Equest Oral Gel (moxidectin)

Click here to Download Data Sheet Health Products Regulatory Authority Summary of Product Characteristics 1 NAME OF THE VETERINARY MEDICINAL PRODUCT EQUEST ORAL GEL, 18.92 mg/g, oral gel or horses and ponies 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each g contains: Active substance: Moxidectin 18.92mg Excipients qsp: Benzyl Alcohol (E1519) 37.84mg Disodium Edetate 0.24 mg For a full list of excipients, see section 6.1 3 PHARMACEUTICAL FORM Oral Gel. Yellow Gel. 4 CLINICAL PARTICULARS 4.1 Target Species Horses and ponies.   4.2 Indications for use, specifying the target species The veterinary medicinal product is indicated for treatment of infections caused by moxidectin sensitive strains of:   -Large strongyles: ×Strongylus vulgaris (adults and arterial stages) ×Strongylus edentatus (adults and visceral stages) ×Triodontophorus brevicauda (adults)  ×Triodontophorus serratus (adults) ×Triodontophorus tenuicollis (adults) -Small strongyles(adults and intraluminal larval stages): × Cyathostomum spp. × Cylicocyclus spp. × Cylicostephanus spp. × Cylicodontophorus spp. × Gyalocephalus spp. - Ascarids: × Parascaris equorum (adult and larval stages) - Other species: × Oxyuris equi (adult and larval stages) × Habronema muscae (adults) × Gasterophilus intestinalis (L2, L3) × Gasterophilus nasalis (L2, L3) × Strongyloides westeri (adults) × Trichostrongylus axei  The veterinary medicinal product has a persistent efficacy of Two weeks against small strongyles. The excretion of small  strongyles eggs is suppressed for 90 days.   The veterinary medicinal product is effective against (developing) Intramucosal L4 stages of small strongyles. At 8 weeks after treatment, early (hypobiotic) EL3 stages of small strongyles are eliminated. 4.3 Contraindications Do not administer to young foals less than 4 months. Do not administer in case of known hypersensitivity to the active ingredient or to any other milbemycins and to any other ingredients of the veterinary medicinal product. 4.4 Special warnings for each target species None.   4.5 Special precautions for use Special precautions for use in animals To avoid overdosing, care should be taken to accurately dose foals, especially low body weight foals or pony foals.  Do not use the same syringe to treat more than one animal unless horses are running together or in direct contact with each other in the same premises. Equest has been formulated specifically for use in horses only. Dogs or cats may be adversely affected by the concentration of moxidectin in this veterinary medicinal product if they are allowed to ingest spilled paste or  have access to used syringes. Neurological signs (such as ataxia, muscle tremor and convulsions) and digestive clinical signs  (such as hypersalivation) were recorded. Special precautions to be taken by the person administering the product to the animals Avoid direct contact with skin and eyes. The use of protective gloves is recommended. Wash hands or any exposed area after use. Do not smoke, drink or eat while handling the veterinary medicinal product. In the event of eye contact, flush the eye with copious amounts of clean water and seek medical advice. Other precautions regarding impact on the environment  Moxidectin fulfils the criteria for a (very) persistent, bioaccumulative and toxic (PBT) substance; therefore, exposure of the  environment to moxidectin must be limited to the extent possible. Treatments should be administered only when necessary and should be based on faecal egg counts or evaluation of the risk of infestation at the animal and/or herd level. In order to reduce the emission of moxidectin to surface water and based on the excretion profile of moxidectin when administered as the oral formulation to horses, treated animals should not have access to watercourses during the first week after treatment.  Like other macrocyclic lactones, moxidectin has the potential to adversely affect non-target organisms:  Faeces containing moxidectin excreted onto pasture by treated animals may temporarily reducetheabundanceofdung feeding organisms. Following treatment of horses with mthe product, levels of moxidectin that are potentially toxic to dung beetles and flies may be excreted over a period of more than 1 week and may decrease dung fauna abundance.  Moxidectin is inherently toxic to aquatic organisms including fish. The product should be used only according to the label  instructions.  4.6 Adverse reactions (frequency and seriousness) Ataxia, depression, abdominal pain, muscle tremor, flaccid lower lip and swelling of the muzzle could be observed on very rare occasions in young animals.  These adverse effects are usually transient and disappear spontaneously in most cases. The frequency of adverse reactions is defined using the following convention: -very common (more than 1 in 10 animals treated displaying adverse reaction(s))  -common (more than 1 but less than 10 animals in 100 animals treated) -uncommon (more than 1 but less than 10 animals in 1,000 animals treated) -rare (more than 1 but less than 10 animals in 10,000 animals treated) -very rare(less than 1 animal in 10,000 animals treated, including isolated reports). 4.7 Use during pregnancy, lactation or lay The veterinary medicinal product has been shown to be safe for use in pregnant and lactating mares. 4.8 Interaction with other medicinal products and other forms of interactions None known. 4.9 Amounts to be administered and administration route A single oral dose of 400 µg moxidectin/kg bodyweight using the calibrated syringe.    Before the first dose, hold the syringe with the capped end pointing to the left and so that you can see the weight measurements and tick marks (small black lines). Set the syringe to zero by moving the dial ring so the left side is set at the first full black mark and depress the plunger, safely discarding any paste that is expelled.   To dose the product, hold the syringe as previously described. Each tick mark relates to 25 kg of body weight and to 10mg  moxidectin. Turn the dial ring until the left side of the ring lines up with the weight of the animal. Use of a scale or weight tape is recommended to ensure accurate dosing. A single syringe treats a 700 kg horse. 4.10 Overdose (symptoms, emergency procedures, antidotes), if necessary Adverse reactions may occur at 2 times the recommended dose in foals and 3 times the recommended dose in adults. The symptoms are depression, inappetance, ataxia and flaccid lower lip in the 8 to 24 hours following treatment. Symptoms of moxidectin overdose are the same as those observed in very rare occasions at the recommended dosage. In addition, hypothermia and lack of appetite may occur. There is no specific antidote.    4.11 Withdrawal period(s) Meat and offal: 32 days. 5 PHARMACOLOGICAL or IMMUNOLOGICAL PROPERTIES Pharmacotherapeutic group Endectocides (milbemycins) ATC Vet code: QP54AB02 5.1 Pharmacodynamic properties Moxidectin is a parasiticide active against a wide range of internal and external parasites and is a second generation macrocyclic lactone of the milbemycin family. Moxidectin interacts with GABA and glutamate gated chloride channels. The net  effect is to open the chloride channels on the postsynaptic junction to allow the inflow of chloride ions and induce an irreversible resting state. This results in flaccid paralysis and eventual death of parasites exposed to the drug. The veterinary medicinal product is effective against benzimidazole resistant strains of cyathostomes. 5.2 Pharmacokinetic particulars Moxidectin is absorbed following oral administration with maximum blood concentrations being achieved 8 hours post application.  Bioavailability by the oral route is 40%. The drug is distributed throughout the body tissues butdue to its lipophilicity it is  selectively concentrated in the fat. The elimination half life is 28 days. Moxidectin undergoes partial biotransformation by hydroxylation in the body and the only significant route of excretion is the faeces. 5.3 Environmental properties Moxidectin fulfils the criteria for a (very) persistent, bioaccumulative and toxic (PBT) substance. In particular, in acute and chronic toxicity studies with algae, crustaceans and fish, moxidectin showed toxicity  EC50: the concentration which results in 50% of the test species individuals being adversely affected, i.e. both mortality and  sub-lethal effects.   NOEC: the concentration in the study at which no effects are observed. This implies that when allowing moxidectin to enter water bodies, this may have a severe and lasting impact on aquatic life. To mitigate this risk, all precautions for use and disposal must be adhered to. 6 PHARMACEUTICAL PARTICULARS 6.1 List of excipients Benzyl alcohol (E1519) Disodium edetate Poloxamer 407 Simethicone Sodium phosphate dibasic Sodium dihydrogen phosphate Propylene glycol Polysorbate 80 Water   6.2 Major incompatibilities None known  6.3 Shelf-life Shelf-life of the veterinary medicinal product as packaged for sale: 2 years. Shelf-life after first opening the immediate packaging: 6 months.   6.4 Special precautions for storage Store below 25°C  6.5 Nature and composition of immediate packaging High density polyethylene syringe containing 14.8g of gel with a graduated plunger with a low density polyethylene piston and cap packed as follows:   Box containing one syringe. Box containing 10 individually boxed syringes,   Box containing 20 syringes. Not all pack sizes may be marketed. 6.6 Special precautions for the disposal of unused veterinary medicinal products or waste materials derived from the use of such products Any unused veterinary medicinal product or waste material derived from such veterinary medicinal products should be disposed of in accordance with local requirements. Do not contaminate watercourses with the product.   The product is toxic for fish and aquatic organisms.  7 MARKETING AUTHORISATION HOLDER Zoetis Belgium S.A. 2nd Floor, Building 10 Cherrywood Business Park, Loughlinstown Co Dublin Ireland 8 MARKETING AUTHORISATION NUMBER(S) VPA10387/025/001 9 DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION Date of first authorisation: 05 February 1999 Date of last renewal: 30 April 2008 10 DATE OF REVISION OF THE TEXT April 2019