Ophthalmologic Manifestations of Onchocerciasis Medication

Updated: Jun 22, 2018
  • Author: Debora E Garcia-Zalisnak, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.



Class Summary

These agents inhibit growth and proliferation of parasites.


Semisynthetic, broad-spectrum antiparasitic agent isolated from Streptomyces avermitilis. It is a mixture of 5-O demethyl-22,23-dihydroavermectin A (90%) and 5-O demethyl-25-de (1-methylpropyl)-22,23-dihydro-25- (1-methylethyl) avermectin A1a (10%).

Selectively binds to glutamate-gated chloride ion channels in muscles and nerve cells of the invertebrate. Increased permeability of cell membrane to chloride ions leads to hyperpolarization of the nerve or muscle cell, paralysis, and death of the parasite.

Active against various life-cycle stages of many nematodes, including microfilariae of O volvulus but has no effect on adult worm.

Metabolized in liver. Plasma half-life is 16 hours, 99% excreted in feces and 1% in urine. Available as 6 mg tab for oral administration. Given as single dose of 12 mg (two 6 mg tab) or 150 mcg/kg.


Moxidectin, a macrocyclic lactone, is an anthelmintic indicated for the treatment of onchocerciasis due to Onchocerca volvulus in patients aged 12 years and older. Plasma half-life is 20-43 days and thereby reduces and maintains low skin microfilarial density effectively. Moxidectin does not kill adult O volvulus. Follow-up evaluation is advised. Safety and efficacy of repeat administration has not been studied.


Antibiotic, Tetracycline Derivative


Tetracycline antibiotic who binds to the 30S ribosomal subunit in the mRNA translation complex therefore inhibiting tRNA to join the mRNA ribosome complex. In O. volvulus, it interferes with microfilarial embryogenesis. It has modes activity against adult works, decreasing them by 50%-60%. It also kills the endosymbiont Wolbachia.