Diethylcarbamazine

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Diethylcarbamazine
Diethylcarbamazine.svg
Clinical data
AHFS/Drugs.com Micromedex Detailed Consumer Information
Routes of
administration
by mouth
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Identifiers
Synonyms N, N-diethyl-4-methyl-1-piperazine carboxamide
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
ECHA InfoCard 100.001.840
Chemical and physical data
Formula C10H21N3O
Molar mass 199.293 g/mol
3D model (Jmol)
  (verify)

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.[1] While it has been used for onchocerciasis (river blindness), invermectin is preferred.[2] It is taken by mouth.[3]

Common side effects itching, facial swelling, headaches, and feeling tired. Other side effects include vision loss and dizziness.[4] It is a recommended treatment in pregnancy and appears to be safe for the baby.[5][6] The World Health Organization; however, recommends until after pregnancy for treatment.[2] It is made from piperazine.[7]

Diethylcarbamazine was discovered in 1947.[8] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[9] The wholesale cost in the developing world is less than 0.01 USD per dose.[3] It is not commercially available in the United States but can be gotten from the Center for Disease Control.[1]

Medical uses[edit]

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.[medical citation needed]

Mechanism[edit]

DEC is an inhibitor of arachidonic acid metabolism in microfilaria. This makes the microfilariae more susceptible to innate immune attack, but does not kill the parasites outright.[10]

Trade names[edit]

  • Hetrazan
  • Carbilazine
  • Caricide
  • Cypip
  • Ethodryl
  • Notézine
  • Spatonin
  • Filaribits
  • Banocide Forte
  • Eofil

References[edit]

  1. ^ a b "Our Formulary Infectious Diseases Laboratories CDC". www.cdc.gov. 22 September 2016. Retrieved 7 December 2016. 
  2. ^ a b WHO Model Formulary 2008 (PDF). World Health Organization. 2009. p. 91. ISBN 9789241547659. 
  3. ^ a b "Diethylcarbamazine Citrate". International Drug Price Indicator Guide. Retrieved 1 December 2016. 
  4. ^ "Diethylcarbamazine Advanced Patient Information - Drugs.com". www.drugs.com. Retrieved 8 December 2016. 
  5. ^ Sweet, Richard L.; Gibbs, Ronald S. (2009). Infectious Diseases of the Female Genital Tract. Lippincott Williams & Wilkins. p. 382. ISBN 9780781778152. 
  6. ^ Herbert-Ashton, Marilyn; Clarkson, Nancy Elaine (2005). Quick Look Nursing: Pharmacology. Jones & Bartlett Learning. p. 48. ISBN 9780763735951. 
  7. ^ "WHO Model Prescribing Information: Drugs Used in Parasitic Diseases - Second Edition: Helminths: Lymphatic filariasis: Diethylcarbamazine". apps.who.int. 1995. p. 152. Retrieved 8 December 2016. 
  8. ^ Busvine, James (2012). Disease Transmission by Insects: Its Discovery and 90 Years of Effort to Prevent it. Springer Science & Business Media. p. 260. ISBN 9783642457166. 
  9. ^ "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Retrieved 8 December 2016. 
  10. ^ El-Shahawi, G. A.; Abdel-Latif, M; Saad, A. H.; Bahgat, M (2010). "Setaria equina: In vivo effect of diethylcarbamazine citrate on microfilariae in albino rats". Experimental Parasitology. 126 (4): 603–10. PMID 20599991. doi:10.1016/j.exppara.2010.06.022.