What is the use of Hetrazan Tablet?
Hetrazan Tablet, whose active ingredient is Diethylcarbamazine Citrate (DEC), is a prescription medication used to treat several types of parasitic worm infections. As a member of the anthelmintic drug class, it is highly specific in its action against filarial parasites, which are microscopic, thread-like roundworms transmitted by insects. The medication works by stunning the worms and increasing their susceptibility to the body's natural immune response, helping to clear the infection and alleviate symptoms. The primary uses of Hetrazan include the treatment of filariasis, tropical pulmonary eosinophilia, and loiasis, among other conditions.
The Anthelmintic Action of Diethylcarbamazine
The active component of Hetrazan, Diethylcarbamazine, exerts its therapeutic effects through a dual mechanism of action against parasitic microfilariae (the larval stage of the worms). First, it acts to decrease the muscular activity of the microfilariae by causing hyperpolarization, which effectively immobilizes them within the body. Second, this immobilization makes the parasites more vulnerable to destruction by the host's own immune system. The drug also has a lethal effect on adult Loa loa worms and is presumed to kill adult Wuchereria bancrofti and Brugia malayi worms, although it does not affect the adult forms of Onchocerca volvulus.
Key Parasitic Conditions Treated with Hetrazan
- Lymphatic Filariasis: Also known as elephantiasis, this condition is caused by the filarial worms Wuchereria bancrofti, Brugia malayi, and Brugia timori. These worms cause severe swelling of the limbs, genitals (hydrocele), or other body parts by obstructing the lymphatic system. Hetrazan is a first-line treatment for this condition, targeting the microfilariae in the bloodstream.
- Loiasis: This eye worm infection is caused by the Loa loa parasite and is transmitted by deer flies. Hetrazan is effective against both the adult and larval forms of this parasite, helping to resolve the infection.
- Tropical Pulmonary Eosinophilia (TPE): A form of occult filariasis that affects the lungs, TPE is characterized by a persistent cough, fever, and high levels of eosinophils (a type of white blood cell). Hetrazan provides rapid relief of the symptoms associated with this condition.
- Visceral Larva Migrans: Hetrazan can be used to treat toxocariasis, a worm infection that can cause rheumatic, neurological, or asthma-related symptoms.
Administration and Treatment Duration
The administration and duration of Hetrazan treatment vary significantly depending on the specific parasitic infection being treated, as well as the patient's body weight and overall health. It is crucial to follow a healthcare provider's instructions carefully. The tablet should always be taken with food to prevent stomach upset. The frequency and length of treatment will be determined by a medical professional based on the condition being treated and individual patient factors.
Potential Side Effects and Adverse Reactions
Side effects of Hetrazan are often related to the body's reaction to the dying parasites and can range from mild to severe. Some of the most common side effects include fever, headache, dizziness, nausea, and vomiting. Allergic reactions, such as skin rashes, swollen lymph nodes, and facial swelling, are also possible, especially in severe infections. In cases of onchocerciasis (river blindness), the death of the worms can cause a severe inflammatory response known as the Mazzotti reaction, which requires close medical supervision and possibly steroid treatment. Long-term use for river blindness has been associated with vision changes.
Important Precautions and Warnings
Before taking Hetrazan, patients must inform their doctor about any existing medical conditions, especially a history of epilepsy, heart disease, or kidney problems. It is contraindicated in patients with hypersensitivity to the drug and is generally not recommended during pregnancy or for severely ill individuals. The medication can cause drowsiness, so caution is advised when driving or operating heavy machinery. It's vital to complete the full course of treatment as prescribed, even if symptoms improve, to ensure all parasites are eliminated.
Comparison of Hetrazan (DEC) with Other Anthelmintics
| Feature | Hetrazan (Diethylcarbamazine) | Ivermectin | Albendazole |
|---|---|---|---|
| Primary Uses | Lymphatic filariasis, Loiasis, TPE | Onchocerciasis, Strongyloidiasis | Intestinal worms, Lymphatic filariasis |
| Mechanism | Immobilizes microfilariae and kills adult Loa loa and likely W. bancrofti / B. malayi | Paralyzes microfilariae and adult worms, leading to their death | Prevents worm cell division by binding to tubulin |
| Effect on Adults | Kills adult Loa loa and likely W. bancrofti / B. malayi but not O. volvulus | Less effective against adult filarial worms | Primarily targets larval stage and some adults |
| Use in Mass Treatment | Often used in combination with other drugs in mass chemotherapy programs | Commonly used in mass treatment for onchocerciasis | Often paired with DEC or Ivermectin for lymphatic filariasis |
| Side Effect Risk | Mazzotti reaction, fever, lymph node swelling | Mazzotti reaction (less severe than DEC), dizziness | Gastrointestinal upset, headache |
Conclusion
HETRAZAN Tablet is a crucial medication in the fight against several parasitic diseases, including lymphatic filariasis and tropical pulmonary eosinophilia. Its active component, Diethylcarbamazine, effectively kills or immobilizes the specific parasitic worms responsible for these conditions. While highly effective when used correctly, it is a prescription drug with potential side effects and contraindications that must be managed by a healthcare professional. Given the complexities of parasitic infections and potential reactions, patients should always consult their doctor for the proper diagnosis, administration, and monitoring to ensure a safe and effective treatment course. The CDC provides further resources on the treatment of filarial diseases, including those managed by DEC(https://www.cdc.gov/filarial-worms/hcp/clinical-care/index.html).
