Home Drug Guide Diethylcarbamazine Citrate

Drug Guide

Generic Name

Diethylcarbamazine Citrate

Brand Names Hetrazan

Classification

Therapeutic: Antiparasitic

Pharmacological: Microfilaricide

FDA Approved Indications

  • Lymphatic filariasis caused by Wuchereria bancrofti, Brugia malayi, and Wuchereria loa.
  • Loiasis caused by Loa loa.

Mechanism of Action

Diethylcarbamazine enhances the host's immune response to microfilariae and adult worms, and affects microfilariae and some adult filarial worms by altering their surface structure and reducing their motility, leading to their destruction.

Dosage and Administration

Adult: Typically 6 mg/kg/day divided into 2 or 3 doses for 12 days, but dosing varies by indication and patient factors.

Pediatric: Dosing based on body weight, generally 6 mg/kg/day divided into 2 or 3 doses for 12 days.

Geriatric: Use with caution; dose adjustments based on renal and hepatic function.

Renal Impairment: Adjust dosage as needed, consult renal function.

Hepatic Impairment: Use with caution; no specific dosing guidelines established.

Pharmacokinetics

Absorption: Approximately 80% absorbed from the gastrointestinal tract.

Distribution: Widely distributed, including into cerebrospinal fluid.

Metabolism: Partially metabolized in the liver.

Excretion: Primarily via urine, some in feces.

Half Life: Approximately 8-12 hours.

Contraindications

  • Hypersensitivity to diethylcarbamazine.
  • Onchocerciasis (due to risk of severe reactions).

Precautions

  • Caution in patients with epilepsy, since seizures have been reported.
  • Monitor for allergic reactions, especially in patients with other parasitic infections.

Adverse Reactions - Common

  • Gastrointestinal discomfort, nausea, vomiting (Common)
  • Dizziness or headache (Common)

Adverse Reactions - Serious

  • Severe allergic reactions including angioedema, urticaria (Rare)
  • Neurotoxicity manifesting as seizures or neuropathy (Rare)

Drug-Drug Interactions

  • Caution with other neurotoxic or immunosuppressive agents.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess for contraindications, such as hypersensitivity or other parasitic infections that might contraindicate use.

Diagnoses:

  • Risk for allergic reactions
  • Ineffective health management due to lack of knowledge.

Implementation: Administer with food to reduce gastrointestinal upset. Monitor patient for adverse reactions and efficacy.

Evaluation: Monitor for clearance of microfilariae and clinical improvement.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any allergic reactions or severe side effects.
  • Attend all follow-up appointments for evaluation.

Special Considerations

Black Box Warnings:

  • Potential for severe allergic reactions in patients with onchocerciasis.
  • Caution in patients with epilepsy.

Genetic Factors: N/A

Lab Test Interference: May affect microfilaria counts.

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, allergic reactions, seizures.

Treatment: Supportive care; activated charcoal may be considered if ingestion is recent; no specific antidote.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.