DIETHYLCARBAMAZINE

Antifilarial medicine

Dosage Forms

Tablet

50 mg

Uses

  • Systemic lymphatic filariasis and occult filariasis
  • Loiasis
  • Tissue nematode infections, in particular, visceral larva migrans

Dose and Duration

To be taken after meals
Lymphatic filariasis(bancroftian)
Adult and child over 10 years: 1 mg/kg twice daily on the first day and increased gradually over 3 days to 3 mg/kg every 12 hours (max 9 mg/kg daily in divided doses) for 12 days
Child under 10 years: 0.5 mg/kg twice daily on the first day and increased gradually over 3 days to 1.5 mg/kg 2 times a day for 12 days
Lymphatic filariasis (brugian)
Adult and child over 10 years: 1 mg/kg as a single dose on the first day, increased gradually over 3 days to 3–6 mg/kg daily, preferably in divided doses after meals, for 6–12 days
Child under 10 years: half the adult dose

For mass treatment control programmes

Adult and child over 10 years: 3–6 mg/kg in divided dos es over 24 hours, 6 times at weekly or monthly intervals
Child under 10 years: half the adult dose
Occult filariasis
Adult:8 mg/kg once daily for 14 days, repeated as necessary if symptoms return
Loiasis
Adult:1 mg/kg as a single dose on the first day, doubled on 2 successive days, then adjusted to 2–3 mg/kg 3 times daily for a further 18 days
Loiasis prophylaxis
Adult:300 mg weekly for as long as exposure occurs

Contraindications

  • Pregnancy
  • Co-infection with onchocerciasis

Side Effects

  • Headache, dizziness
  • Nausea, vomiting
  • Immunological reactions within a few hours of the first dose, resembling Mazzotti reaction (fever, headache, joint pain, dizziness, anorexia, malaise, transient haematuria, urticaria, vomiting, and asthma in asthmatics)
  • Nodules formed by recently killed worms
  • Transient lymphangitis
  • Exacerbation of lymphoedema

Patient Instructions

  • Take your medication after food
  • Complete the prescribed course as directed to minimise reactions of dying parasites

Pregnancy

  • Do not use

Breastfeeding

  • Can be used

⚠️ Caution

  • Reduce dose in moderate to severe renal impairment
  • Delay treatment in pregnancy until delivery
  • In case of other severe acute disease, delay diethylcarbamazine treatment until after recovery
  • Use with caution in cardiac disorders