• Dehydroemetine is an antiprotozoal agent and a synthetic derivative of emetine with similar anti-amebic properties but with fewer side effects.
Dehydroemetine is classified as an antiprotozoal agent. It is a less toxic derivative of emetine, the parent compound. Since it acts as a severe irritant when given orally, it is mostly given as an injection.
It is used for the treatment of
• Amebic Dysentery as an alternative to metronidazole injection and to 5-nitroimidazole when the latter does not show adequate response
• Amebic abscess when it becomes necessary to give a second round of treatment 6 weeks later in patients with extensive hepatic abscesses.
• Dehydroemetine is contraindicated in patients with condition like polyneuritis (weakness and pain due to nerve damage) and heart disease.
• The recommended dose of dehydroemetine is
Adults: 1 mg/kg daily, up to a maximum of 60 mg, for up to 4-6 days.
Elderly and severely ill patients: Reduction by up to 50% of adult dose.
Children: 1 mg/kg daily for no more than 5 days.
• While treating amebic dysentery, supplementary treatment with tetracycline will help in reducing bacterial superinfection.
• While treating hepatic abscess, supplementary treatment with chloroquine may be given orally, either simultaneously or immediately afterwards.
• Diloxanide (a second line treatment for amebic infections) should be taken orally by all patients after treatment is discontinued to eliminate surviving organisms in the colon.
• Dehydroemetine is available in an injection form as 60 mg of dehydroemetine dihydrochloride in a 1-ml ampoule.
• Injections should always be given intramuscularly with a minimum of at least 6 weeks before a second course is started.
• Dehydroemetine should be administered only in a hospital.
• Heart rate and blood pressure of the patient should be monitored carefully and the drug should be discontinued if there are signs of fast heart beat, very low blood pressure or if there are any electrical changes in the heart.
• Patients with preexisting cardiac disease, renal or neuromuscular disease should strictly avoid using the drug.
• Symptoms of weakness and serious toxic effects may be warning signs to reduce dosage.
• Avoid use in pregnancy (due to its toxicity to the fetus); maybe given to protect the mother only if amebic dysentery develops in late pregnancy.
• Skin: Abscess formation, eczema like rash
• Neuromuscular disorder: Weakness, muscular pain in limbs and neck, shortness of breath; neuromuscular symptoms are dose-related and are mostly followed by cardiotoxicity
• Cardiac effects: Hypotension, tachycardia, and dysrhythmias; changes in electrical activity that might be followed by toxicity
• Other: Headache, nausea, vomiting, local pain
• Avoid if allergic to the drug or any of its ingredients.
• Avoid if you are or planning to become pregnant or are breastfeeding.
. • You should discontinue the use of this drug after delivery.
• Drugs that can cause dysrhythmias can increase the cardiotoxic effects of dehydroemetine.
• Store at room temperature below 30°C.
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