Cattle.

In cattle weighing from 100 to 500 kg body weight, treatment and prevention of mixed infestations by the following gastro-intestinal nematodes, respiratory nematodes and certain arthropod parasites:

− Adult and immature gastro-intestinal nematodes:

. Ostertagia ostertagi (including inhibited larvae)

. Nematodirus helvetianus (adults only)

. Bunostomum phlebotomum (adults only)

. Chabertia ovina (adults only)

. Trichuris spp. (adults only)

− Adult and immature respiratory tract nematode

− Warble grubs (migrating larvae)

− Lice

. Bovicola bovis (aid in control)

− Mange mites

. Chorioptes bovis (aid in control)

The drug has a persistent action and protects cattle for certain duration against infection or re-infection with the following parasites for the period indicated:

Species	Protection period (days)
Dictyocaulus viviparus	120
Ostertagia ostertagi	120
Haemonchus placei	90
Oesophagostomum radiatum	150
Trichostrongylus axei	90
Linognathus vituli	133

The veterinary medicinal product is effective against Hypoderma larvae at the time of treatment but its persistent activity against Hypoderma has not been evaluated.

If the veterinary medicinal product is given before the end of the fly season complimentary treatment with a product effective against Hypoderma may be required.

Persistent efficacy periods have not been established for parasite species other than those included in the above list. Therefore, re-infection of animals on pasture contaminated by parasites other than these remains possible before the end of the 90 day minimum persistency period demonstrated for specific species.

Do not use in animals less than 100 kg bodyweight or greater than 500 kg.

Do not inject the veterinary medicinal product by intravascular route. Intravascular injection may result in ataxia, paralysis, convulsions, collapse and death. To prevent any intravascular injection, carefully follow the administration procedure described in item “Administration routes and dosage” below.

Unnecessary use of antiparasitics or use deviating from the instructions given in the SPC may increase the resistance selection pressure and lead to reduced efficacy. The decision to use the product should be based on confirmation of the parasitic species and burden, or of the risk of infestation based on its epidemiological features, for each individual herd.

Care should be taken to avoid the following practices, because they increase the risk of development of resistance and could ultimately result in ineffective therapy:

Too frequent and repeated use of anthelmintics from the same class, over an extended period of time. Repeated use for an extended period, particularly when using the same class of substances, increases the risk of resistance development. Within a herd, maintenance of susceptible refugia is essential to reduce that risk. Systematically applied interval-based treatment and treatment of a whole herd should be avoided. Instead, if feasible, only selected individual animals or subgroups should be treated (targeted selective treatment). This should be combined with appropriate husbandry and pasture management measures. Guidance for each specific herd should be sought from the responsible veterinarian;

Underdosing which may due to underestimation of body weight, misadministration of the veterinary medicinal product, or lack of calibration of the dosing device (if any).

Suspected clinical cases of resistance to anthelmintics should be further investigated using appropriate tests (e.g. Faecal Egg Count Reduction Test). Where the results of the test(s) strongly suggest resistance to a particular anthelmintic, an anthelmintic belonging to another pharmacological class and having a different mode of action should be used.

Resistance to moxidectin has been reported in Cooperia spp. and Ostertagia spp. in cattle.

Psoroptes ovis is an extremely contagious external parasite of sheep and cattle. To ensure complete control, great care must be taken to avoid reinfestation, as mites may be viable for up to 15 days off the animal. It is important that all animals which have been in contact with infected ones are treated with an appropriate product. Contact between treated, infected and untreated herds must be avoided until at least seven days after treatment.

Resistance to moxidectin has been reported in Psoroptes ovis scab mites in sheep and in cattle. Cases of side-resistance with other macrocyclic lactones (ivermectin and doramectin) have been reported as well. The use of this product should take into account local information about susceptibility of the target parasites, where available.

To prevent a possible anaphylactic type reaction, do not inject the product intravenously.

In order to prevent abscesses, a strict aseptic technique is recommended.

The veterinary medicinal product has been formulated specifically for subcutaneous injection in dorsal surface of the ear of cattle and must not be given by any other route of administration or to any other species.

To avoid possible secondary reactions by the death of Hypoderma larvae in the spine or the oesophagus of animals, it is recommended to administer a product effective against Hypoderma larvae after the end of fly activity and before the larvae reach their resting sites. Consult your veterinary surgeon on the correct timing of this treatment.

Immunity to nematodes depends on adequate exposure to infection. Although not normally the case, circumstances could occur in which anthelmintic control measures might increase the vulnerability of cattle to re-infection. Animals may be at risk towards the end of their first grazing season, particularly if the season is long, or in the following year if they move onto heavily contaminated pasture. In such instances, further control measures may be necessary.

Avoid direct contact with skin and eyes.

Wash hands after use.

Do not smoke, drink or eat while handling the veterinary medicinal product.

Take care to avoid self-injection. Advice to Medical Practitioners in case of accidental self-injection: Treat symptomatically.

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.

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 cattle with the veterinary medicinal product, levels of moxidectin that are potentially toxic to dung fly species may be excreted over a period more than 4 weeks and may decrease dung fly abundance during that period. It has been established in laboratory tests that moxidectin may temporarily affect dung beetle reproduction; however, field studies indicate no long-term effects. Nevertheless, in case of repeated treatments with moxidectin (as with veterinary medicinal products of the same anthelmintic class) it is advisable not to treat animals every time on the same pasture to allow dung fauna populations to recover.

∙ Moxidectin is inherently toxic to aquatic organisms including fish. The veterinary medicinal product should be used only according to the label instructions. Based on the excretion profile of moxidectin when administered as the injectable formulation, treated animals should not have access to watercourses during the 10 days after treatment.

Cattle:

Rare (1 to 10 animals / 10,000 animals treated):	Injection site swelling1,2 Depression Ataxia
Very rare (<1 animal / 10,000 animals treated, including isolated reports):	Injection site abscess2 Hypersensitivity reaction3 Neurological disorder4 (such as collapse, convulsion, paralysis, blindness)

1immediate or delayed, may further develop into injection site abscesses, frequency tends to be higher in heavier animals

2generally disappear without treatment within 14 days after administration, may persist up to 5 weeks (<5% of cases) or longer (very rare occasions)

3 If such reaction occur, a symptomatic treatment should be applied.

4 Severe reactions may be fatal.

Reporting adverse events is important. It allows continuous safety monitoring of a veterinary medicinal product. Reports should be sent, preferably via a veterinarian, to either the marketing authorisation holder or its local representative or the national competent authority via the national reporting system. See also the package leaflet for respective contact details.

Can be used during pregnancy. However, note section "Contraindications".

The effects of GABA agonists are increased by moxidectin.

Subcutaneous use.

Dosage is 0.5 ml/50 kg bodyweight, equivalent to 1.0 mg moxidectin/kg bodyweight, given by a single subcutaneous injection in the ear using an 18 gauge, 25 – 40 mm hypodermic needle. The 50ml vial stoppers must not be broached more than 20 times. Use automatic syringe equipment for the 200 ml vial.

Shake well before use.

Underdosing could result in ineffective use and may favour resistance development. To ensure administration of a correct dosage, body weight should be determined as accurately as possible. If animals are to be treated collectively, reasonably homogeneous groups should be set up, and all animals of a group should be dosed at the rate corresponding to the heaviest one. Accuracy of the dosing device should be thoroughly checked.

The injection should be given subcutaneously in the loose tissues on the dorsal surface of the ear, just distal to the distal edge of the auricular cartilage.

The dorsal (outer) surface of the ear should first be cleansed with antiseptic and allowed to briefly air dry. Palpate the edge of of the auricular cartilage closest to the head, on the dorsal (hairy) surface of the ear. From this landmark, taking care to avoid blood vessels (artery,vein), the needle should be inserted subcutaneously starting at a point approximately 3 to 3.5 cm distal to this edge (away from the head), and directed towards the base of the ear, and the needle advanced to the hub. At this point, gently aspirate the syringe to confirm that the needle is not in a blood vessel.

Upon injection, the resulting depot should reside just distal to the edge of the auricular cartilage.

Following administration, the needle is withdrawn from the skin as pressure is applied for several seconds with the thumb at the point of insertion.

Due to the long-lasting protection against Dictyocaulus viviparus and the stomach worms, Ostertagia ostertagi and Haemonchus placei, a single treatment with the formulation at turn-out helps control parasitic bronchitis (lungworm) and parasitic gastro-enteritis throughout the grazing season by reducing the build-up of infective larvae on pasture associated with these parasites. For best results the injection should be given to each calf of target weight to be grazed together immediately prior to being turned out to pasture. Animals should be set stocked throughout the grazing season or moved to a pasture which has not been grazed by other cattle earlier in the season.

Diagram: Ear injection procedure

Reactions at the injection site have to be expected more frequently and severe depending on the injected volume. Systemic signs of overdoses are consistent with the mode of action of moxidectin. These signs are manifested as transient salivation, depression, drowsiness and ataxia 24 to 36 hours post-treatment. The systemic signs usually disappear within 36 to 72 hours without treatment. At doses >3 times the recommended dose divided on both ears, the systemic signs included recumbency, muscle tremor, ruminal tympany and dehydration, which were resolved after treatment with fluids. The systemic signs can last for a few days to ten days. There is no specific antidote.

Not applicable.

Meat and offal: 108 days.

Milk: Not authorised for use in animals producing milk for human consumption. Do not use in pregnant animals which are intended to produce milk for human consumption within 80 days of expected parturition.

The withdrawal period is based solely on a single injection at the ear site of injection.