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Rafoxanide is a halogenated salicylanilide anthelmintic primarily used in veterinary medicine for the treatment and control of acute and chronic fascioliasis (liver fluke infestation) in cattle, sheep, and goats. It is effective against both mature and immature stages of Fasciola hepatica, Fasciola gigantica, and certain nematodes such as Haemonchus spp., Bunostomum spp., Trichuris spp., and Oesophagostomum spp. Mechanistically, rafoxanide acts by uncoupling oxidative phosphorylation in parasite mitochondria, leading to energy depletion and parasite death. Recent studies have shown rafoxanide inhibits B-Raf V600E kinase and displays anticancer properties in vitro and in vivo, including induction of apoptosis through mitochondrial and endoplasmic reticulum stress pathways, downregulation of the p38 MAPK pathway, and enhancement of DNA damage response. Rafoxanide also exhibits antibacterial and antifungal effects, potentially mediated by inhibition of histidine kinase enzymes in bacteria and fungi, and may synergize with antibiotics and antifungals to overcome drug resistance[1][2][3][5][6][7][9].
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