Indications
Diethylcarbamazine is indicated for Filariasis, Lymphatic filariasis, Pulmonary eosinophilia, Loiasis, Toxocariasis.
Pharmacology
The mechanism of action of diethylcarbamazine is thought to involve sensitizing the microfilariae to phagocytosis. One study showed that diethylcarbamazine's activity against Brugia malayi microfilariae is dependent on inducible nitric-oxide synthase and the cyclooxygenase pathway. It confirmed the important role of the arachidonic acid metabolic pathway in diethylcarbamazine's mechanism of action in vivo and showes that in addition to its effects on the 5-lipoxygenase pathway, it targets the cyclooxygenase pathway and COX-1.
Dosage And Administration
Inital: 1 mg/kg/day, may increase to 6 mg/kg/day over 3 days, then maintain for 3 wk. Prophylaxis of loiasis 300 mg/wk.
Interaction
There are no known drug interactions and none well documented.
Contraindications
Pregnancy, hypersensitivity; lactation; infants, elderly or debilitated patients; impaired renal function; cardiac disease.
Side Effects
Fever, headache, vomiting, dizziness, drowsiness, nausea, chills.
Potentially Fatal: Severe hypersensitivity reactions may occur especially in the treatment of onchocerciasis where rare Mazzotti reaction characterised by rash, itching, headache, muscle and joint pains, tachycardia, postural hypotension may start within 2 hr of drug administration. Encephalitis and retinal haemorrhage
Pregnancy And Lactation
Pregnancy Category- X. Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
Precautions And Warnings
Patients with poor health.
Lactation: not known if excreted in breast milk
Therapeutic Class
Other Anti-protozoals