Diethylcarbamazine

Last updated
Diethylcarbamazine
Diethylcarbamazine.svg
Clinical data
Other namesDEC, N, N-diethyl-4-methyl-1-piperazine carboxamide
AHFS/Drugs.com Micromedex 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 InfoCard 100.001.840 OOjs UI icon edit-ltr-progressive.svg
Chemical and physical data
Formula C10H21N3O
Molar mass 199.298 g·mol−1
3D model (JSmol)
Melting point 47 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 Yes check.svgY
  • Key:RCKMWOKWVGPNJF-UHFFFAOYSA-N Yes check.svgY
   (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]

Contents

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.[ citation needed ]

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.[ medical citation needed ]

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.[ citation needed ]

Veterinary uses

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

Related Research Articles

<i>Loa loa</i> filariasis Medical condition

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, the vectors for Loa loa. The adult Loa loa filarial worm migrates throughout the subcutaneous tissues of humans, occasionally crossing into subconjunctival tissues of the eye where it can be easily observed. Loa loa does not normally affect one's vision but can be painful when moving about the eyeball or across the bridge of the nose. The disease can cause red itchy swellings below the skin called "Calabar swellings". The disease is treated with the drug diethylcarbamazine (DEC), and when appropriate, surgical methods may be employed to remove adult worms from the conjunctiva. Loiasis belongs to the so-called neglected diseases.

<i>Loa loa</i> Species of roundworm

Loa loa is a filarial (arthropod-borne) nematode (roundworm) that causes Loa loa filariasis. Loa loa actually means "worm worm", but is commonly known as the "eye worm", as it localizes to the conjunctiva of the eye. Loa loa is commonly found in Africa. It mainly inhabits rain forests in West Africa and has native origins in Ethiopia. The disease caused by Loa loa is called loiasis and is one of the neglected tropical diseases.

<span class="mw-page-title-main">Onchocerciasis</span> Human helminthiasis (infection by parasite)

Onchocerciasis, also known as river blindness, is a disease caused by infection with the parasitic worm Onchocerca volvulus. Symptoms include severe itching, bumps under the skin, and blindness. It is the second-most common cause of blindness due to infection, after trachoma.

<span class="mw-page-title-main">Filariasis</span> Parasitic disease caused by a family of nematode worms

Filariasis is a parasitic disease caused by an infection with roundworms of the Filarioidea type. These are spread by blood-feeding insects such as black flies and mosquitoes. They belong to the group of diseases called helminthiases.

<i>Wuchereria bancrofti</i> Species of parasitic worm

Wuchereria bancrofti is a filarial (arthropod-borne) nematode (roundworm) that is the major cause of lymphatic filariasis. It is one of the three parasitic worms, together with Brugia malayi and B. timori, that infect the lymphatic system to cause lymphatic filariasis. These filarial worms are spread by a variety of mosquito vector species. W. bancrofti is the most prevalent of the three and affects over 120 million people, primarily in Central Africa and the Nile delta, South and Central America, the tropical regions of Asia including southern China, and the Pacific islands. If left untreated, the infection can develop into lymphatic filariasis. In rare conditions, it also causes tropical pulmonary eosinophilia. No vaccine is commercially available, but high rates of cure have been achieved with various antifilarial regimens, and lymphatic filariasis is the target of the World Health Organization Global Program to Eliminate Lymphatic Filariasis with the aim to eradicate the disease as a public-health problem by 2020. However, this goal was not met by 2020.

<i>Brugia malayi</i> Medical condition

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 limbs. The two other filarial causes of lymphatic filariasis are Wuchereria bancrofti and Brugia timori, which both differ from B. malayi morphologically, symptomatically, and in geographical extent.

Acanthocheilonemiasis is a rare tropical infectious disease caused by a parasite known as Acanthocheilonema perstans. It can cause skin rashes, abdominal and chest pains, muscle and joint pains, neurological disorders and skin lumps. It is mainly found in Africa. The parasite is transmitted through the bite of small flies. Studies show that there are elevated levels of white blood cells.

<span class="mw-page-title-main">Lymphatic filariasis</span> Medical condition

Lymphatic filariasis is a human disease caused by parasitic worms known as filarial worms. Usually acquired in childhood, it is a leading cause of permanent disability worldwide, impacting over a hundred million people and manifesting itself in a variety of severe clinical pathologies While most cases have no symptoms, some people develop a syndrome called elephantiasis, which is marked by severe swelling in the arms, legs, breasts, or genitals. The skin may become thicker as well, and the condition may become painful. Affected people are often unable to work and are often shunned or rejected by others because of their disfigurement and disability.

<i>Mansonella perstans</i> Species of roundworm

Mansonella perstans is a filarial (arthropod-borne) nematode (roundworm), transmitted by tiny blood-sucking flies called midges. Mansonella perstans is one of two filarial nematodes that causes serous cavity filariasis in humans. The other filarial nematode is Mansonella ozzardi. M. perstans is widespread in many parts of sub-Saharan Africa, parts of Central and South America, and the Caribbean.

Mansonelliasis is the condition of infection by the nematode Mansonella. The disease exists in Africa and tropical Americas, spread by biting midges or blackflies. It is usually asymptomatic.

<span class="mw-page-title-main">Eradication of infectious diseases</span> Elimination of a disease from all hosts

The eradication of infectious diseases is the reduction of the prevalence of an infectious disease in the global host population to zero.

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 agent was not known until 1977. In that same year, Anopheles barbirostris was shown to be its primary vector. There is no known animal reservoir host.

<span class="mw-page-title-main">Filarioidea</span> Superfamily of roundworms

The Filarioidea are a superfamily of highly specialised parasitic nematodes. Species within this superfamily are known as filarial worms or filariae. Infections with parasitic filarial worms cause disease conditions generically known as filariasis. Drugs against these worms are known as filaricides.

Mansonella streptocerca,, is a filarial (arthropod-borne) nematode (roundworm) causing the disease streptocerciasis. It is a common parasite in the skin of humans in the rain forests of Africa, where it is thought to be a parasite of chimpanzees, as well.

Tropical pulmonary eosinophilia, is characterized by cough, bronchospasm, wheezing, abdominal pain, and an enlarged spleen. Occurring most frequently in the Indian subcontinent and Southeast Asia, TPE is a clinical manifestation of lymphatic filariasis, a parasitic infection caused by filarial roundworms that inhabit the lymphatic vessels, lymph nodes, spleen, and bloodstream. Three species of filarial roundworms, all from the Onchocercidae family, cause human lymphatic filariasis: Wuchereria bancrofti, Brugia malayi, and Brugia timori.

The London Declaration on Neglected Tropical Diseases was a collaborative disease eradication programme launched on 30 January 2012 in London. It was inspired by the World Health Organization roadmap to eradicate or prevent transmission for neglected tropical diseases by the year 2020. Officials from WHO, the World Bank, the Bill & Melinda Gates Foundation, the world's 13 leading pharmaceutical companies, and government representatives from US, UK, United Arab Emirates, Bangladesh, Brazil, Mozambique and Tanzania participated in a joint meeting at the Royal College of Physicians to launch this project. The meeting was spearheaded by Margaret Chan, Director-General of WHO, and Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation.

<i>Brugia</i> Genus of roundworms

Brugia is a genus for a group of small roundworms. They are among roundworms that cause the parasitic disease filariasis. Specifically, of the three species known, Brugia malayi and Brugia timori cause lymphatic filariasis in humans; and Brugia pahangi and Brugia patei infect domestic cats, dogs and other animals. They are transmitted by the bite of mosquitos.

The eradication of lymphatic filariasis is the ongoing attempt to eradicate the Filarioidea worms which cause the disease lymphatic filariasis and also treat the people who already have the infection.

Lymphatic filariasis in India refers to the presence of the disease lymphatic filariasis in India and the social response to the disease. In India, 99% of infections come from a type of mosquito spreading a type of worm through a mosquito bite. The treatment plan provides 400 million people in India with medication to eliminate the parasite. About 50 million people in India were carrying the worm as of the early 2010s, which is 40% of all the cases in the world. In collaboration with other countries around the world, India is participating in a global effort to eradicate lymphatic filariasis. If the worm is eliminated from India then the disease could be permanently eradicated. In October 2019 the Union health minister Harsh Vardhan said that India's current plan is on schedule to eradicate filariasis by 2021.

<span class="mw-page-title-main">Ikechukwu Dozie</span> Nigerian academician

Professor Ikechukwu Nosike Simplicius Dozie is a professor of Microbiology, a public health scientist, teacher and community health specialist currently serving at the Department of Public Health, Federal University of Technology Owerri, Nigeria. He is a member of American Society of Tropical Medicine & Hygiene (ASTMH). Dozie was a consultant to the World Health Organization’s African programme for Onchocerciasis. He is the Director, Linkages and Advancement, Federal University of Technology Owerri.

References

  1. 1 2 3 "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. 1 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. 1 2 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.