Diethylcarbamazine

Aka: Diethylcarbamazine

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II. Indications

  1. Lymphatic Filariasis
    1. Treat coinfection with Onchocerca Volvulus (River Blindness) first with Ivermectin or Moxidectin
    2. Avoid when concurrent infection with Loa Loa with blood concentration >2500 microfilaria/ml
  2. Loa loa with concentration <2500 microfilaria/ml
  3. Visceral Larva Migrans
  4. Tropical pulmonary Eosinophilia

III. Contraindications

  1. Onchocerca Volvulus (River Blindness)
    1. Risk of Mazzotti reaction (severe response associated with Parasite death)
  2. Loa Loa with blood concentration >2500 microfilaria/ml
    1. Risk of severe encephalopathy

IV. Mechanism

  1. Facilitates Phagocytosis of microfilaria

V. Dosing

  1. See Lymphatic Filariasis for dosing protocol in coinfections (Onchocerca Volvulus, Loa loa)
  2. Tropical pulmonary Eosinophilia
    1. DEC 6 mg/kg/day divided 2-3x/day for 21 days
  3. Loa loa with blood concentration >2500 microfilaria/ml
    1. Diethylcarbamazine (DEC) 9 mg/kg divided three times daily orally for 21 days
  4. Lymphatic Filariasis if no coinfections (monoinfection)
    1. Treat Diethylcarbamazine (DEC) 6 mg/kg orally once AND
    2. Doxycycline 200 mg/day for 6 weeks

VI. Adverse Effects

  1. Common
    1. Fever
    2. Headache
    3. Myalgias
    4. Rash
  2. Serious
    1. Mazzotti reaction
      1. Severe response associated with Parasite death

VII. References

  1. Gladwin, Trattler and Mahan (2014) Clinical Microbiology, Medmaster, Fl, p. 367
  2. Freedman (2024) Sanford Guide, accessed on IOS 8/4/2025

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