medication
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field and re ...
used in the treatment of
filariasis
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.
These ...
including
lymphatic filariasis
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. While most cases have no symptoms, some people develop a syndrome ...
,
tropical pulmonary eosinophilia Tropical pulmonary eosinophilia (TPE, tropical eosinophilia, or Weingarten's syndrome), is characterized by cough, bronchospasm, Wheeze, wheezing, abdominal pain, and an splenomegaly, enlarged spleen. Occurring most frequently in the Indian subconti ...
, and
loiasis
''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 (''Chrysops'' spp.), the vectors for ''Loa loa''. The adult ''Loa loa'' filarial ...
. It may also be used for prevention of loiasis in those at high risk. While it has been used for
onchocerciasis
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 blindne ...
(river blindness),
ivermectin
Ivermectin (, '' EYE-vər-MEK-tin'') is an antiparasitic drug. After its discovery in 1975, its first uses were in veterinary medicine to prevent and treat heartworm and acariasis. Approved for human use in 1987, today it is used to treat i ...
is preferred. It is taken
by mouth
Oral administration is a route of administration where a substance is taken through the mouth. Per os abbreviated to P.O. is sometimes used as a direction for medication to be taken orally. Many medications are taken orally because they are i ...
.
Common side effects include itching, facial swelling, headaches, and feeling tired. Other side effects include
vision loss
Visual impairment, also known as vision impairment, is a medical definition primarily measured based on an individual's better eye visual acuity; in the absence of treatment such as correctable eyewear, assistive devices, and medical treatment†...
and
dizziness
Dizziness is an imprecise term that can refer to a sense of disorientation in space, vertigo, or lightheadedness. It can also refer to disequilibrium or a non-specific feeling, such as giddiness or foolishness.
Dizziness is a common medical c ...
. It is a recommended treatment in
pregnancy
Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins.
Pregnancy usually occurs by sexual intercourse, but ca ...
and appears to be safe for the baby. The
World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
; however, recommends waiting until after pregnancy for treatment when feasible. It is made from 4-
methyl
In organic chemistry, a methyl group is an alkyl derived from methane, containing one carbon atom bonded to three hydrogen atoms, having chemical formula . In formulas, the group is often abbreviated as Me. This hydrocarbon group occurs in many ...
-
piperazine
Piperazine () is an organic compound that consists of a six-membered ring containing two nitrogen atoms at opposite positions in the ring. Piperazine exists as small alkaline deliquescent crystals with a saline taste.
The piperazines are a broad ...
.
Diethylcarbamazine was discovered in 1947 by
Yellapragada Subbarow
Yellapragada Subba Rao (12 January 1895 – 8 August 1948) was a pioneering Indian biochemist who discovered the function of adenosine triphosphate (ATP) as an energy source in the cell, developed methotrexate for the treatment of cancer ...
. It is on the
World Health Organization's List of Essential Medicines
The WHO Model List of Essential Medicines (aka Essential Medicines List or EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health ...
. It is not commercially available in the United States but can be acquired from the
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
.
Medical uses
Diethylcarbamazine is
indicated
In medicine, an indication is a valid reason to use a certain test, medication, procedure, or surgery. There can be multiple indications to use a procedure or medication. An indication can commonly be confused with the term diagnosis. A diagnosis ...
for the treatment of people with certain
filaria
''Filaria'' is a genus of nematodes belonging to the family Filariidae.
The genus has cosmopolitan distribution.
Species:
*'' Filaria acutiuscula''
*'' Filaria bufonis''
*'' Filaria loliginis''
*'' Filaria martis''
*'' Filaria piscium'' ...
l
disease
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
s, including
lymphatic filariasis
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. While most cases have no symptoms, some people develop a syndrome ...
caused by
infection
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
with ''
Wuchereria bancrofti
''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 lymphat ...
'', ''
Brugia malayi
''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 l ...
loiasis
''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 (''Chrysops'' spp.), the vectors for ''Loa loa''. The adult ''Loa loa'' filarial ...
and tropical pulmonary eosinophilia.
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.
In India and China, diethylcarbamazine has been added to salt to combat lymphatic filariasis.
Contraindications
Contraindications are previous history of heart problems, gastrointestinal problems, and allergies.
Diethylcarbamazine is contraindicated in patients who may have onchocerciasis, due to the risk of the Mazzotti reaction.
Mechanism
Diethylcarbamazine is an inhibitor of arachidonic acid metabolism in
microfilariae
::''Microfilaria may also refer to an informal "collective group" genus name, proposed by Cobbold in 1882. While a convenient category for newly discovered microfilariae which can not be assigned to a known species because the adults are unknown, ...
. This makes the microfilariae more susceptible to innate immune attack, but does not kill the parasites outright.
heartworm
''Dirofilaria immitis'', also known as heartworm or dog heartworm, is a parasitic roundworm that is a type of filarial worm, a small thread-like worm, that causes dirofilariasis. It is spread from host to host through the bites of mosquitoe ...