Routes ofadministration by mouth CAS ID 90-89-1 | CAS Number 90-89-1 Molar mass 199.293 g/mol | |
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AHFS/Drugs.com Micromedex Detailed Consumer Information ATC code P02CB02 (WHO) QP52AH02 (WHO) Legal status In general: ℞ (Prescription only) Synonyms N, N-diethyl-4-methyl-1-piperazine carboxamide | ||
Diethylcarbamazine (DEC) is a medication used in the treatment of filariasis including lymphatic filariasis, tropical pulmonary eosinophilia, and loiasis. It may also be used for prevention of loiasis in those at high risk. While it has been used for onchocerciasis (river blindness), invermectin is preferred. It is taken by mouth.
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Common side effects itching, facial swelling, headaches, and feeling tired. Other side effects include vision loss and dizziness. It is a recommended treatment in pregnancy and appears to be safe for the baby. The World Health Organization; however, recommends until after pregnancy for treatment. It is made from piperazine.
Diethylcarbamazine was discovered in 1947. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. The wholesale cost in the developing world is less than 0.01 USD per dose. It is not commercially available in the United States but can be gotten from the Center for Disease Control.
Medical uses
DEC is indicated for treatment of individual patients with certain filarial diseases. These diseases include: lymphatic filariasis caused by infection with Wuchereria bancrofti, Brugia malayi, or Brugia timori; tropical pulmonary eosinophilia, and loiasis.
In cases of onchocerciasis, another common filarial parasite, the drug is not used. This is because of the intense and unbearable itching associated with the dead subcutaneous parasites.
DEC continues to be the mainstay for treatment of patients with lymphatic filariasis and loiasis. DEC is also used to prevent heartworm in dogs.
Now WHO recommends prescribing DEC to patients who are infected with microfilariae of filarial parasite and also to control transmission of infection in filariasis endemic areas.
Contraindications are previous history of heart problems, gastrointestinal problems, and allergy.
Mechanism
DEC is an inhibitor of arachidonic acid metabolism in filarial microfilaria. This makes the microfilariae more susceptible to innate immune attack, but does not kill the parasites outright.