Last reviewed 2026-04-22 · How we verify

Moxonidine (Physiotens)

Moxonidine is a selective imidazoline-1 receptor agonist that reduces sympathetic nervous system activity to lower blood pressure.

Moxonidine is a selective imidazoline I1-receptor agonist that reduces sympathetic nervous system activity to lower blood pressure. Used for Essential hypertension, Hypertension in patients with metabolic syndrome.

At a glance

Mechanism of action

Moxonidine acts as a central-acting antihypertensive by selectively stimulating imidazoline-1 (I1) receptors in the rostral ventrolateral medulla of the brainstem. This activation suppresses sympathetic outflow, leading to decreased peripheral vascular resistance and reduced blood pressure. It has greater selectivity for I1 receptors compared to older alpha-2 agonists, potentially resulting in fewer central nervous system side effects.

Approved indications

• Essential hypertension
• Hypertension in patients with metabolic syndrome or diabetes

Common side effects

• Dry mouth
• Dizziness
• Headache
• Fatigue
• Sedation

Key clinical trials

• Autonomic Determinants of POTS - Pilot1 (EARLY_PHASE1)
• Autonomic Determinants of POTS - Pilot 2 (EARLY_PHASE1)
• Sympathetic Mechanisms in Obesity-Crossover Design (PHASE1, PHASE2)
• Sympathetic Mechanisms in the Cardiovascular and Metabolic Alterations of Obesity (PHASE1)
• Sympathetic Nervous System Inhibition for the Treatment of Diabetic Kidney Disease (PHASE4)
• Sympathoinhibition as a Preferred Second Line Treatment of Obesity Related Hypertension (PHASE4)
• Role of Sympathetic Activation in Ischemia Reperfusion Injury (PHASE4)
• Moxonidine Effects on Neuropeptide Y (PHASE4)

Primary sources

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