DIETHYLCARBAMAZINE = DEC oral

• 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