medication
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to medical diagnosis, diagnose, cure, treat, or preventive medicine, prevent disease. Drug therapy (pharmacotherapy) is an imp ...
tropical pulmonary eosinophilia Tropical pulmonary eosinophilia (TPE, tropical eosinophilia, or Weingarten's syndrome), is characterized by cough, bronchospasm, wheezing, abdominal pain, and an enlarged spleen. Occurring most frequently in the Indian subcontinent and Southeast As ...
, and
loiasis
''Loa loa'' filariasis is a skin and eye disease caused by the nematode worm ''Loa loa''. Humans contract this disease through the bite of a deer fly or mango fly (''Chrysops'' spp.), the vectors for ''Loa loa''. The adult ''Loa loa'' filaria ...
. It may also be used for prevention of loiasis in those at high risk. While it has been used for onchocerciasis (river blindness), ivermectin is preferred. It is taken
by mouth
Oral administration is a route of administration where a substance is taken through the mouth. Per os abbreviated to P.O. is sometimes used as a direction for medication to be taken orally. Many medications are taken orally because they are in ...
.
Common side effects include 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 waiting until after pregnancy for treatment when feasible. It is made from 4-
methyl
In organic chemistry, a methyl group is an alkyl derived from methane, containing one carbon atom bonded to three hydrogen atoms, having chemical formula . In formulas, the group is often abbreviated as Me. This hydrocarbon group occurs in man ...
- piperazine.
Diethylcarbamazine was discovered in 1947 by
Yellapragada Subbarow
Yellapragada Subba Rao (12 January 1895 – 8 August 1948) was a pioneering Indian biochemist who discovered the function of adenosine triphosphate (ATP) as an energy source in the cell, developed methotrexate for the treatment of cancer a ...
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georg ...
.
Medical uses
Diethylcarbamazine is
indicated
In medicine, an indication is a valid reason to use a certain test, medication, procedure, or surgery. There can be multiple indications to use a procedure or medication. An indication can commonly be confused with the term diagnosis. A diagnosi ...
Brugia malayi
''Brugia malayi'' is a filarial (arthropod-borne) nematode (roundworm), one of the three causative agents of lymphatic filariasis in humans. Lymphatic filariasis, also known as elephantiasis, is a condition characterized by swelling of the lower l ...
'', or ''
Brugia timori
''Brugia timori'' is a filarial (arthropod-borne) nematode (roundworm) which causes the disease "Timor filariasis", or "Timorian filariasis". While this disease was first described in 1965, the identity of ''Brugia timori'' as the causative agen ...
'';
loiasis
''Loa loa'' filariasis is a skin and eye disease caused by the nematode worm ''Loa loa''. Humans contract this disease through the bite of a deer fly or mango fly (''Chrysops'' spp.), the vectors for ''Loa loa''. The adult ''Loa loa'' filaria ...
and tropical pulmonary eosinophilia.
The WHO recommends prescribing diethylcarbamazine to people who are infected with microfilariae of filarial parasites and also to control transmission of infection in filariasis-endemic areas.
In India and China, diethylcarbamazine has been added to salt to combat lymphatic filariasis.
Contraindications
Contraindications are previous history of heart problems, gastrointestinal problems, and allergies.
Diethylcarbamazine is contraindicated in patients who may have onchocerciasis, due to the risk of the
Mazzotti reaction
The Mazzotti reaction, first described in 1948, is a symptom complex seen in patients after undergoing treatment of nematode infestation, particularly with the medication diethylcarbamazine (DEC). Mazzotti reactions can be life-threatening, and ar ...
.
Mechanism
Diethylcarbamazine is an inhibitor of
arachidonic acid
Arachidonic acid (AA, sometimes ARA) is a polyunsaturated omega-6 fatty acid 20:4(ω-6), or 20:4(5,8,11,14). It is structurally related to the saturated arachidic acid found in cupuaçu butter. Its name derives from the New Latin word ''arachi ...
metabolism in
microfilariae
::''Microfilaria may also refer to an informal "collective group" genus name, proposed by Cobbold in 1882. While a convenient category for newly discovered microfilariae which can not be assigned to a known species because the adults are unknown, ...
. This makes the microfilariae more susceptible to innate immune attack, but does not kill the parasites outright.
Society and culture
Brand names
Brand names include Hetrazan, Carbilazine, Caricide, Cypip, Ethodryl, Notézine, Spatonin, Filaribits, Banocide Forte, and Eofil.
Veterinary uses
Diethylcarbamazine is used to prevent
heartworm
''Dirofilaria immitis'', also known as heartworm or dog heartworm, is a parasitic roundworm that is a type of filarial worm, a small thread-like worm, that causes dirofilariasis. It is spread from host to host through the bites of mosquitoes. ...