Generic Name: mefloquine (MEF loe kwin)
Brand Names: Lariam
What is mefloquine?
Mefloquine is a medication to treat malaria, a disease caused by parasites. This medicine works by interfering with the growth of parasites in the red blood cells of the human body.
Parasites that cause malaria typically enter the body through the bite of a mosquito. Malaria is common in areas such as Africa, South America, and Southern Asia.
Mefloquine is used to treat or prevent malaria.
Mefloquine may also be used for other purposes not listed in this medication guide.
What is the most important information I should know about mefloquine?
Do not use this medication if you are allergic to mefloquine or similar medications such as quinine (Qualaquin) or quinidine (Quinaglute, Quinidex, Quin-Release).
You should not use this medication to prevent malaria if you have a recent history of seizures, depression, anxiety, or a psychiatric illness such as schizophrenia. However, your doctor may prescribe mefloquine to treat malaria even if you do have any of these conditions.
Before using this medication, tell your doctor if you have liver or kidney disease, severe complications from infection with malaria, or uncontrolled vomiting or diarrhea.
If you vomit within 1 hour after taking this medication, take another dose. If your vomiting continues, call your doctor.
If you are taking this medicine to prevent malaria, start taking it 1 week before entering an area where malaria is common. Take the medication once per week during your stay and for at least 4 weeks after you leave. If you stop taking the medicine early for any reason, contact a healthcare professional about another form of malaria prevention.
If you are taking this medicine to treat malaria, the usual dose is 5 tablets at one time as a single dose.
Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated.
In addition to taking mefloquine, use protective clothing, insect repellents, and mosquito netting around your bed to further prevent mosquito bites that could cause malaria.
Contact your doctor as soon as possible if you have been exposed to malaria, or if you have a fever or other symptoms of illness during or after a stay in an area where malaria is common.
No medication is 100% effective in treating or preventing malaria. For best results, keep using the medication as directed. Talk with your doctor if you have fever, vomiting, or diarrhea during your treatment.
What should I discuss with my healthcare provider before taking mefloquine?
Do not use this medication if you are allergic to mefloquine or similar medications such as quinine (Qualaquin) or quinidine (Quinaglute, Quinidex, Quin-Release).
You also should not use mefloquine to prevent malaria if you have a recent history of:
seizures;
depression;
anxiety; or
schizophrenia or other psychiatric illness.
However, your doctor may prescribe mefloquine to treat malaria even if you do have any of the conditions listed above.
If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:
liver disease;
a history of depression;
epilepsy or other seizure disorder;
kidney disease;
severe complications from malaria; or
uncontrolled vomiting or diarrhea.
FDA pregnancy category C. It is not known whether mefloquine is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Malaria is more likely to cause death in a pregnant woman. If you are pregnant, talk with your doctor about the risks of traveling to areas where malaria is common. Mefloquine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Mefloquine should not be used to treat malaria in a child younger than 6 months old or who weighs less than 11 pounds. Mefloquine should not be used to prevent malaria in a child who weighs less than 99 pounds.
How should I take mefloquine?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.
It is important to use this medication regularly to best prevent malaria. If you stop using the medication early for any reason, talk to your doctor about other forms of malaria prevention.
If you have trouble swallowing the mefloquine tablet, you may crush the tablet and mix it into a small glass of milk, water, or other beverage to make swallowing easier.
If you vomit within 1 hour after taking this medication, take another half dose. If your vomiting continues, call your doctor.
If you are taking this medicine to prevent malaria:
Start taking the medicine 1 week before entering an area where malaria is common. Continue taking the medicine once weekly during your stay and for at least 4 weeks after you leave the area.
Take your weekly dose on the same day each week.
If you stop taking the medicine early for any reason, contact a healthcare professional about another form of malaria prevention.
If you are taking mefloquine to treat malaria:
Take five (5) tablets at one time, unless your doctor tells you otherwise.
- Do not take mefloquine on an empty stomach.
- Take the medicine with a full glass (8 ounces) of water.
In addition to taking mefloquine, use protective clothing, insect repellents, and mosquito netting around your bed to further prevent mosquito bites that could cause malaria.
To be sure this medication is not causing harmful effects, your liver function may need to be tested with blood tests on a regular basis. You may also need regular eye exams. Do not miss any visits to your doctor.
Contact your doctor as soon as possible if you have been exposed to malaria, or if you have fever or other symptoms of illness during or after a stay in an area where malaria is common.
No medication is 100% effective in treating or preventing malaria. For best results, keep using the medication as directed. Talk with your doctor if you have fever, vomiting, or diarrhea during your treatment.
Store mefloquine at room temperature away from moisture and heat.
See also: Mefloquine dosage (in more detail)
What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine.
Overdose symptoms may include stomach discomfort, vomiting, mouth sores, hair loss, easy bruising or bleeding, and peeling of the skin on your hands or feet.
What should I avoid while taking mefloquine?
Do not take halofantrine (Halfan) while you are taking mefloquine or just after you stop taking it. Serious, life-threatening side effects on your heart can occur if you take halofantrine before the mefloquine has cleared from your body.
Avoid taking chloroquine (Aralen Phosphate), quinine (Qualaquin) or quinidine (Quinaglute, Quinidex, Quin-Release) while you are taking mefloquine.
Mefloquine can cause side effects that may impair your thinking or reactions. Be careful if you drive, operate machinery, pilot an airplane, SCUBA dive, or do anything that requires you to be awake and alert.
Mefloquine side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking mefloquine and call your doctor at once if you have a serious side effect such as:
depressed mood, feeling restless or anxious;
confusion, extreme fear, hallucinations, unusual thoughts or behavior;
severe or uncontrolled vomiting or diarrhea;
fever;
cough, wheezing, feeling short of breath;
nausea, stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
mouth sores;
unusual aches and pains, tired feeling, weight loss;
severe skin rash; or
easy bruising or bleeding.
Less serious side effects may include:
cough;
headache;
weakness;
dizziness; or
itching.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Mefloquine Dosing Information
Usual Adult Dose for Malaria:
Mild to moderate infections due to Plasmodium vivax or mefloquine-susceptible P falciparum: 1250 mg (5 tablets) orally as a single dose; alternatively, a regimen of 750 mg initially, followed by 500 mg 6 to 12 hours later has been used
The drug should not be taken on an empty stomach and should be administered with at least 8 oz (240 mL) of water.
In addition, primaquine should be given to patients with P vivax infections to eliminate hepatic phase parasites.
Patients with severe or life-threatening malaria infections should be treated with IV antimalarials. Mefloquine may be used to complete the course of therapy after IV therapy has been completed.
Usual Adult Dose for Malaria Prophylaxis:
250 mg orally once a week on the same day, preferably after the main meal
Administration should begin 1 to 2 weeks before departure and continued for 4 weeks after returning. The dose should not be taken on an empty stomach and should be administered with at least 8 oz (240 mL) of water.
Patients should be advised that additional precautions are necessary (i.e., protective clothing, insect repellents, and bednets), and that they should seek medical attention if they develop a febrile illness after returning from an endemic area.
Usual Pediatric Dose for Malaria:
6 months or older:
Mild to moderate infections due to mefloquine-susceptible P falciparum: 20 to 25 mg/kg orally once (maximum dose: 1250 mg)
The total dose may be split into 2 doses given 6 to 8 hours apart, to reduce the severity of side effects. Alternatively, 15 mg/kg initially, followed by 10 mg/kg 12 hours later has been suggested.
Experience with mefloquine in pediatric patients weighing less than 20 kg is limited.
The dose should not be taken on an empty stomach and should be administered with plenty of water.
A second full dose should be given if the patient vomits less than 30 minutes after taking mefloquine. An additional half-dose should be given if the patient vomits 30 to 60 minutes after taking mefloquine.
Usual Pediatric Dose for Malaria Prophylaxis:
The recommended prophylactic dose is approximately 5 mg/kg orally once a week on the same day, starting 1 to 2 weeks before departure and continuing for 4 weeks after return. The dose should not be taken on an empty stomach and should be administered with plenty of water.
9 kg or less: 5 mg/kg orally once a week has been suggested
10 to 19 kg: 62.5 mg (1/4 tablet) orally once a week has been suggested
20 to 30 kg: 125 mg (1/2 tablet) orally once a week
30 to 45 kg: 187.5 mg (3/4 tablet) orally once a week
Greater than 45 kg: 250 mg (1 tablet) orally once a week
Experience with mefloquine in pediatric patients weighing less than 20 kg is limited.
Patients should be advised that additional precautions are necessary (i.e., protective clothing, insect repellents, and bednets), and that they should seek medical attention if they develop a febrile illness after returning from an endemic area.
What other drugs will affect mefloquine?
The following drugs can interact with mefloquine. Tell your doctor if you are using any of these:
a blood thinner such as warfarin (Coumadin);
ketoconazole (Nizoral);
rifabutin (Mycobutin);
rifampin (Rifadin, Rifater, Rifamate, Rimactane);
tetracycline (Brodspec, Panmycin, Sumycin, Tetracap); or
metoclopramide (Reglan).
This list is not complete and there may be other drugs that can interact with mefloquine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.
More mefloquine resources
- Mefloquine Side Effects (in more detail)
- Mefloquine Dosage
- Mefloquine Use in Pregnancy & Breastfeeding
- Drug Images
- Mefloquine Drug Interactions
- Mefloquine Support Group
- 0 Reviews for Mefloquine - Add your own review/rating
- mefloquine Advanced Consumer (Micromedex) - Includes Dosage Information
- Mefloquine MedFacts Consumer Leaflet (Wolters Kluwer)
- Mefloquine Prescribing Information (FDA)
- Lariam Monograph (AHFS DI)
- Lariam Prescribing Information (FDA)
Compare mefloquine with other medications
- Malaria
- Malaria Prevention
Where can I get more information?
- Your pharmacist can provide more information about mefloquine.
See also: mefloquine side effects (in more detail)
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