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Mefloquine
Aka: Mefloquine, Lariam
- Indications
- Prophylaxis or Treatment of Malaria
- Preferred agent in Chloroquine resistance areas
- Contraindications
- History of Epilepsy (Seizure Disorder)
- History of psychiatric disorder
- Concomitant Beta Blocker use
- First Trimester Pregnancy
- May be used in second or third trimester pregnancy
- Children under age 3 months
- Pharmacokinetics
- Half-life: 33 days
- Steady state reached
- Weekly dose: 7 weeks
- Loading dose: 4 days
- Adverse Effects
- Vestibular toxicity
- Risk of longterm Vertigo and Tinnitus
- Arrhythmia in patients with cardiac conduction defect
- QT Prolongation
- Bradycardia
- Neuropsychological effects (uncommon 1:200 to 1:500, but is a FDA black box warning)
- Insomnia
- Nightmares
- Anxiety
- Irritability
- Major Depression
- Possible increased Suicidality
- Psychosis (paranoia, Hallucinations) or Seizures (rare)
- Prophylaxis Incidence: <1:10,000
- Treatment Incidence: 1:100 to 1:1500
- Pregnancy
- No significant adverse fetal affects in studies
- Directions
- Take with food and full glass of water
- Dosing: Prophylaxis
- Protocol
- Start dosing 1 week before exposure
- Complete dosing 4 weeks after exposure
- Adult
- Mefloquine 228 mg base (250mg salt) PO once weekly
- Child
- Weight <15 kg
- Dose: 4.6 mg/kg base (5 mg/kg salt) PO once weekly
- Weight 15-19 kg
- Mefloquine 1/4 tablet PO once per week
- Weight: 20-30 kg
- Mefloquine 1/2 tablet PO once per week
- Weight: 31-45 kg
- Mefloquine 3/4 tablet PO once per week
- Weight: >45 kg
- Mefloquine 1 tablet PO once per week
- Dosing: Treatment
- Adult: 1250 mg for 1 dose
- Child: 15 mg/kg for 1 dose
- References
- (2013) Presc Lett 20(9)
- Boudreau (1993) Trop Med Parasitol 44(3):257-65 [PubMed]
- Vanhauwere (1998) Am J Trop Med Hyg 58:17-21 [PubMed]
- Weimeke (1991) Am J Trop Med Hyg 45:86-9 [PubMed]