DIETHYLCARBAMAZINE = DEC oral

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    Last updated: November 2023

     

    Prescription under medical supervision

     

     
    Due to the numerous and potentially severe adverse effects of DEC, patients should be kept under close surveillance.

     

    Therapeutic action

    • Anthelminthic (antifilarial)

    Indications

    • Lymphatic filariasis

    Forms and strengths

    • 100 mg breakable tablet

    Dosage

    • Child under 10 years: 0.5 mg/kg on D1, then increase the dose gradually over 3 days to 1 mg/kg 3 times daily
    • Child over 10 years and adult: 1 mg/kg on D1, then increase the dose gradually over 3 days to 2 mg/kg 3 times daily

    Duration

    • W. bancrofti: 12 days 
    • B. malayi, B. timori: 6 to 12 days

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with onchocerciasis or heavy Loa loa microfilareamia; to infants, older patients and patients with heart or renal diseases.
    • Do not administer during acute attacks (risk of severe reactions).
    • Administer with caution in patients with history of seizures.
    • May cause:
      • nausea, vomiting, headache, dizziness, drowsiness, fever, joint pain, urticaria, transient haematuria, subcutaneous nodules, lymphangitis, localized oedema;
      • in patients with associated onchocerciasis: severe ocular damages (optic nerve lesions, retinal lesions);
      • in patients with associated loiasis: encephalitis (potentially fatal) if Loa loa microfilaraemia is high.
    • Reduce dosage in patients with renal impairment.
    • Pregnancy: CONTRA-INDICATED (treatment may be deferred until after delivery)
    • Breast-feeding: not recommended

    Remarks

    • In countries with a national programme for the elimination of bancroftian filariasis, the combination diethylcarbamazine + albendazole is administered as a single annual dose for 4 to 6 years. This regimen is only suitable for countries that are free from Onchocerca volvulus and/or Loa loa.

    Storage

     
    –  Between 15 °C and 25 °C 
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