8 ways to cure scabies 

with the Healthy Skin Program

Moxidectin for curing scabies

Clinical testing of moxidectin for curing scabies

Conclusions of the preclinical trial

Why moxidectin works better

Cautions

Take with food or fasting?

What is the “right” dose of moxidectin?

How to measure moxidectin with the included syringe

Measuring small doses

Miscellaneous Info

Clinical testing of moxidectin for curing scabies

In 2016 there was a preclinical study on treating scabies. Pigs were chosen for test subjects “To provide proof of concept, we utilized an experimental scabies pig model that closely resembles the human route of scabies infection.” It has been tested in humans and “is registered worldwide as a veterinary anti-parasitic agent for use in companion and farm animals.” So please be aware moxidectin has not been approved for use in humans to treat scabies.

Both moxidectin and ivermectin have been approved by the FDA in humans but only for treating a disease called river blindness. When used to treat scabies, it is called an “off label” treatment. Moxidectin is now in clinical trials for treating that same disease. “Results of recent phase II, and III human clinical trials demonstrated that MOX [moxidectin] is likely more effective than IVM [ivermectin] at controlling onchocerciasis [river blindness], and has the potential to advance efforts to eliminate this disease. “  So it is possible one fine day moxidectin will be available for prescription use for scabies.

Conclusions of the preclinical trial

A single dose of moxidectin cures scabies better than two doses of ivermectin (a week apart).

Moxidectin stays in the body 9 times longer than ivermectin.

“Our data demonstrate that oral single-dose MOX [moxidectin] was more effective than two consecutive IVM-doses [ivermectin], supporting MOX as potential therapeutic approach for scabies.”

Why moxidectin works better

Look at the graph I made (below) and you can see why the moxidectin is more effective.

The red line shows that 5 days after taking ivermectin almost all of the ivermectin is gone from the body. That’s why one takes ivermectin once or twice a week for several weeks.

But look at the blue line. It shows that the moxidectin takes months to exit the body.

A scabies mite has a life cycle of around 14 days. That means after an egg hatches it crawls to the skin’s surface, and then hangs on with pincers for 10 to 14 days to mature. Then it mates, burrows under your skin and starts laying new eggs.  The adult mites can live for around 1 or 2 months.

So even though repeated weekly doses of ivermectin can kill scabies mites, moxidectin persists for the entire life cycle of the mites and beyond. Neither ivermectin nor moxidectin kill scabies eggs. But because moxidectin hangs around longer it is more effective in killing the mites after they hatch.

Cautions

Be aware moxidectin and ivermectin have been approved by the FDA in humans but only for treating a disease called river blindness. In other words, I am NOT telling anyone to take this. Do your own research, and make up your own mind what you are going to do or not do. 

Because moxidectin stays in the body a long time it means one dose of moxidectin is enough to treat scabies. With ivermectin one takes one or two doses a week, but not with moxidectin!

Taking multiple doses of moxidectin means it will build up in one’s body. This will lead to “adverse effects” (AEs)…or what you and I call “side effects”. With higher doses there was “a slightly higher incidence of transient, mild, and moderate central nervous system AEs as the dose increased…”

Here’s an example. If a person took some moxidectin today, a month from now there would still be 50% of the moxidectin in their body. If they took another full dose that day, they would have 150% of the recommended dose in their body. That’s too much!

If they took a half a dose a month after the first dose, then there would be 100% of the recommended dose in their body. But there is no need to take a second dose. One dose is enough. 

Combine the oral moxidectin with a topical (skin surface) treatment and it’s a one-two punch to really knock out scabies.

DO NOT take both ivermectin and moxidectin at the same time. After taking taking ivermectin it takes about a week for it to exit the body, then one could use moxidectin. But if you have taken moxidectin, DO NOT take ivermectin for about three months.

Take with food or when fasting?

It doesn’t matter. It turned out there was no difference in how much total moxidectin was concentrated in one’s body regardless of whether one took it with food or not. So relax. You can even mix it with a little applesauce or strawberry jam to make it more palatable.

What is the “right” dose of moxidectin?

Not a lot of testing for dosing has been done with humans. Lots of testing with mice, rats, sheep, cattle, dogs, pigs and horses. One report says, “Moxidectin is well established in veterinary practice to treat a range of parasites, including sarcoptic mange. This provides a solid foundation for considering its potential translation to human scabies. Some studies show excellent efficacy as a single 0.2 mg/kg dose, with 100% cure at day 14 in cattle…”

In a clinical study humans were given doses of moxidectin from 3 mg to 36 mg, up to ~0.6 mg/kg. They found moxidectin “was generally safe and well tolerated”.  Side effects increased as the dose was raised, so there is no sense in going crazy and using a higher dose.

So it appears, with a real minimum of information, that a human effective dose would be between 0.15 and 0.6 mg per kg or approximately 0.1 to 0.3 mg per pound. That is within the dosing range tested in the clinical trial.

Above: You turn the ring to measure a dose of moxidectin. The numbers indicate body weight. 

Each lower tick mark is for 50 lbs. of body weight

How to measure moxidectin with the included syringe

1. Hold the tube with the capped end pointing to the left and so that you can see the weight measurements and tick marks (small black lines). Each weight number is for 250 lbs of body weight…obviously for large bodies such as horses! 

Turn the plunger and below you’ll see tick marks. Each one is for to 50 lb of body weight (at 0.4 mg/ kg or approximately 0.2 mg/lb). 

2. Turn the dial ring until the left side of the ring lines up with the weight of the animal.

3. Press the plunger to squirt the gel out into an animal’s mouth (or onto a spoon).

Measuring small doses

A syringe of 2% moxidectin contains enough to treat an 1150 pound horse. It has a measuring device built into the syringe’s plunger (see my video on how to measure a dose — COMING SOON). The Quest dispensing system is intended for large animals and can make it hard to measure out small amounts for a smaller dose. 

The simplest way to measure a small dose is to measure out a DOUBLE dose using the numbers on the syringe’s plunger and then squirt that amount onto a plate.  For instance, for a 125 pound dose, set the ring at the 250 mark.

Then divide that into two piles using a credit card or razor blade. Use one pile as a dose and throw away the other pile. 

TIP: To make it easier to see what I’m doing I just add some applesauce, strawberry jam or some other food to make a bigger pile which is easier to divide in two.

Another method is to squirt the paste into a disposable 3cc (3ml)  syringe and then use the syringe’s markings to measure a dose. Each gram or ml of paste is a dose for 101 lbs, so it’s approximately 0.1 ml per 10 pounds of body weight. For example, for 130 lbs, the dose would be 1.3 ml.. For 250 lbs, the dose would be 2.5 ml. If you have a sensitive enough scale, you could weigh a dose, but not many folks have that sort of a scale, and disposable syringes with blunt tips can be very cheap.

Miscellaneous Info

In the Quest Gel (moxidectin) instructions it says it is 2% moxidectin. 

It also says the measurements on the plunger “enables the administration of the recommended dose level of 0.4 mg moxidectin/kg body weight…”.

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