クエン酸ジエチルカルバマジン
Diethylcarbamazine Citrate
Diethylcarbamazine acid citrate
別名: Hetrazan · Banocide · Diethizine · Filarcidan · Notezine · DEC · Diethylcarbamazine acid citrate · Diethylcarbamazini citras · Ditrazini citras · RP-3799
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Heartworm prophylaxis | 6.6 mg/kg PO once a day preceding infection and for 60 days following last exposure to mosquitoes. | PO | q24h | 60 days post-exposure | 🌎 NA |
| Heartworm prophylaxis | 6.6 mg/kg PO daily from beginning of mosquito season and for two months thereafter. | PO | q24h | Seasonal + 2 months | 🌎 NA |
| Heartworm prophylaxis | 2.5-3 mg/kg PO daily; begin prior to mosquito season | PO | q24h | Continuous | 🌎 NA |
| Heartworm prophylaxis | 5-7 mg/kg PO daily. Begin before infection is likely and continue 60 days after mosquito season. | PO | q24h | Seasonal + 60 days | 🌎 NA |
| Treatment of ascarids | 55-110 mg/kg PO | PO | Once | Single dose | 🌎 NA |
| Treatment of lungworms (Crenosoma vulpis) | 80 mg/kg PO q12h for 3 days | PO | q12h | 3 days | 🌎 NA |
- Heartworm prophylaxis: In dogs that become microfilaremic while on DEC, may continue, but do not interrupt daily DEC therapy.
- Heartworm prophylaxis: Should be given year-round in areas where mosquitoes are active throughout the year. Re-examine 3 months after starting therapy and at 6-month intervals for microfilaria.
- Heartworm prophylaxis: Some areas will require year-round treatment.
- Treatment of ascarids: Must not be used in microfilaria positive patients. May be used as a preventative for ascaridiasis when dosed at 6.6 mg/kg PO per day.
- Treatment of lungworms (Crenosoma vulpis): Must not be used in microfilaria positive patients.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Treatment of ascarids | 55-110 mg/kg PO | PO | Once | Single dose | 🌎 NA |
フェレット
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Heartworm prophylaxis | 5.5 mg/kg PO once a day | PO | q24h | Continuous | 🌎 NA |
牛
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Treatment of early stages of Dictyocaulus viviparous infestations | 22 mg/kg IM for 3 successive days; or 44 mg/kg IM once. | IM | q24h or Once | 3 days or Single dose | 🌎 NA |
- Treatment of early stages of Dictyocaulus viviparous infestations: DEC is available in an injectable dosage form containing 400 mg/mL in the U.K., no FDA-approved injectable form is available in the U.S.A.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
クエン酸ジエチルカルバマジン (DEC) はピペラジン誘導体の駆虫薬であり、かつては犬の毎日のフィラリア予防における標準的な薬剤でした。
- 現状: 現在では、月に1回投与するマクロライド系薬剤（イベルメクチン、ミルベマイシンなど）にほぼ取って代わられています。米国では獣医用経口剤は市販されていません。
- 適応症: 犬のフィラリア（D. immitis）予防および回虫症の治療薬としてFDAに承認されています。フェレット、動物園の動物、および牛や羊の寄生虫性気管支炎（英国）にも使用されます。
- 臨床のポイント: 新しい月1回の予防薬とは異なり、DECは毎日投与する必要があるため、飼い主のコンプライアンス維持が歴史的な課題でした。
作用機序
The exact mechanism of DEC is not completely understood, but it exhibits both direct paralytic and host-dependent immunomodulatory effects:
- Direct Paralysis: DEC acts as an agonist at nicotinic acetylcholine receptors (nAChRs) on the nematode somatic muscle → Depolarization of the muscle membrane → Spastic paralysis of the parasite.
- Immunomodulation: DEC alters the parasite's surface membrane (interfering with arachidonic acid metabolism) → Exposes hidden antigens → Enhances host immune system clearance of microfilariae.
安全性・警告
禁忌
- Dogs with circulating microfilaria (due to risk of severe shock-like reaction)
有害事象
- Vomiting
- Diarrhea
- Fixed drug eruptions (rare)
- Severe anaphylactoid reaction (in microfilaremic dogs)
- Hepatic injury (reported in cats)
注意事項
CRITICAL WARNING: DEC is strictly contraindicated in dogs with circulating microfilariae.
- Administration to microfilaremic dogs can trigger a severe, potentially fatal anaphylactoid (shock-like) reaction within 20 minutes to 2 hours. Signs include salivation, vomiting, ataxia, shock, and DIC.
- Always verify a negative heartworm test (specifically checking for microfilaria) before initiating therapy.
- If microfilaria are detected in dogs undergoing adulticide therapy while on DEC, stop DEC immediately until microfilaria are eliminated.
- Rare reports of infertility in male dogs exist, though controlled studies show no adverse effects on semen.
医薬品相互作用
Theoretical enhancement of toxic effects due to shared nicotine-like mechanism of action; use with intensified monitoring.
Theoretical enhancement of toxic effects due to shared nicotine-like mechanism of action; use with intensified monitoring.
Theoretical enhancement of toxic effects due to shared nicotine-like mechanism of action; use with intensified monitoring.
監視
- Microfilaria status (prior to and during heartworm prophylaxis)
- Clinical efficacy (when used as an anthelmintic)
薬物動態
吸収
Rapidly absorbed after oral administration, with peak serum levels occurring in about 3 hours.
分布
Distributed to all tissues and organs except fat.
代謝
Rapidly metabolized.
消失
Primarily excreted in the urine (70% of a dose within 24 hours) as metabolites or unchanged drug (10-25% of a dose).
過剰投与
DEC is considered a relatively non-toxic compound with a wide margin of safety.
- Clinical Signs: Large overdoses generally result in self-limiting vomiting or CNS depression.
- Management: For very large, recent ingestions, consider GI decontamination (inducement of vomiting, activated charcoal, cathartics). If clinical signs occur, provide supportive care (e.g., IV fluids).
製品
製剤
- Tablets
- Injection (UK only)
動物用医薬品
- No oral products currently marketed in the USA (though 10 are FDA-approved).
- Injectable 400 mg/mL (Available in the U.K. only)
ヒト用医薬品
- Diethylcarbamazine Citrate Tablets: 50 mg (Hetrazan®) - Available for compassionate use only.
規制ステータス
規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store in tight containers at room temperature and protect from light, unless otherwise specified by the manufacturer.
飼主向け情報
- 毎日の投与: 現代の月1回のフィラリア予防薬とは異なり、この薬は効果を得るために毎日投与する必要があります。獣医師の指示通りに正確に投与してください。
- 検査の必須性: 春にこの薬の投与を開始または再開する前に、必ず犬のフィラリア（ミクロフィラリア）検査を受けなければなりません。すでに感染している犬にこの薬を与えると、致命的なアレルギー反応を引き起こす可能性があります。
- 定期検査: 一年中この薬を投与している犬は、6ヶ月ごとにフィラリア検査を受ける必要があります。
- 投与のアドバイス: 食事と一緒に、または食後すぐに薬を与えると、胃腸の不調を防ぐのに役立ちます。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。