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Diethylcarbamazine

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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 Edit this at Wikidata
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)

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]

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

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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.[citation needed]

In India and China, diethylcarbamazine has been added to salt to combat lymphatic filariasis.[12]

Contraindications

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Contraindications are previous history of heart problems, gastrointestinal problems, and allergies.[medical citation needed]

Diethylcarbamazine is contraindicated in patients who may have onchocerciasis, due to the risk of the Mazzotti reaction.[13]

Mechanism

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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

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Brand names

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Brand names include Hetrazan, Carbilazine, Caricide, Cypip, Ethodryl, Notézine, Spatonin, Filaribits, Banocide Forte, and Eofil.[citation needed]

Veterinary uses

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Diethylcarbamazine is used to prevent heartworm in dogs.[citation needed]

References

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  1. ^ a b c "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. ^ a b 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. ^ a b c "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. 7 (3). Oxford University Press: 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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