Mefloquine

Listed in Dosage.

Adult: PO Malaria Initially, 15 mg/kg followed by 10 mg/kg after 6-24 hr. Malaria prophylaxis 250 mg/wk taken 1-3 wk before exposure and continuing for 4 wk after leaving the malarious area.

Should be taken with food. Best taken w/ meals & a full glass of water.

Hypersensitivity to related compounds (e.g. quinine and quinidine); history of blackwater fever;, prophylactic use in patients w/ history of psychiatric (including depression) or convulsive disorders; retreatment w/ mefloquine. Severe hepatic impairment. Concomitant use w/ halofantrine.

Patients w/ epilepsy, acute anxiety, restlessness or confusion, cardiac conduction disorders. Renal impairment. Pregnancy and lactation. Patient Counselling May impair ability to drive and operate machineries. Monitoring Parameters Periodic evaluation of liver function and ophthalmologic examinations (long-term prophylaxis). Neuropsychiatric symptoms; atypical behaviour (suicidal ideation and behaviour) during and after therapy.

Diarrhoea, nausea, vomiting, pruritus, rash, abdominal pain, anorexia, dizziness or vertigo, loss of balance, somnolence and sleep disorders (e.g. insomnia and abnormal dreams). Neuropsychiatric disturbances including motor and sensory neuropathies, ataxia, tremor, visual disorders (e.g. retinal degeneration or optic neuropathy), tinnitus and hearing impairment, convulsions, anxiety, depression, hallucinations, confusion, panic attacks, emotional instability, aggression and agitation, and acute psychosis, suicidal ideation; hair loss, myalgia. Decreased haematocrit and increased transaminase value; thrombocytopenia and leucopenia.

Increased risk of ECG abnormalities w/ quinine or chloroquine, antihistamines, TCAs and phenothiazines. May increase risk of seizure w/ quinidine or quinine. Concomitant use w/ valproic acid, phenobarbital, carbamazepine and phenytoin may cause loss of seizure control and lower plasma levels of anticonvulsants. Increased risk of QT prolongation and arrhythmia w/ ketoconazole. Concomitant use w/ digoxin, Ca-channel blockers, antiarrhythmics and β-blockers may increase the risk of cardiotoxicity. Increased risk of ventricular arrhythmias w/ amiodarone. Concomitant use w/ TCAs, SSRIs, buprion, antipsychotic, tramadol may increase the risk of convulsions. Increased plasma levels w/ metoclopromide. May compromise adequate immunisation by live typhoid vaccine. Vaccinations w/ attenuated live bacteria should be completed at least 3 days prior the 1st dose of mefloquine.

Antimalarials

P01BC02 - mefloquine ; Belongs to the class of methanolquinoline antimalarials.