Mefloquine

Mefloquine Brand Name– Lariam

What is Mefloquine

Mefloquine is an oral antimalarial agent. It is used for malaria prophylaxis or for treatment of susceptible strains of malaria.

Prophylactic dosing should begin 1 week before entering endemic area and continue for 4 weeks after leaving.

Due to the existance of chloroquine- and proguanil-resistant strains of malaria, mefloquine has been used as an alternative antimalarial, especially in European countries.

Mefloquine was approved by the FDA in 1989 and is the treatment of choice for malaria in the United States.

Indications

  1. malaria
  2. malaria prophylaxis
  3. Plasmodium falciparum
  4. Plasmodium vivax

Side Effects

  1. abdominal pain
  2. acute generalized exanthematous pustulosis (AGEP)
  3. agitation
  4. agranulocytosis
  5. alopecia
  6. anxiety
  7. aplastic anemia
  8. arthralgia
  9. asthenia
  10. ataxia
  11. AV block
  12. bradycardia
  13. chest pain (unspecified)
  14. chills
  15. confusion
  16. depression
  17. diarrhea
  18. dizziness
  19. drowsiness
  20. dyspepsia
  21. dyspnea
  22. edema
  23. elevated hepatic enzymes
  24. emotional lability
  25. encephalopathy
  26. erythema multiforme
  27. fatigue
  28. fever
  29. flushing
  30. hallucinations
  31. headache
  32. hearing loss
  33. hepatic failure
  34. hyperhidrosis
  35. hypertension
  36. hypotension
  37. insomnia
  38. leukocytosis
  39. malaise
  40. memory impairment
  41. muscle cramps
  42. myalgia
  43. nausea
  44. palpitations
  45. paranoia
  46. paresthesias
  47. pneumonitis
  48. PR prolongation
  49. pruritus
  50. psychosis
  51. QT prolongation
  52. rash
  53. restlessness
  54. seizures
  55. sinus tachycardia
  56. Stevens-Johnson syndrome
  57. suicidal ideation
  58. syncope
  59. thrombocytopenia
  60. tinnitus
  61. tremor
  62. urticaria
  63. vertigo
  64. visual impairment
  65. vomiting
  66. weakness

Monitoring Parameters

  • CBC
  • ophthalmologic exam

Contraindications

  • anxiety
  • apheresis
  • AV block
  • behavioral changes
  • bradycardia
  • breast-feeding
  • cardiomyopathy
  • celiac disease
  • depression
  • driving or operating machinery
  • females
  • fever
  • geriatric
  • heart failure
  • hepatic disease
  • human immunodeficiency virus (HIV) infection
  • hyperparathyroidism
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hypothermia
  • hypothyroidism
  • long QT syndrome
  • mefloquine hypersensitivity
  • myocardial infarction
  • neurologic events
  • ocular disease
  • pheochromocytoma
  • pregnancy
  • psychiatric event
  • psychosis
  • QT prolongation
  • quinidine hypersensitivity
  • quinine hypersensitivity
  • rheumatoid arthritis
  • schizophrenia
  • seizure disorder
  • seizures
  • sickle cell disease
  • sleep deprivation
  • stroke
  • suicidal ideation
  • systemic lupus erythematosus (SLE)
  • tinnitus

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