Hetrazan
Hetrazan (diethylcarbamazine 100 mg) — first-line oral antifilarial for lymphatic filariasis (Wuchereria bancrofti, Brugia malayi), loiasis, and tropical pulmonary eosinophilia. WHO-listed essential medicine.
✓ Orvosi ellenőrzés Morgan Ellis — Gyógyszerkutató · 8 év tapasztalat · Utolsó felülvizsgálat: 2026 május
Gyors válasz
Hetrazan tartalmaz diethylcarbamazine citrate (DEC) 100 mg per tablet — the WHO first-line antifilarial drug for lymphatic filariasis (Wuchereria bancrofti, Brugia malayi, Brugia timori) and tropical pulmonary eosinophilia. Standard adult dose: 6 mg/kg/day, single or divided. Critical exclusion: in onchocerciasis (river blindness) and high-density loiasis, DEC can trigger severe Mazzotti or encephalopathic reactions — confirm parasite species before treatment.
📦 Minden rendelést fedez a Újraküldési Garancia — ha a csomagod nem érkezik meg 20 munkanapon belül, újraküldjük.
What diethylcarbamazine is
Diethylcarbamazine (DEC) is a piperazine derivative discovered in 1947 and the WHO first-line oral microfilaricide for lymphatic filariasis. It works through two mechanisms: (1) it sensitises microfilariae to host immune attack by altering their surface membranes, and (2) it activates the host arachidonic acid pathway leading to rapid clearance from peripheral blood. It also has slow macrofilaricidal activity against adult worms over multiple courses.
Indikációk
- Lymphatic filariasis — Wuchereria bancrofti, Brugia malayi, Brugia timori. Adult dose 6 mg/kg/day for 12 days, or single annual 6 mg/kg dose with albendazole 400 mg in mass drug administration (MDA) programmes.
- Tropical pulmonary eosinophilia (TPE) — hypersensitivity response to filarial antigens. 6 mg/kg/day in 3 divided doses for 14–21 days.
- Loiasis (Loa loa) — 8–10 mg/kg/day for 21 days, started at lower doses with steroid cover. Hospital-based treatment.
- Mansonelliasis (Mansonella streptocerca, perstans) — variable response.
NEVER use without species confirmation in
- Onchocerciasis (river blindness) — DEC kills microfilariae rapidly, releasing antigen and triggering a severe inflammatory Mazzotti reaction with intense pruritus, fever, lymphadenopathy, hypotension, and irreversible eye damage. Use ivermectin instead.
- High-density loiasis (microfilarial count > 8,000/ml) — DEC can trigger fatal encephalopathy. Pre-treatment microfilarial count and apheresis or albendazole pre-treatment is needed.
- Always confirm parasite species with thick blood film, antigen test (ICT for W. bancrofti) or antibody serology before starting.
Adagolás
| Agoprex is a 25 mg agomelatine tablet supplied by Sun Pharma. Agomelatine is mechanistically unique among antidepressants: it acts as an agonist at melatonin MT1 and MT2 receptors and an antagonist at 5-HT2C serotonin receptors. The dual mechanism resynchronises disrupted circadian rhythms (a feature of major depression) while indirectly increasing dopamine and noradrenaline release in the frontal cortex. | Adult dose | Időtartam |
|---|---|---|
| Lymphatic filariasis (curative course) | 6 mg/kg/day, divided 3 times | 12 days |
| Lymphatic filariasis (MDA, with albendazole) | 6 mg/kg single dose + albendazole 400 mg single dose | Once a year for 5–6 years |
| Tropical pulmonary eosinophilia | 6 mg/kg/day, divided 3 times | 14–21 days |
| Loiasis (specialist care) | Start 1 mg/kg day 1, escalate to 8–10 mg/kg/day | 21 days, with steroid cover |
Mellékhatások
DEC has TWO categories of adverse reaction:
Direct drug effects (mild, transient)
- Headache, malaise, anorexia, mild nausea
- Minor abdominal discomfort
- Joint and muscle aches
Microfilarial-killing reaction (Mazzotti-like, dose- and parasite-load-dependent)
- Fever (often within hours of first dose)
- Generalised pruritus, urticaria, papular rash
- Lymphadenitis and tender lymph nodes (swollen scrotal lymphatics in W. bancrofti males)
- Headache, dizziness, malaise
- Eosinophilia rebound
- In ocular filariasis or onchocerciasis: severe eye inflammation, can lead to blindness
- In high-burden Loa loa: severe encephalopathy, coma — preventable by pre-treatment screening
Manage Mazzotti-like reactions with paracetamol, antihistamines, and short oral corticosteroid courses (prednisolone 0.5–1 mg/kg/day) for severe cases. Do NOT stop DEC for mild reactions — they reflect parasite kill and will subside.
Ellenjavallatok
- Confirmed onchocerciasis (use ivermectin)
- Loiasis with microfilarial density > 8,000/ml without specialist hospital care
- Pregnancy (relative — defer treatment until after delivery where possible)
- Severe renal or hepatic impairment without dose adjustment
- Children under 18 months
Gyógyszerkölcsönhatások
Few significant interactions. Monitor INR if on warfarin. Co-administration with albendazole 400 mg single dose is the WHO MDA standard for lymphatic filariasis and is well tolerated.
Terhesség és szoptatás
- Pregnancy — limited data. WHO defers MDA until after delivery; treatment for active disease in pregnancy is decided case by case.
- Breastfeeding — small amounts excreted in milk; usually compatible if treatment is necessary.
Tárolás
Store below 25 °C, dry, original blister. Tablets are stable for the full labelled shelf life when kept dry.
Miért rendelj a MedsBase-ról
Hetrazan is supplied through a WHO-GMP certified manufacturer with full COA documentation. We ship worldwide in plain, discreet packaging, and every order is covered by our Újraküldési Garancia. Your statement descriptor when paying by card shows the regulated payment processor (a regulated card-payment processor), never "MedsBase" or any medication name.
Gyakran Ismételt Kérdések
How quickly does Hetrazan kill the worms?
Microfilariae (the larval stage circulating in blood) are cleared from peripheral blood within hours to days. Adult worms are reduced more slowly over weeks; multiple courses or repeated annual MDA doses are usually needed to fully clear an established infection.
Why are some people told to take it with albendazole?
In WHO mass drug administration (MDA) for lymphatic filariasis, single-dose DEC 6 mg/kg + albendazole 400 mg is given annually for 5–6 years to interrupt transmission. The combination is more effective at suppressing microfilariae than DEC alone.
I have river blindness (onchocerciasis) — can I take Hetrazan?
No. DEC triggers a severe Mazzotti reaction in onchocerciasis, with intense skin reaction and irreversible eye damage. Ivermectin (Mectizan) is the WHO standard for onchocerciasis. Always confirm species before starting DEC.
I am from Central Africa — should I be tested for Loa loa first?
Yes if you are in or from Central Africa (Cameroon, Congo, Gabon, etc.). High-density Loa loa microfilaraemia + DEC can trigger fatal encephalopathy. A pre-treatment day-time blood film for microfilaria count is essential.
What should I expect during the first few days of treatment?
Mild fever, headache, itching and tender lymph nodes are common from microfilarial kill — they peak in the first 24–72 hours and settle. Take paracetamol; do not stop DEC unless reactions are severe (high fever, breathing difficulty, eye pain). Severe reactions need medical review and short oral steroid.
How is tropical pulmonary eosinophilia different from regular asthma?
TPE is a hypersensitivity response to filarial antigens — chronic dry cough, breathlessness and very high eosinophilia (often > 3,000/μL) in someone from a filaria-endemic area. Lung function suggests restriction or obstruction; chest X-ray shows reticulonodular opacities. DEC at 6 mg/kg/day for 14–21 days resolves both symptoms and eosinophilia in most cases.
How long does my filariasis treatment take to fully cure me?
A 12-day curative course often clears microfilariae and reduces adult worm burden, but established lymphatic damage (lymphedema, hydrocoele) is not reversed by DEC and needs supportive lymphatic care. Adult worm clearance can take multiple courses over years.
Is there a way to prevent filariasis?
Vector control (mosquito nets, indoor residual spraying) plus annual MDA with DEC + albendazole has eliminated transmission in many WHO-targeted areas. Personal prevention in endemic zones: long sleeves at dusk, repellent, bed nets.
Can I take it during pregnancy?
WHO defers MDA in pregnancy. Active disease in pregnancy is decided case-by-case with specialist input. Limited safety data; treatment is usually delayed where possible.
How is DEC different from ivermectin?
DEC is first-line for lymphatic filariasis (Wuchereria, Brugia) and tropical pulmonary eosinophilia. Ivermectin is first-line for onchocerciasis (river blindness) and strongyloidiasis, and is preferred over DEC in mixed infection areas because it does not trigger the dangerous Mazzotti reaction in onchocerciasis. The two drugs cover different parasites.
Other Antiparasitic & Anthelmintic Medications
- All Antiparasitic & Worm Treatments
- Vermact (ivermectin) — first-line for onchocerciasis and strongyloidiasis
- Ivecop (ivermectin) — alternative ivermectin brand
- Wormentel — broad-spectrum anthelmintic
- Prazihet (praziquantel) — for schistosomiasis and tapeworm
- Ivermectin + Fenbendazole Combo Pack
Orvosi felelősségi nyilatkozat
This information is provided for educational purposes only and is not a substitute for medical advice. Always consult a qualified healthcare professional before starting, changing, or stopping any medication.
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| Erősség | 100 mg |
|---|---|
| Mennyiség | 30 tabletta, 60 tabletta, 90 tabletta, 180 tabletta |
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