Old Drug Schedule (using 50mg DEC tablets)
In the filariasis control program, both microfilariae (MF)-positive patients and disease patients are treated with diethylcarbamazine (DEC) tablets as per the old drug schedule at a dosage of 6 mg/kg body weight for 12 continuous days. However, since weighing the patients every time for treatment is difficult, the treatment with DEC tablets should be given according to the following chart (when 50 mg DEC tablets are available):
| Sr. No. | Age in years | Doses of DEC Tab. (50 mg) | Number of tablets |
| 1 | 0 – 1 yrs | Nil | NA |
| 2 | 1-2 yrs | 25 mg | Half tablet of 50 mg |
| 3 | 2 – 4 yrs | 50 mg | One tablet of 50 mg |
| 4 | 4-6 yrs | 100 mg | Two tablets of 50 mg |
| 5 | 6 – 12 yrs | 150 mg | Three tablets of 50 mg |
| 6 | 12-18 yrs | 200 mg | Four tablets of 50 mg |
| 7 | 18 & above | 300 mg | Six tablets of 50 mg |
Precautions (Old Schedule)
- The drug should not be administered on an empty stomach.
- The drug distributor must ensure that the patient swallows the drug in their presence.
- The drug should not be left with the patient or relatives for consumption later on.
- The drug should not be given to infants, infirm and very old persons, pregnant women, or chronically ill persons suffering from diseases involving the heart, lungs, kidneys, etc.
Revised DEC Dosage Schedule
Safe and cost-effective filariasis control methods/doses are now available. Instead of the 12-day drug regimen with DEC tablets, a single-day treatment once a year was found equally effective in reducing transmission.
The new strategy is envisaged to encompass a four-pronged attack on the disease:
- All individuals more than two years of age must be administered a single dose of Triple Drug Therapy (DEC, Albendazole, and Ivermectin) as per guidelines.
- Management of acute and chronic filariasis episodes to reduce the morbidity associated with frequent acute infection at the patient’s doorstep.
- Information, Education, and Communication (IEC) to promote individual/community-based protective and preventive habits as an integral part of the filaria control strategy.
- Continuation of existing control measures in National Filaria Control Programme (NFCP) towns to supplement the single annual dose treatment with DEC, Albendazole, and Ivermectin, as per guidelines.
Methodology (Revised Schedule)
The single dose of DEC treatment will be 6 mg/kg body weight, as per the existing dose. Since it is not feasible to weigh every individual in the field, the dose schedule is adjusted according to the different age groups adopted in the program. DEC is now supplied as 100 mg tablets. The single dose of 6 mg DEC per kg body weight has been adjusted, and the age-wise streamlined dosage is given below:
1. DEC Dosages Schedule (using 100 mg tablets)
| Sr. No. | Age in years | Doses of DEC Tab. (100 mg) | Number of tablets |
| 1 | 0 – 2 yrs | Nil | NA |
| 2 | 2-5 yrs | 100 mg | One tablet of 100 mg |
| 3 | 6 – 14 yrs | 200 mg | Two tablets of 100 mg each |
| 4 | 15 & above | 300 mg | Three tablets of 100 mg each |
2. Ivermectin Dosages Schedule (Single dose)
| Sr. No. | Height in cm | Doses of Ivermectin Tab. (3 mg) | Number of tablets |
| 1 | 90 – 119 | 3 mg | 1 |
| 2 | 120 – 140 | 6 mg | 2 |
| 3 | 141 – 158 | 9 mg | 3 |
| 4 | 159 & more | 12 mg | 4 |
3. Albendazole (400 mg) Dosages Schedule
| Sr. No. | Age in years | Doses of Albendazole Tab. (400 mg) | Number of tablets |
| 1 | 2-5 yrs | 400 mg | 1 |
| 2 | 6 – 14 yrs | 400 mg | 1 |
| 3 | 15 & above | 400 mg | 1 |
Precautions (Revised Schedule)
- Children below 2 years of age, pregnant women, and seriously ill individuals should not be administered the drug.
- Children between 2 and 5 years of age are to be given only DEC and albendazole.
- Children above 5 years of age will receive ivermectin, DEC, and albendazole.
- The beneficiary should not consume triple drug therapy on an empty stomach.
- Ivermectin and DEC tablets should be swallowed with water.
- The Albendazole tablet should be chewed and consumed with water.
- The drug administrator should directly observe the beneficiary consuming the drugs.
Side Effects of DEC
DEC is a safe drug that has been used in India for more than 50 years. However, DEC may produce side reactions in a small proportion of the population, especially among those harboring the infection (microfilaria in circulating blood), who are usually symptomless. The drug reactions may be of two kinds:
- Those due to the drug itself (pharmacological toxicity): headache, anorexia, nausea, abdominal pain, vomiting, dizziness, weakness, or lethargy. These symptoms begin within 1–2 hours of taking the drug and persist for a few hours.
- Those due to an allergic reaction from the destruction of microfilariae and adult worms (attributable to filaricidal action): fever, local inflammation around dead worms, or pruritus. These reactions are transitory and subside within two days and can be treated with symptomatic therapy.
