Diethylcarbamazine

Diethylcarbamazine is a medication used in the treatment of filariasis including lymphatic filariasis, tropical pulmonary eosinophilia, and loiasis.[1] It may also be used for prevention of loiasis in those at high risk.[1] While it has been used for onchocerciasis (river blindness), ivermectin is preferred.[2] It is taken by mouth.[3]

Diethylcarbamazine
Clinical data
Other namesDEC, N, N-diethyl-4-methyl-1-piperazine carboxamide
AHFS/Drugs.comMicromedex Detailed Consumer Information
Routes of
administration		By mouth
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Identifiers
  • N,N-diethyl-4-methylpiperazine-1-carboxamide
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.001.840
Chemical and physical data
FormulaC10H21N3O
Molar mass199.298 g·mol−1
3D model (JSmol)
Melting point47 to 49 °C (117 to 120 °F)
  • C1CN(C)CCN1C(=O)N(CC)CC
  • InChI=1S/C10H21N3O/c1-4-12(5-2)10(14)13-8-6-11(3)7-9-13/h4-9H2,1-3H3 checkY
  • Key:RCKMWOKWVGPNJF-UHFFFAOYSA-N checkY
  (verify)

Common side effects include itching, facial swelling, headaches, and feeling tired.[3] Other side effects include vision loss and dizziness.[3] It is a recommended treatment in pregnancy and appears to be safe for the baby.[4][5] The World Health Organization; however, recommends waiting until after pregnancy for treatment when feasible.[2] It is made from 4-methyl-piperazine.[6]

Diethylcarbamazine was discovered in 1947[7] by Yellapragada Subbarow.[8][9] It is on the World Health Organization's List of Essential Medicines.[10] It is not commercially available in the United States but can be acquired from the Centers for Disease Control and Prevention.[1]

Medical uses

Diethylcarbamazine is indicated for the treatment of people with certain filarial diseases, including lymphatic filariasis caused by infection with Wuchereria bancrofti, Brugia malayi, or Brugia timori; loiasis and tropical pulmonary eosinophilia.[11]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.[12]

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.[13]

Mechanism

Diethylcarbamazine is an inhibitor of arachidonic acid metabolism in microfilariae. This makes the microfilariae more susceptible to innate immune attack, but does not kill the parasites outright.[14]

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 in dogs.

References
  1. "Our Formulary Infectious Diseases Laboratories CDC". www.cdc.gov. 22 September 2016. Archived from the original on 16 December 2016. Retrieved 7 December 2016.
  2. World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 91. hdl:10665/44053. ISBN 9789241547659.
  3. "Diethylcarbamazine Advanced Patient Information - Drugs.com". www.drugs.com. Archived from the original on 20 December 2016. Retrieved 8 December 2016.
  4. Sweet RL, Gibbs RS (2009). Infectious Diseases of the Female Genital Tract. Lippincott Williams & Wilkins. p. 382. ISBN 9780781778152. Archived from the original on 2017-09-10.
  5. Herbert-Ashton M, Clarkson NE (2005). Quick Look Nursing: Pharmacology. Jones & Bartlett Learning. p. 48. ISBN 9780763735951. Archived from the original on 2017-09-10.
  6. "WHO Model Prescribing Information: Drugs Used in Parasitic Diseases - Second Edition: Helminths: Lymphatic filariasis: Diethylcarbamazine". apps.who.int. 1995. p. 152. Archived from the original on 20 November 2016. Retrieved 8 December 2016.
  7. Busvine J (2012). Disease Transmission by Insects: Its Discovery and 90 Years of Effort to Prevent it. Springer Science & Business Media. p. 260. ISBN 9783642457166. Archived from the original on 2017-09-10.
  8. Hewitt R, Wallace W (June 1948). "The treatment of ascariasis in dogs with 1-diethylcarbamyl-4-methylpiperazine hydrochloride". The Journal of Parasitology. 34 (3): 237–239. doi:10.2307/3273270. JSTOR 3273270. PMID 18867399. S2CID 43592055.
  9. Kamath P, Shenoy KA (2013). "Yellapragada Subba Rao: The Unsung Hero". Muller Journal of Medical Sciences and Research. 4 (2): 130–132. doi:10.4103/0975-9727.118248. S2CID 72843672.
  10. World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  11. Ottesen EA (1985). "Efficacy of diethylcarbamazine in eradicating infection with lymphatic-dwelling filariae in humans". Reviews of Infectious Diseases. Oxford University Press. 7 (3): 341–356. doi:10.1093/clinids/7.3.341. JSTOR 4453627. PMID 3895352.
  12. Lammie P, Milner T, Houston R (July 2007). "Unfulfilled potential: using diethylcarbamazine-fortified salt to eliminate lymphatic filariasis". Bulletin of the World Health Organization. 85 (7): 545–549. doi:10.2471/blt.06.034108. PMC 2636360. PMID 17768503.
  13. "Lymphatic Filariasis - Resources for Health Professionals - Guidance for Evaluation and Treatment". U.S. Centers for Disease Control and Prevention (CDC). 2020-10-26. Retrieved 2022-05-06.
  14. El-Shahawi GA, Abdel-Latif M, Saad AH, Bahgat M (December 2010). "Setaria equina: in vivo effect of diethylcarbamazine citrate on microfilariae in albino rats". Experimental Parasitology. 126 (4): 603–610. doi:10.1016/j.exppara.2010.06.022. PMID 20599991.
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