increased risk of adverse neurological effects
모니터링
- Heartworm status prior to initiation of therapy
- Fecal egg count reduction testing (FECRT) in horses (target >95% reduction to monitor for resistance)
- Signs of neurotoxicity, especially in herding breeds or animals with low body fat
- Heartworm status (antigen/microfilariae testing) prior to initiating preventative therapy
- Resolution of clinical signs of parasitic infection
- Application site for erythema or pruritus
약동학
반감기
흡수
Highly lipophilic (100 times that of ivermectin).
분포
Volumes of distribution are very high due to extreme lipophilicity. Animals with very low body fat (neonates, cachexia) may have significantly higher serum levels than normal patients.
대사
Hepatic metabolism (inferred from macrocyclic lactone class properties).
배설
Long duration of plasma residence (14-15 days in cattle). After SC injection in cows, approximately 5% of the dose can be passed to the suckling calf.
과다투여
Moxidectin generally has a wide margin of safety when administered at labeled doses.
- Dogs: Dosages up to 300X (1120 mcg/kg) demonstrated little to no effects in normal dogs. However, in dogs with the ABCB1 (MDR1) mutant genotype, toxicity can be seen at doses as low as 90 mcg/kg.
- Clinical Signs of Toxicity: Dysorexia, hypersalivation, mydriasis, fasciculations, ataxia, tremors, seizures, vomiting, hyperesthesia, and recumbency/coma.
- Treatment: Supportive care. Intravenous fat emulsion (IVFE) has been successfully used to treat toxicity associated with macrocyclic lactones due to their highly lipid-soluble nature.
제품
제형
- Sustained-release injection (microspheres)
- Topical solution (spot-on)
- Pour-on solution
- Injectable solution
- Oral drench
- Oral gel
- Topical spot-on: 10 mg/kg imidacloprid + 1.0 mg/kg moxidectin (Cats)
- Topical spot-on: 10 mg/kg imidacloprid + 2.5 mg/kg moxidectin (Dogs)
- Topical spot-on: 280 mg/ml fluralaner + 14 mg/ml moxidectin (Cats - Bravecto Plus)
동물용의약품
- ProHeart 6: 10% Sustained-Release Injectable (598 mg/vial)
- Cydectin Pour-On for Cattle: 0.5% (5 mg/mL)
- Cydectin Injectable Solution: 10 mg/mL
- Cydectin Oral Drench for Sheep: 1 mg/mL
- Quest Oral Gel: 20 mg/mL
- Quest Plus Oral Gel: 20 mg/mL moxidectin + 125 mg/mL praziquantel
- Advantage Multi for Cats: 10 mg/mL moxidectin + 100 mg/mL imidacloprid
- Advantage Multi for Dogs: 25 mg/mL moxidectin + 100 mg/mL imidacloprid
- Advocate spot-on solution
- Bravecto Plus spot-on solution
- Endectrid spot-on solution
- Moxiclear spot-on solution
- Prinovox spot-on solution
규제 현황
투여 중단 기간: cattle meat 14-65 days depending on formulation
POM-V classification.
POM-V classification.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
ProHeart 6: Store unconstituted product at or below 25°C (77°F) and protect from light. Once constituted, stable for 4 weeks under refrigeration at 2°-8°C (36°-46°F). Cydectin injection/drench: Store at or below 25°C (77°F) and protect from light. Cydectin Pour-on: Store at or below room temperature; do not freeze. Quest gel: Store at room temperature (59°F-86°F); avoid freezing.
보호자 정보
- 심장사상충 검사: 이 약을 시작하기 전에 반드시 반려동물의 심장사상충 감염 여부를 검사해야 합니다. 심장사상충에 감염된 반려동물에게 이 약을 투여하면 심각한 부작용이 발생할 수 있습니다.
- 사용 방법: 바르는 스팟온 제품을 사용할 경우, 반려동물이 핥을 수 없는 목덜미나 어깨뼈 사이의 피부에 직접(털을 갈라서) 발라주세요. 바른 부위가 마를 때까지 몇 시간 동안은 치료받은 반려동물을 다른 반려동물이나 어린이와 분리해 두십시오.
- 부작용: 무기력, 구토, 비틀거림(운동 실조) 또는 과도한 침 흘림 등의 증상이 있는지 관찰하십시오. 신경학적 이상 징후를 발견하면 즉시 수의사에게 연락하십시오.
- ProHeart 6 (장기 지속형 주사): 반려견이 6개월 지속형 주사를 맞은 경우, 수의사가 제공한 보호자 안내서를 반드시 읽고 주사 후 며칠 동안 알레르기 반응(얼굴 부종, 두드러기, 심한 무기력 등)이 나타나지 않는지 관찰하십시오.
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