Diethyl Carbamazine
Mechanism :
Diethylcarbamazine is an anthelmintic drug that does not resemble other antiparasitic compounds. It is a synthetic organic compound which is highly specific for several parasites and does not contain any toxic metallic elements. The most important action of DEC appears to be alteration of organelle membranes of the Mf promoting cell death. DEC is indicated for treatment of individual patients with certain filarial diseases.
Indication :
- Filariasis
- Loiasis
- Tropical pulmonary eosinophilia
Contraindications :
Known hypersensitivity to diethylcarbamazine or its components is a contraindication for its use. Severe allergic reactions have been reported. Encephalitis has occurred in loiasis patients and eye changes in onchocerciasis patients. Dose reduction may be required in impaired renal function.
Dosing :
Day 1:
1 mg/kg orally after meal.
Day 2:
1 mg/kg orally thrice daily.
Day 3:
1-2 mg/kg orally thrice daily.
Day 4-14:
6 mg/kg/day orally in three divided doses in filariasis and 9 mg/kg/day orally in three divided doses in Loa Loa.
Adverse Effect :
Headache, weakness, malaise, nausea, vomiting, skin rash, allergic phenomenon, facial edema, pruritus, enlargement of lymph nodes, bronchospasm and fall in BP, leukocytosis and mild albuminuria.
Interaction :
Corticosteroids: Concurrent use may reduce the antifilarial activity
Urinary alkalinizers: reduces urinary elimination
urinary acidifiers : can increase elimination
Hepatic Dose :
Use with caution in hepatic impairment and consider dose reduction as it is metabolized primarily in the liver.