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Avermectin - Wikipedia

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</div> </a> <ul id="toc-Dosing-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mechanism_of_action" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Mechanism_of_action"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Mechanism of action</span> </div> </a> <ul id="toc-Mechanism_of_action-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Toxicity_and_side_effects" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Toxicity_and_side_effects"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Toxicity and side effects</span> </div> </a> <ul id="toc-Toxicity_and_side_effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Avermectin_biosynthesis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Avermectin_biosynthesis"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Avermectin biosynthesis</span> </div> </a> <ul id="toc-Avermectin_biosynthesis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_uses" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Other_uses"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Other uses</span> </div> </a> <ul id="toc-Other_uses-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span 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Available in 18 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-18" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">18 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A3%D9%81%D9%8A%D8%B1%D9%85%D9%8A%D9%83%D8%AA%D9%86" title="أفيرميكتن – Arabic" lang="ar" hreflang="ar" data-title="أفيرميكتن" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Avermectina" title="Avermectina – Catalan" lang="ca" hreflang="ca" data-title="Avermectina" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Avermectin" title="Avermectin – Danish" lang="da" hreflang="da" data-title="Avermectin" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Avermectine" title="Avermectine – German" lang="de" hreflang="de" data-title="Avermectine" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Avermectina" title="Avermectina – Spanish" lang="es" hreflang="es" data-title="Avermectina" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Avermectina" title="Avermectina – Basque" lang="eu" hreflang="eu" data-title="Avermectina" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A7%D9%88%D8%B1%D9%85%DA%A9%D8%AA%DB%8C%D9%86" title="اورمکتین – Persian" lang="fa" hreflang="fa" data-title="اورمکتین" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Avermectine" title="Avermectine – French" lang="fr" hreflang="fr" data-title="Avermectine" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Avermectina" title="Avermectina – Galician" lang="gl" hreflang="gl" data-title="Avermectina" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%95%84%EB%B2%84%EB%A9%95%ED%8B%B4" title="아버멕틴 – Korean" lang="ko" hreflang="ko" data-title="아버멕틴" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%82%A2%E3%83%99%E3%83%AB%E3%83%A1%E3%82%AF%E3%83%81%E3%83%B3" title="アベルメクチン – Japanese" lang="ja" hreflang="ja" data-title="アベルメクチン" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Avermectina" title="Avermectina – Portuguese" lang="pt" hreflang="pt" data-title="Avermectina" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Avermectin%C4%83" title="Avermectină – Romanian" lang="ro" hreflang="ro" data-title="Avermectină" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%90%D0%B2%D0%B5%D1%80%D0%BC%D0%B5%D0%BA%D1%82%D0%B8%D0%BD%D1%8B" title="Авермектины – Russian" lang="ru" hreflang="ru" data-title="Авермектины" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Avermectin" title="Avermectin – Swedish" lang="sv" hreflang="sv" data-title="Avermectin" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%90%D0%B2%D0%B5%D1%80%D0%BC%D0%B5%D0%BA%D1%82%D0%B8%D0%BD" title="Авермектин – Ukrainian" lang="uk" hreflang="uk" data-title="Авермектин" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a 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#36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Missing_information plainlinks metadata ambox ambox-content" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><a href="/wiki/File:Wiki_letter_w.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/en/thumb/6/6c/Wiki_letter_w.svg/44px-Wiki_letter_w.svg.png" decoding="async" width="44" height="44" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/6/6c/Wiki_letter_w.svg/66px-Wiki_letter_w.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/6/6c/Wiki_letter_w.svg/88px-Wiki_letter_w.svg.png 2x" data-file-width="44" data-file-height="44" /></a></span></div></td><td class="mbox-text"><div class="mbox-text-span">This article <b>is missing information</b> about what the chemical structures of A1, A2, B1, B2 each are. The Abamectin pic can be reused, just need one more R group according to YoongKim04.<span class="hide-when-compact"> Please expand the article to include this information. Further details may exist on the <a href="/wiki/Talk:Avermectin" title="Talk:Avermectin">talk page</a>.</span> <span class="date-container"><i>(<span class="date">September 2023</span>)</i></span></div></td></tr></tbody></table> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Avermectins_skeletal.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3f/Avermectins_skeletal.svg/300px-Avermectins_skeletal.svg.png" decoding="async" width="300" height="163" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3f/Avermectins_skeletal.svg/450px-Avermectins_skeletal.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/3f/Avermectins_skeletal.svg/600px-Avermectins_skeletal.svg.png 2x" data-file-width="1360" data-file-height="740" /></a><figcaption>Skeletal structure of the 8 different natural avermectins<sup id="cite_ref-YoonKim2004_1-0" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup></figcaption></figure> <p>The <b>avermectins</b> are a series of <a href="/wiki/Drug" title="Drug">drugs</a> and <a href="/wiki/Pesticide" title="Pesticide">pesticides</a> used to treat parasitic worm infestations and to reduce insect <a href="/wiki/Pest_(organism)" title="Pest (organism)">pests</a>. They are a group of 16-membered macrocyclic <a href="/wiki/Lactone" title="Lactone">lactone</a> derivatives with potent <a href="/wiki/Anthelmintic" title="Anthelmintic">anthelmintic</a> and <a href="/wiki/Insecticide" title="Insecticide">insecticidal</a> properties.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Pitterna_3-0" class="reference"><a href="#cite_note-Pitterna-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> These naturally occurring compounds are generated as fermentation products by <i><a href="/wiki/Streptomyces_avermitilis" title="Streptomyces avermitilis">Streptomyces avermitilis</a></i>, a soil <a href="/wiki/Actinomycete" class="mw-redirect" title="Actinomycete">actinomycete</a>. Eight different avermectins were isolated in four pairs of homologue compounds (A1, A2, B1, B2), with a major (a-component) and minor (b-component) component usually in ratios of 80:20 to 90:10.<sup id="cite_ref-Pitterna_3-1" class="reference"><a href="#cite_note-Pitterna-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> Avermectin B1, a mixture of B1a and B1b, is the drug and pesticide <a href="/wiki/Abamectin" title="Abamectin">abamectin</a>. Other anthelmintics derived from the avermectins include <a href="/wiki/Ivermectin" title="Ivermectin">ivermectin</a>, <a href="/wiki/Selamectin" title="Selamectin">selamectin</a>, <a href="/wiki/Doramectin" title="Doramectin">doramectin</a>, <a href="/wiki/Eprinomectin" title="Eprinomectin">eprinomectin</a>. </p><p>Half of the 2015 <a href="/wiki/Nobel_Prize_in_Physiology_or_Medicine" title="Nobel Prize in Physiology or Medicine">Nobel Prize in Physiology or Medicine</a> was awarded to <a href="/wiki/William_C._Campbell_(scientist)" title="William C. Campbell (scientist)">William C. Campbell</a> and <a href="/wiki/Satoshi_%C5%8Cmura" title="Satoshi Ōmura">Satoshi Ōmura</a> for discovering avermectin,<sup id="cite_ref-Nobel_4-0" class="reference"><a href="#cite_note-Nobel-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> "the derivatives of which have radically lowered the incidence of <a href="/wiki/Onchocerciasis" title="Onchocerciasis">river blindness</a> and <a href="/wiki/Lymphatic_filariasis" title="Lymphatic filariasis">lymphatic filariasis</a>, as well as showing efficacy against an expanding number of other parasitic diseases." </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Avermectin&amp;action=edit&amp;section=1" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 1978, an actinomycete was isolated at the <a href="/wiki/Kitasato_Institute" class="mw-redirect" title="Kitasato Institute">Kitasato Institute</a> from a soil sample collected at Kawana, <a href="/wiki/It%C5%8D,_Shizuoka" title="Itō, Shizuoka">Ito City</a>, Shizuoka Prefecture, Japan. Later that year, the isolated actinomycete was sent to <a href="/wiki/Merck_Sharp_and_Dohme" class="mw-redirect" title="Merck Sharp and Dohme">Merck Sharp and Dohme</a> Research Laboratories for testing. Various carefully controlled broths were fermented using the isolated actinomycete. Early tests indicated that some of the whole, fermented broths were active against <i><a href="/wiki/Nematospiroides_dubius" class="mw-redirect" title="Nematospiroides dubius">Nematospiroides dubius</a></i> in mice over at least an eight-fold range without notable toxicity. Subsequent to this, the anthelmintic activity was isolated and identified as a family of closely related compounds. The compounds were finally characterized and the novel species that produced them were described by a team at Merck in 1978, and named <i>Streptomyces avermitilis</i> (with the adjective probably intended to mean that it kills worms).<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> </p><p>In 2002, Yoko Takahashi and others at the Kitasato Institute for Life Sciences, Kitasato University, and at the Kitasato Institute, proposed that <i>Streptomyces avermitilis</i> be renamed <i>Streptomyces avermectinius</i>.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Dosing">Dosing</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Avermectin&amp;action=edit&amp;section=2" title="Edit section: Dosing"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A commonly used therapy in recent times has been based on oral, <a href="/wiki/Parenteral" class="mw-redirect" title="Parenteral">parenteral</a>, topical, or spot topical (as in veterinary flea repellant "drops") administration of avermectins. They show activity against a broad range of <a href="/wiki/Nematode" title="Nematode">nematodes</a> and <a href="/wiki/Arthropod" title="Arthropod">arthropod</a> parasites of domestic animals at dose rates of 300&#160;μg/kg or less (200&#160;μg/kg ivermectin appearing to be the common interspecies standard, from humans to horses to house pets, unless otherwise indicated).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2020)">citation needed</span></a></i>&#93;</sup> Unlike the <a href="/wiki/Macrolide" title="Macrolide">macrolide</a> or <a href="/wiki/Polyene" title="Polyene">polyene</a> antibiotics, they lack significant antibacterial or antifungal activities.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Mechanism_of_action">Mechanism of action</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Avermectin&amp;action=edit&amp;section=3" title="Edit section: Mechanism of action"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The avermectins block the transmission of electrical activity in invertebrate nerve and muscle cells mostly by enhancing the effects of <a href="/wiki/Glutamate" class="mw-redirect" title="Glutamate">glutamate</a> at the <a href="/wiki/Glutamate-gated_chloride_channel" class="mw-redirect" title="Glutamate-gated chloride channel">glutamate-gated chloride channel</a> that is specific to <a href="/wiki/Protostome" title="Protostome">protostome</a> invertebrates,<sup id="cite_ref-Wolstenholme-2012_8-0" class="reference"><a href="#cite_note-Wolstenholme-2012-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> with minor effects on <a href="/wiki/Gamma-aminobutyric_acid" class="mw-redirect" title="Gamma-aminobutyric acid">gamma-aminobutyric acid</a> receptors.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> This causes an influx of chloride ions into the cells, leading to hyperpolarisation and subsequent paralysis of invertebrate neuromuscular systems; comparable doses are not toxic for mammals because they do not possess <a href="/wiki/Protostome" title="Protostome">protostome-specific</a> glutamate-gated chloride channels.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">&#91;</span>12<span class="cite-bracket">&#93;</span></a></sup><sup class="noprint Inline-Template" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Accuracy_dispute#Disputed_statement" title="Wikipedia:Accuracy dispute"><span title="Turtles are also not protostomes, but they appear affected (see the ivermectin article ref). So are border collies with the MDR1 mutation. The role of the blood-brain barrier in selectivity should be mentioned. (November 2023)">dubious</span></a>&#32;&#8211; <a href="/wiki/Talk:Avermectin#Dubious" title="Talk:Avermectin">discuss</a></i>&#93;</sup><sup id="cite_ref-Wolstenholme-2012_8-1" class="reference"><a href="#cite_note-Wolstenholme-2012-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Toxicity_and_side_effects">Toxicity and side effects</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Avermectin&amp;action=edit&amp;section=4" title="Edit section: Toxicity and side effects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Anthelmintic_resistance" class="mw-redirect" title="Anthelmintic resistance">Resistance to avermectins</a> has been reported, which suggests moderation in use.<sup id="cite_ref-Clark-et-al-1995_13-0" class="reference"><a href="#cite_note-Clark-et-al-1995-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> Resistance in <i><a href="/wiki/Caenorhabditis_elegans" title="Caenorhabditis elegans">Caenorhabditis elegans</a></i> has been observed by the most obvious route – variation of the <a href="/wiki/Glutamate-gated_chloride_channel" class="mw-redirect" title="Glutamate-gated chloride channel">glutamate-gated chloride channel</a>.<sup id="cite_ref-Ghosh-et-al-2012_14-0" class="reference"><a href="#cite_note-Ghosh-et-al-2012-14"><span class="cite-bracket">&#91;</span>14<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Horoszok-et-al-2001_15-0" class="reference"><a href="#cite_note-Horoszok-et-al-2001-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> Research on <a href="/wiki/Ivermectin" title="Ivermectin">ivermectin</a>, <a href="/wiki/Piperazine" title="Piperazine">piperazine</a>, and <a href="/wiki/Dichlorvos" title="Dichlorvos">dichlorvos</a> in combinations also shows potential for toxicity.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> Avermectin has been reported to block LPS-induced secretion of <a href="/wiki/Tumor_necrosis_factors" class="mw-redirect" title="Tumor necrosis factors">tumor necrosis factor</a>, <a href="/wiki/Nitric_oxide" title="Nitric oxide">nitric oxide</a>, <a href="/wiki/Prostaglandin" title="Prostaglandin">prostaglandin</a> E2, and increase of intracellular concentration of Ca<sup>2+</sup>.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Adverse effects are usually transient; severe effects are rare and probably occur only with substantial overdose, but include <a href="/wiki/Coma" title="Coma">coma</a>, <a href="/wiki/Hypotension" title="Hypotension">hypotension</a>, and <a href="/wiki/Respiratory_failure" title="Respiratory failure">respiratory failure</a>, which can lead to death. No specific therapy exists, but symptomatic management usually leads to a favorable prognosis.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">&#91;</span>18<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Avermectin_biosynthesis">Avermectin biosynthesis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Avermectin&amp;action=edit&amp;section=5" title="Edit section: Avermectin biosynthesis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Avermectin_Biosynthesis_Pathway.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/96/Avermectin_Biosynthesis_Pathway.png/220px-Avermectin_Biosynthesis_Pathway.png" decoding="async" width="220" height="136" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/96/Avermectin_Biosynthesis_Pathway.png/330px-Avermectin_Biosynthesis_Pathway.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/96/Avermectin_Biosynthesis_Pathway.png/440px-Avermectin_Biosynthesis_Pathway.png 2x" data-file-width="11042" data-file-height="6840" /></a><figcaption>Diagram showing the schematic synthesis of avermectins</figcaption></figure> <p>The gene cluster for biosynthesis of avermectin from <i><a href="/wiki/Streptomyces_avermitilis" title="Streptomyces avermitilis">S. avermitilis</a></i> has been sequenced.<sup id="cite_ref-&#80;MID10449723_20-0" class="reference"><a href="#cite_note-PMID10449723-20"><span class="cite-bracket">&#91;</span>20<span class="cite-bracket">&#93;</span></a></sup> The avermectin <a href="/wiki/Biosynthesis_gene_cluster" class="mw-redirect" title="Biosynthesis gene cluster">biosynthesis gene cluster</a> encodes enzymes responsible for four steps of avermectin production: 1) production of the avermectin <a href="/wiki/Aglycon" class="mw-redirect" title="Aglycon">aglycon</a> by <a href="/wiki/Polyketide_synthases" class="mw-redirect" title="Polyketide synthases">polyketide synthases</a>, 2) modification of the aglycon, 3) synthesis of modified sugars, and 4) glycosylation of the modified avermectin aglycon. This gene cluster can produce eight avermectins which have minor structural differences.<sup id="cite_ref-YoonKim2004_1-1" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> </p> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Avermectin_PKS.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d8/Avermectin_PKS.png/220px-Avermectin_PKS.png" decoding="async" width="220" height="63" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d8/Avermectin_PKS.png/330px-Avermectin_PKS.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d8/Avermectin_PKS.png/440px-Avermectin_PKS.png 2x" data-file-width="22374" data-file-height="6359" /></a><figcaption>Organization of the avermectin polyketide synthase</figcaption></figure> <p>The avermectin initial aglycon is synthesized by the <a href="/wiki/Polyketide_synthase" title="Polyketide synthase">polyketide synthase</a> activity of four proteins (AVES 1, AVES 2, AVES 3, and AVES 4). The activity of this enzyme complex is similar to type I polyketide synthases.<sup id="cite_ref-YoonKim2004_1-2" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> Either 2-methylbutyryl CoA or isobutyryl CoA can be used as starting units and are extended by seven acetate units and five propionate units to produce avermectin “a” series or “b” series, respectively.<sup id="cite_ref-YoonKim2004_1-3" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> The initial aglycon is subsequently released from the thioesterase domain of AVES 4 by formation of an intramolecular <a href="/wiki/Lactone" title="Lactone">cyclic ester</a>.<sup id="cite_ref-YoonKim2004_1-4" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> </p><p>The avermectin initial aglycon is further modified by other enzymes in the avermectin biosynthetic gene cluster. AveE has cytochrome P450 monooxygenase activity and facilitates the furan ring formation between C6 and C8.<sup id="cite_ref-YoonKim2004_1-5" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> AveF has NAD(P)H-dependent ketoreductase activity which reduces the C5 keto group to a hydroxyl.<sup id="cite_ref-YoonKim2004_1-6" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> AveC influences the dehydratase activity in module two (affecting C22-C23), although the mechanism by which it does this is not clear.<sup id="cite_ref-&#80;MID10449723_20-1" class="reference"><a href="#cite_note-PMID10449723-20"><span class="cite-bracket">&#91;</span>20<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-YoonKim2004_1-7" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> AveD has SAM-dependent C5 O-methyltransferase activity.<sup id="cite_ref-YoonKim2004_1-8" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> Whether AveC or AveD acts on the aglycon determines whether the resulting avermectin aglycon will produce avermectin, series “A” or “B” and series 1 or 2 (see synthesis schematic diagram table), respectively.<sup id="cite_ref-YoonKim2004_1-9" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> </p><p>Nine open reading frames (orf1 and aveBI-BVIII) are downstream of aveA4, which are known involved with glycosylation and sugar synthesis.<sup id="cite_ref-YoonKim2004_1-10" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> AveBII-BVIII are responsible for synthesis of dTDP-L-<a href="/wiki/Oleandrose" title="Oleandrose">oleandrose</a> and AveBI is responsible for glycosylation of the avermectin aglycon with the dTDP-sugar.<sup id="cite_ref-YoonKim2004_1-11" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> The sequence of orf1 suggests that its product will have reductase activity, but this functionality does not appear to be necessary for avermectin synthesis.<sup id="cite_ref-YoonKim2004_1-12" class="reference"><a href="#cite_note-YoonKim2004-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Other_uses">Other uses</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Avermectin&amp;action=edit&amp;section=6" title="Edit section: Other uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Abamectin" title="Abamectin">Abamectin</a> is the active ingredient in some commercial ant bait traps. Ivermectin, formulated from Avermectin, has a wide variety of uses in human beings. According to a paper (Ivermectin: “Wonder Drug” from Japan: the human use perspective) written by the drugs co-creator Satoshi Ōmura and Andy Crump for The Japan Academy, Ivermectin has improved the lives of billions of people worldwide and not solely for uses as an anti parasitic.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">&#91;</span>21<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Avermectin&amp;action=edit&amp;section=7" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Milbemycin" title="Milbemycin">Milbemycins</a> are a chemically closely related group of parasiticides.</li> <li>Avermectin/ivermectin <a href="/wiki/Glycorandomization" title="Glycorandomization">glycorandomization</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Avermectin&amp;action=edit&amp;section=8" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-columns references-column-width reflist-columns-2"> <ol class="references"> <li id="cite_note-YoonKim2004-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-YoonKim2004_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-YoonKim2004_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-YoonKim2004_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-YoonKim2004_1-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-YoonKim2004_1-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-YoonKim2004_1-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-YoonKim2004_1-6"><sup><i><b>g</b></i></sup></a> <a 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a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output 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"Acute Human Toxicity of Macrocyclic Lactones". <i>Current Pharmaceutical Biotechnology</i>. <b>13</b> (6): 999–1003. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.2174%2F138920112800399059">10.2174/138920112800399059</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22039794">22039794</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Current+Pharmaceutical+Biotechnology&amp;rft.atitle=Acute+Human+Toxicity+of+Macrocyclic+Lactones&amp;rft.volume=13&amp;rft.issue=6&amp;rft.pages=999-1003&amp;rft.date=2012&amp;rft_id=info%3Adoi%2F10.2174%2F138920112800399059&amp;rft_id=info%3Apmid%2F22039794&amp;rft.aulast=Yang&amp;rft.aufirst=Chen-Chang&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAvermectin" class="Z3988"></span></span> </li> <li id="cite_note-19"><span class="mw-cite-backlink"><b><a href="#cite_ref-19">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPeter" class="citation news cs1">Peter, John. <a rel="nofollow" class="external text" href="https://www.firstmedinc.com">"Ivermectin"</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.atitle=Ivermectin&amp;rft.aulast=Peter&amp;rft.aufirst=John&amp;rft_id=https%3A%2F%2Fwww.firstmedinc.com&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAvermectin" class="Z3988"></span></span> </li> <li id="cite_note-&#80;MID10449723-20"><span class="mw-cite-backlink">^ <a href="#cite_ref-PMID10449723_20-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-PMID10449723_20-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFIkedaNonomiyaUsamiOhta1999" class="citation journal cs1">Ikeda, H.; Nonomiya, T.; Usami, M.; Ohta, T.; Omura, S. (1999). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC22239">"Organization of the biosynthetic gene cluster for the polyketide anthelmintic macrolide avermectin in Streptomyces avermitilis"</a>. <i>Proceedings of the National Academy of Sciences</i>. <b>96</b> (17): 9509–9514. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/1999PNAS...96.9509I">1999PNAS...96.9509I</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1073%2Fpnas.96.17.9509">10.1073/pnas.96.17.9509</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC22239">22239</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10449723">10449723</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Proceedings+of+the+National+Academy+of+Sciences&amp;rft.atitle=Organization+of+the+biosynthetic+gene+cluster+for+the+polyketide+anthelmintic+macrolide+avermectin+in+Streptomyces+avermitilis&amp;rft.volume=96&amp;rft.issue=17&amp;rft.pages=9509-9514&amp;rft.date=1999&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC22239%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F10449723&amp;rft_id=info%3Adoi%2F10.1073%2Fpnas.96.17.9509&amp;rft_id=info%3Abibcode%2F1999PNAS...96.9509I&amp;rft.aulast=Ikeda&amp;rft.aufirst=H.&amp;rft.au=Nonomiya%2C+T.&amp;rft.au=Usami%2C+M.&amp;rft.au=Ohta%2C+T.&amp;rft.au=Omura%2C+S.&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC22239&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAvermectin" class="Z3988"></span></span> </li> <li id="cite_note-21"><span class="mw-cite-backlink"><b><a href="#cite_ref-21">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCrumpŌmura2011" class="citation journal cs1">Crump, Andy; Ōmura, Satoshi (2011). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043740">"Ivermectin, 'wonder drug' from Japan: the human use perspective"</a>. <i>Proceedings of the Japan Academy. Series B, Physical and Biological Sciences</i>. <b>87</b> (2): 13–28. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2011PJAB...87...13C">2011PJAB...87...13C</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.2183%2Fpjab.87.13">10.2183/pjab.87.13</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043740">3043740</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21321478">21321478</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Proceedings+of+the+Japan+Academy.+Series+B%2C+Physical+and+Biological+Sciences&amp;rft.atitle=Ivermectin%2C+%27wonder+drug%27+from+Japan%3A+the+human+use+perspective.&amp;rft.volume=87&amp;rft.issue=2&amp;rft.pages=13-28&amp;rft.date=2011&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3043740%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F21321478&amp;rft_id=info%3Adoi%2F10.2183%2Fpjab.87.13&amp;rft_id=info%3Abibcode%2F2011PJAB...87...13C&amp;rft.aulast=Crump&amp;rft.aufirst=Andy&amp;rft.au=%C5%8Cmura%2C+Satoshi&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3043740&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAvermectin" class="Z3988"></span></span> </li> </ol></div> <div class="navbox-styles"><style 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title="Antiparasitic">Antiparasitics</a>&#160;– <a href="/wiki/Anthelmintic" title="Anthelmintic">Anthelmintics</a> (<a href="/wiki/ATC_code_P02" title="ATC code P02">P02</a>) and <a href="/wiki/Endectocides" class="mw-redirect" title="Endectocides">endectocides</a> (<a href="/wiki/ATCvet_code_QP54" title="ATCvet code QP54">QP54</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Antiplatyhelmintic_agent" title="Antiplatyhelmintic agent">Antiplatyhelmintic agents</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Trematoda" title="Trematoda">Antitrematodals</a><br />(<a href="/wiki/Schistosomicide" class="mw-redirect" title="Schistosomicide">schistosomicides</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Binds <a href="/wiki/Tubulin" title="Tubulin">tubulin</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Benzimidazole" title="Benzimidazole">benzimidazole</a></i> <ul><li><a href="/wiki/Triclabendazole" title="Triclabendazole">Triclabendazole</a><sup>#</sup></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Acetylcholinesterase_inhibitor" title="Acetylcholinesterase inhibitor">AChE inhibitor</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Phosphonic_acid" class="mw-redirect" title="Phosphonic acid">phosphonic acid</a></i> <ul><li><a href="/wiki/Metrifonate" title="Metrifonate">Metrifonate</a><sup>‡</sup></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other/unknown</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Quinoline" title="Quinoline">quinoline</a></i> <ul><li><a href="/wiki/Arpraziquantel" title="Arpraziquantel">Arpraziquantel</a></li> <li><a href="/wiki/Praziquantel" title="Praziquantel">Praziquantel</a><sup>#</sup> (<a href="/wiki/Esafoxolaner/eprinomectin/praziquantel" title="Esafoxolaner/eprinomectin/praziquantel">+esafoxolaner/eprinomectin</a>)</li> <li><a href="/wiki/Oxamniquine" title="Oxamniquine">Oxamniquine</a><sup>#</sup></li></ul></li> <li><i><a href="/wiki/Phenol" title="Phenol">phenol</a></i> <ul><li><a href="/wiki/Bithionol" title="Bithionol">Bithionol</a></li></ul></li> <li><i><a href="/wiki/Thiazole" title="Thiazole">thiazole</a></i> <ul><li><a href="/wiki/Niridazole" title="Niridazole">Niridazole</a></li></ul></li> <li><i><a href="/wiki/Thioxanthone" title="Thioxanthone">thioxanthone</a></i> <ul><li><a href="/wiki/Hycanthone" title="Hycanthone">Hycanthone</a></li> <li><a href="/wiki/Lucanthone" title="Lucanthone">Lucanthone</a></li></ul></li> <li><i><a href="/wiki/Antimony" title="Antimony">antimony</a> compounds</i> <ul><li><a href="/wiki/Stibophen" title="Stibophen">Stibophen</a></li> <li><a href="/wiki/Tartar_emetic" class="mw-redirect" title="Tartar emetic">Tartar emetic</a><sup>‡</sup></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anticestodal_agent" title="Anticestodal agent">Anticestodals</a><br />(<a href="/wiki/Taeniacide" title="Taeniacide">taeniacides</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Binds <a href="/wiki/Tubulin" title="Tubulin">tubulin</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Benzimidazole" title="Benzimidazole">benzimidazole</a></i> <ul><li><a href="/wiki/Albendazole" title="Albendazole">Albendazole</a><sup>#</sup></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other/unknown</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Quinoline" title="Quinoline">quinoline</a></i> <ul><li><a href="/wiki/Praziquantel" title="Praziquantel">Praziquantel</a><sup>#</sup> (<a href="/wiki/Esafoxolaner/eprinomectin/praziquantel" title="Esafoxolaner/eprinomectin/praziquantel">+esafoxolaner/eprinomectin</a>)</li></ul></li> <li><i><a href="/wiki/Salicylanilide" title="Salicylanilide">salicylanilide</a></i> <ul><li><a href="/wiki/Niclosamide" title="Niclosamide">Niclosamide</a><sup>#</sup></li></ul></li> <li><i><a href="/wiki/9-Aminoacridine" title="9-Aminoacridine">aminoacridine</a></i> <ul><li><a href="/wiki/Quinacrine" class="mw-redirect" title="Quinacrine">Quinacrine</a></li></ul></li> <li><i><a href="/wiki/Butyrophenone" title="Butyrophenone">butyrophenone</a></i> <ul><li><a href="/wiki/Desaspidin" title="Desaspidin">Desaspidin</a></li></ul></li> <li><i><a href="/wiki/Chlorophenol" title="Chlorophenol">chlorophenol</a></i> <ul><li><a href="/wiki/Dichlorophen" title="Dichlorophen">Dichlorophen</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Antinematodal_agent" class="mw-redirect" title="Antinematodal agent">Antinematodal agents</a><br />(including<br /><a href="/wiki/Macrofilaricide" class="mw-redirect" title="Macrofilaricide">macrofilaricides</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Binds <a href="/wiki/Tubulin" title="Tubulin">tubulin</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Benzimidazole" title="Benzimidazole">benzimidazole</a></i> <ul><li><a href="/wiki/Mebendazole" title="Mebendazole">Mebendazole</a><sup>#</sup></li> <li><a href="/wiki/Albendazole" title="Albendazole">Albendazole</a><sup>#</sup></li> <li><a href="/wiki/Tiabendazole" title="Tiabendazole">Tiabendazole</a></li> <li><a href="/wiki/Fenbendazole" title="Fenbendazole">Fenbendazole</a></li> <li><a href="/wiki/Ciclobendazole" title="Ciclobendazole">Ciclobendazole</a></li> <li><a href="/wiki/Flubendazole" title="Flubendazole">Flubendazole</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Glutamate-gated_chloride_channel" class="mw-redirect" title="Glutamate-gated chloride channel">Glutamate-gated chloride channel</a>, <a href="/wiki/GABA_receptor" title="GABA receptor">GABA receptor</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a class="mw-selflink selflink">avermectins</a></i> <ul><li><a href="/wiki/Abamectin" title="Abamectin">Abamectin</a></li> <li><a href="/wiki/Doramectin" title="Doramectin">Doramectin</a></li> <li><a href="/wiki/Emamectin" title="Emamectin">Emamectin</a></li> <li><a href="/wiki/Eprinomectin" title="Eprinomectin">Eprinomectin</a> (<a href="/wiki/Esafoxolaner/eprinomectin/praziquantel" title="Esafoxolaner/eprinomectin/praziquantel">+esafoxolaner/praziquantel</a>)</li> <li><a href="/wiki/Ivermectin" title="Ivermectin">Ivermectin</a><sup>#</sup></li> <li><a href="/wiki/Selamectin" title="Selamectin">Selamectin</a></li></ul></li> <li><i><a href="/wiki/Milbemycin" title="Milbemycin">milbemycins</a></i> <ul><li><a href="/wiki/Moxidectin" title="Moxidectin">Moxidectin</a> (<a href="/wiki/Fluralaner/moxidectin" class="mw-redirect" title="Fluralaner/moxidectin">+fluralaner</a>)</li> <li><a href="/wiki/Milbemycin_oxime" title="Milbemycin oxime">Milbemycin oxime</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Neuromuscular_depolarizing_agent" class="mw-redirect" title="Neuromuscular depolarizing agent">NMDA</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Tetrahydropyrimidine" class="mw-redirect" title="Tetrahydropyrimidine">tetrahydropyrimidine</a></i> <ul><li><a href="/wiki/Pyrantel" title="Pyrantel">Pyrantel</a><sup>#</sup> <ul><li><a href="/wiki/Pyrantel_pamoate" class="mw-redirect" title="Pyrantel pamoate">pyrantel pamoate</a></li></ul></li> <li><a href="/wiki/Oxantel" title="Oxantel">Oxantel</a></li> <li><a href="/wiki/Morantel" title="Morantel">Morantel</a></li> <li><a href="/w/index.php?title=Carbantel&amp;action=edit&amp;redlink=1" class="new" title="Carbantel (page does not exist)">Carbantel</a></li> <li><a href="/w/index.php?title=Febantel&amp;action=edit&amp;redlink=1" class="new" title="Febantel (page does not exist)">Febantel</a> (aka <a href="/w/index.php?title=Felsantel&amp;action=edit&amp;redlink=1" class="new" title="Felsantel (page does not exist)">felsantel</a>)</li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other/unknown</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i>piperazine</i> <ul><li><a href="/wiki/Piperazine" title="Piperazine">Piperazine</a></li> <li><a href="/wiki/Diethylcarbamazine" title="Diethylcarbamazine">Diethylcarbamazine</a><sup>#</sup></li></ul></li> <li><i><a href="/wiki/Thiazole" title="Thiazole">thiazole</a></i> <ul><li><a href="/wiki/Levamisole" title="Levamisole">Levamisole</a><sup>#</sup></li></ul></li> <li><i><a href="/wiki/Quinolinium" class="mw-redirect" title="Quinolinium">quinolinium</a></i> <ul><li><a href="/wiki/Pyrvinium" title="Pyrvinium">Pyrvinium</a></li></ul></li> <li><i><a href="/wiki/Benzylammonium" class="mw-redirect" title="Benzylammonium">benzylammonium</a></i> <ul><li><a href="/wiki/Bephenium_hydroxynaphthoate" title="Bephenium hydroxynaphthoate">Bephenium</a></li></ul></li> <li><i><a href="/wiki/Naphthalenesulfonate" title="Naphthalenesulfonate">naphthalenesulfonate</a></i> <ul><li><a href="/wiki/Suramin" title="Suramin">Suramin</a><sup>#</sup></li></ul></li> <li><a href="/wiki/Ascaridole" title="Ascaridole">Ascaridole</a><sup>‡</sup></li> <li><a href="/wiki/Hexylresorcinol" class="mw-redirect" title="Hexylresorcinol">Hexylresorcinol</a></li> <li><a href="/wiki/Santonin" title="Santonin">Santonin</a><sup>‡</sup></li> <li><a href="/wiki/Tribendimidine" title="Tribendimidine">Tribendimidine</a></li> <li><a href="/wiki/Tetrachloroethylene" title="Tetrachloroethylene">Tetrachloroethylene</a><sup>‡</sup></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="background: transparent; padding: 0px;"><div><div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table></div> <!-- NewPP limit report Parsed by mw‐web.codfw.main‐f69cdc8f6‐44cqd Cached time: 20241122142120 Cache expiry: 2592000 Reduced expiry: false Complications: [vary‐revision‐sha1, show‐toc] CPU time usage: 0.559 seconds Real time usage: 0.687 seconds Preprocessor visited node count: 2231/1000000 Post‐expand include size: 97345/2097152 bytes Template argument size: 2956/2097152 bytes Highest expansion depth: 12/100 Expensive parser function count: 4/500 Unstrip recursion depth: 1/20 Unstrip post‐expand size: 99006/5000000 bytes Lua time usage: 0.331/10.000 seconds Lua memory usage: 6168313/52428800 bytes Number of Wikibase entities loaded: 0/400 --> <!-- Transclusion expansion time report (%,ms,calls,template) 100.00% 596.811 1 -total 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