Diethylcarbamazine

Diethylcarbamazine (DEC) is a medication used in the treatment of filariasis including lymphatic filariasis, tropical pulmonary eosinophilia, and loiasis. It may also be used for prevention of loiasis in those at high risk. While it has been used for onchocerciasis (river blindness), ivermectin is preferred. It is taken by mouth.
Common side effects include itching, facial swelling, headaches, and feeling tired. Other side effects include vision loss and dizziness. It is a recommended treatment in pregnancy and appears to be safe for the baby. The World Health Organization; however, recommends waiting until after pregnancy for treatment when feasible. It is made from 4-methyl-piperazine.
Diethylcarbamazine was discovered in 1947. It is on the World Health Organization's List of Essential Medicines. It is not commercially available in the United States but can be acquired from the Centers for Disease Control and Prevention.
Medical uses.
DEC is indicated for treatment of individual patients with certain filarial diseases, including lymphatic filariasis caused by infection with "Wuchereria bancrofti", "Brugia malayi", or "Brugia timori"; tropical pulmonary eosinophilia; and loiasis.
In cases of onchocerciasis, another common filarial parasite, the drug is effective.
DEC continues to be the mainstay for treatment of patients with lymphatic filariasis and loiasis. DEC is also used to prevent heartworm in dogs.
Now, the WHO recommends prescribing DEC to patients who are infected with microfilariae of filarial parasites and also to control transmission of infection in filariasis-endemic areas.
Contraindications are previous history of heart problems, gastrointestinal problems, and allergies.
In India and China, diethylcarbamazine has been added to salt to combat lymphatic filariasis.
Mechanism.
DEC 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.