{
  "schema_version": 1,
  "kind": "condition",
  "id": "filariasis",
  "name": "Filariasis",
  "category": "chronic",
  "sources": "Filariasis - StatPearls - NCBI Bookshelf (NBK556012) - https://www.ncbi.nlm.nih.gov/books/NBK556012/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class AD24.02 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Filariasis - disease-level clinical article (filariasis-full.txt)",
  "review_status": "reviewed",
  "verified_against": "No dose - referral pathway, no medicine given in primary care · Filariasis - disease-level clinical article (filariasis-full.txt)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 732,
      "generic": "Recognise and refer (Referral & Advice)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": "Umbrella term for infection with filarial nematodes. Egypt's own Nile Delta focus (lymphatic filariasis) has been declared eliminated as a public health problem, so a genuinely new Egyptian case is very unlikely - but a Cairo practice sees returning travellers and migrants, and chronic lymphoedema, hydrocele or acute adenolymphangitis in a patient from a previously endemic Delta village still needs recognising. Confirm the species and the microfilarial count before any drug: that is what decides the treatment, and getting it wrong can kill.",
      "adult_duration": "Refer, with advice",
      "dose_source": "No dose - referral pathway, no medicine given in primary care",
      "rationale": "Umbrella term for infection with filarial nematodes. Egypt's own Nile Delta focus (lymphatic filariasis) has been declared eliminated as a public health problem, so a genuinely new Egyptian case is very unlikely - but a Cairo practice sees returning travellers and migrants, and chronic lymphoedema, hydrocele or acute adenolymphangitis in a patient from a previously endemic Delta village still needs recognising. Confirm the species and the microfilarial count before any drug: that is what decides the treatment, and getting it wrong can kill.",
      "cautions": [
        "Rare in Egyptian primary care.",
        "Species and microfilarial count are established by a tropical-medicine service before any antifilarial is given - anyone coming from a region where onchocerciasis or loiasis is endemic is tested for coinfection first. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012) The drug rows below are the regimens that service uses, so a physician can recognise a course, understand its length, and know why the test came first. They are not a licence to treat on suspicion.",
        "RED FLAG - New lymphoedema, hydrocele or recurrent adenolymphangitis attacks: refer for parasitological and serological work-up. Fever with red, tender, ascending lymphangitis: treat as bacterial superinfection and refer."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children follow the same pathway: recognise and refer. No primary-care medicine is implied.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "filariasis"
    },
    {
      "id": 733,
      "generic": "Ivermectin",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 6.0,
      "adult_dose": "150 micrograms/kg as a SINGLE dose, swallowed on an empty stomach and washed down with a full glass of water. Repeat at 3-to-6-month intervals until symptoms have gone, which can mean 10 years of treatment or longer. The same 150 micrograms/kg single dose is the ivermectin half of the first-line pair for lymphatic filariasis with onchocerciasis.",
      "adult_duration": "One dose, repeated every 3 to 6 months while symptoms persist; the article says treatment may take 10 years or more",
      "dose_source": "Filariasis - disease-level clinical article (filariasis-full.txt)",
      "rationale": "Ivermectin is the article's drug of choice where onchocerciasis is the only infection present, given as a single dose of 150 micrograms/kg - one sentence carrying both the indication and the dose. It is registered in Egypt in eleven forms, IVACTIN 6 mg at 13.50 EGP for six tablets. Egypt's own lymphatic-filariasis focus in the Delta was eliminated, but a Cairo practice sees returning travellers and migrants from sub-Saharan Africa, which is who the card is for.",
      "cautions": [
        "TEST FOR ONCHOCERCIASIS AND LOIASIS BEFORE TREATING - this is the sentence that kills people if it is skipped. Give diethylcarbamazine (DEC) to someone who has onchocerciasis and it can set off a severe inflammatory reaction; give either DEC or ivermectin to someone who has loiasis and it can cause an encephalopathy that kills. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012) So anyone from a region where onchocerciasis or loiasis is endemic is tested for coinfection before treatment starts. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012)",
        "How to take it: ivermectin is swallowed with a full glass of water, on an empty stomach, and the dose is repeated at intervals of 3 to 6 months until the symptoms are gone. That can mean 10 years of treatment, or more. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012)",
        "The reaction on day 3 is expected, not an allergy. Fever, rash, dizziness, itch, aching muscles and joints, and tender lymph nodes are what ivermectin commonly produces. They are the immune system answering the Wolbachia antigens as they are released, and they usually show up around day 3 of treatment. An analgesic and an antihistamine can take the edge off. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012)",
        "It does not cure. Ivermectin leaves the adult worms alive, and does not clear a parasitic infection. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012)",
        "DIETHYLCARBAMAZINE (DEC) IS THE TREATMENT OF CHOICE AND IS NOT REGISTERED IN EGYPT. It kills the microfilariae and the adult worms both, and is what the article chooses for a single infection with W bancrofti, B malayi or B timori. The regimen is 6 mg/kg, taken once a day or split into 3 doses, for 12 days; where there is tropical pulmonary eosinophilia the course runs longer, 14 to 21 days. There are ZERO diethylcarbamazine products in the 25,070-product Egyptian register, so no row is written for it - the regimen is printed here so a physician who needs it knows what to ask a tropical-medicine centre for."
      ],
      "peds_mgkg_low": 150.0,
      "peds_mgkg_high": 150.0,
      "peds_max_mg": null,
      "peds_basis": "dose",
      "peds_unit": "mcg",
      "peds_note": "The same 150 micrograms/kg single dose. The article states no separate paediatric regimen and no minimum age or weight; ivermectin is conventionally avoided under 15 kg, which no document held here states, so weigh the child and take specialist advice in the very small.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": [
        {
          "weight_kg": 10,
          "low_mg": 1500,
          "high_mg": 1500,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 3000,
          "high_mg": 3000,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 4500,
          "high_mg": 4500,
          "capped": false
        },
        {
          "weight_kg": 40,
          "low_mg": 6000,
          "high_mg": 6000,
          "capped": false
        }
      ],
      "brands": [
        {
          "trade_name": "IVACTIN 6MG 6 F.C.TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "DELTA PHARMA",
          "price_egp": 13.5,
          "pack_count": 6,
          "unit_price": 2.25,
          "strength_mg": 6.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "IVERZINE 6MG 24 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "UNIPHARMA CO. > UNIPHARMA",
          "price_egp": 84.0,
          "pack_count": 24,
          "unit_price": 3.5,
          "strength_mg": 6.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "filariasis"
    },
    {
      "id": 734,
      "generic": "Doxycycline",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 100.0,
      "adult_dose": "200 mg orally once daily for 6 weeks, given together with ivermectin 150 micrograms/kg as a single dose. It works by killing the Wolbachia endosymbiont, which is why the course is long.",
      "adult_duration": "6 weeks",
      "dose_source": "Filariasis - disease-level clinical article (filariasis-full.txt)",
      "rationale": "For lymphatic filariasis with onchocerciasis the article makes the pair first-line and states both doses in one sentence: doxycycline by mouth, 200 mg once daily for 6 weeks, together with a single 150 micrograms/kg dose of ivermectin. It names doxycycline separately as the alternative in lymphatic filariasis where DEC cannot be got or cannot be given - which in Egypt is always, since no DEC product is registered. Doxycycline is on every Egyptian shelf.",
      "cautions": [
        "TEST FOR ONCHOCERCIASIS AND LOIASIS BEFORE TREATING - this is the sentence that kills people if it is skipped. Give diethylcarbamazine (DEC) to someone who has onchocerciasis and it can set off a severe inflammatory reaction; give either DEC or ivermectin to someone who has loiasis and it can cause an encephalopathy that kills. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012) So anyone from a region where onchocerciasis or loiasis is endemic is tested for coinfection before treatment starts. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012)",
        "Why it is used at all: doxycycline is the fallback where DEC cannot be got or cannot be given. It kills microfilariae and adult worms alike by going after the Wolbachia bacteria, and it works against W bancrofti and B malayi. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012)",
        "Not in pregnancy, and not in a young child. The article's note on the alternatives - that DEC is unsuitable in pregnancy, and that albendazole, though pregnancy category C, is held to be safe enough in the second and third trimesters and while breastfeeding under WHO guidance - says nothing in favour of doxycycline in pregnancy, and a tetracycline is not given then.",
        "Six weeks is the course. A short course does not clear Wolbachia and does not work.",
        "DIETHYLCARBAMAZINE (DEC) IS THE TREATMENT OF CHOICE AND IS NOT REGISTERED IN EGYPT. It kills the microfilariae and the adult worms both, and is what the article chooses for a single infection with W bancrofti, B malayi or B timori. The regimen is 6 mg/kg, taken once a day or split into 3 doses, for 12 days; where there is tropical pulmonary eosinophilia the course runs longer, 14 to 21 days. There are ZERO diethylcarbamazine products in the 25,070-product Egyptian register, so no row is written for it - the regimen is printed here so a physician who needs it knows what to ask a tropical-medicine centre for."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "NOT for young children - doxycycline is a tetracycline and stains developing teeth; it is conventionally avoided under 8 years. The article states no paediatric filarial regimen at all. A child with filariasis goes to a tropical-medicine service.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "FARCODOXIN 100MG 10 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHARCO",
          "price_egp": 11.0,
          "pack_count": 10,
          "unit_price": 1.1,
          "strength_mg": 100.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "DOXY M.R.100 MG 10 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ADWIA",
          "price_egp": 12.0,
          "pack_count": 10,
          "unit_price": 1.2,
          "strength_mg": 100.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "GRANUDOXY 100MG 10 F.C. TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > PIERRE  FRANCE",
          "price_egp": 12.0,
          "pack_count": 10,
          "unit_price": 1.2,
          "strength_mg": 100.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "DOXYDOX 100 MG 10 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EIPICO",
          "price_egp": 23.0,
          "pack_count": 10,
          "unit_price": 2.3,
          "strength_mg": 100.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "DOXYMYCIN 100 MG 10 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EL NILE.",
          "price_egp": 30.0,
          "pack_count": 10,
          "unit_price": 3.0,
          "strength_mg": 100.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "TABOCINE 100MG 10 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA",
          "price_egp": 46.0,
          "pack_count": 10,
          "unit_price": 4.6,
          "strength_mg": 100.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "VIBRAMYCIN 100MG 10 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PFIZER",
          "price_egp": 65.0,
          "pack_count": 10,
          "unit_price": 6.5,
          "strength_mg": 100.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "filariasis"
    },
    {
      "id": 735,
      "generic": "Albendazole",
      "line": 2,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 200.0,
      "adult_dose": "Loiasis with more than 8000 microfilariae/mL: 200 mg twice daily for 21 days, to bring the burden down before anything else is given. It is also the additional alternative in lymphatic filariasis for patients who cannot take doxycycline or who have loiasis or onchocerciasis as well, where it is combined with ivermectin.",
      "adult_duration": "21 days for the loiasis load-reduction course",
      "dose_source": "Filariasis - disease-level clinical article (filariasis-full.txt)",
      "rationale": "Where the count runs above 8000 microfilariae/mL the article starts with albendazole to bring the burden down - 200 mg twice a day for 21 days - and adds apheresis when the load is very high; drug, dose and duration in one sentence. It names albendazole again as the alternative in lymphatic filariasis. Eleven Egyptian products are registered, ALZENTAL 200 mg among them. It sits at line 2 because it is the load-reduction and fallback drug, not the first thing given.",
      "cautions": [
        "TEST FOR ONCHOCERCIASIS AND LOIASIS BEFORE TREATING - this is the sentence that kills people if it is skipped. Give diethylcarbamazine (DEC) to someone who has onchocerciasis and it can set off a severe inflammatory reaction; give either DEC or ivermectin to someone who has loiasis and it can cause an encephalopathy that kills. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012) So anyone from a region where onchocerciasis or loiasis is endemic is tested for coinfection before treatment starts. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012)",
        "The microfilarial count decides the drug, not the diagnosis. Where the microfilarial load is high, DEC can produce severe inflammatory reactions - encephalitis, shock - so it is the count that settles which treatment is right. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012) Counting comes before prescribing.",
        "In pregnancy: albendazole is pregnancy category C, and WHO guidance holds it to be safe enough through the second and third trimesters and while breastfeeding. First-trimester use is not covered by that sentence.",
        "Combined with ivermectin it works better - albendazole and ivermectin together suppress the microfilaraemia more effectively than either alone. (Filariasis - StatPearls - NCBI Bookshelf, NBK556012)",
        "DIETHYLCARBAMAZINE (DEC) IS THE TREATMENT OF CHOICE AND IS NOT REGISTERED IN EGYPT. It kills the microfilariae and the adult worms both, and is what the article chooses for a single infection with W bancrofti, B malayi or B timori. The regimen is 6 mg/kg, taken once a day or split into 3 doses, for 12 days; where there is tropical pulmonary eosinophilia the course runs longer, 14 to 21 days. There are ZERO diethylcarbamazine products in the 25,070-product Egyptian register, so no row is written for it - the regimen is printed here so a physician who needs it knows what to ask a tropical-medicine centre for."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "The article states no paediatric filarial regimen. Albendazole is dosed elsewhere in this app for the common intestinal worms; the 21-day loiasis course is a different use and a specialist decision.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "BENDAX 200 MG 6 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SIGMA",
          "price_egp": 23.0,
          "pack_count": 6,
          "unit_price": 3.83,
          "strength_mg": 200.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "VERMIZOLE 200MG 6 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "AMOUN",
          "price_egp": 30.0,
          "pack_count": 6,
          "unit_price": 5.0,
          "strength_mg": 200.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ALZENTAL 200 MG 6 F.C.TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EIPICO",
          "price_egp": 33.0,
          "pack_count": 6,
          "unit_price": 5.5,
          "strength_mg": 200.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ANTIZOLE 200MG 2 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ALEXANDRIA",
          "price_egp": 13.0,
          "pack_count": 2,
          "unit_price": 6.5,
          "strength_mg": 200.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ANTIZOLE 100MG/5ML SUSP. 30ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ALEXANDRIA",
          "price_egp": 19.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 100.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ALZENTAL 20MG/ML SUSP. 20ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EIPICO",
          "price_egp": 21.0,
          "pack_count": null,
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          "strength_mg": 20.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "filariasis"
    }
  ]
}