Meds and you

27 September 2013

Mefloquine

Mefloquine is an antimalarial. Antimalarials are drugs that are used to prevent or treat malaria caused by susceptible strains of the parasite.

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Mefloquine is the active ingredient of Lariam tablets (Nappi code: 797677-011) & Mefliam tablets (Nappi code: 835552-004).

General information
Mefloquine is an antimalarial. Antimalarials are drugs that are used to prevent or treat malaria caused by susceptible strains of the parasite.

In South Africa mefloquine is registered for the prevention of malaria in areas where resistance to other antimalarial drugs occurs.

For this medication to be effective it has to be taken regularly - Missing a dose may increase your risk of getting malaria. It is furthermore advised to take additional precautions to avoid being bitten by mosquitoes. These methods include using mosquito repellants, protective clothing and sleeping under mosquito nets.

Should you experience severe side-effects from this medication, it is advised that you consult your doctor for an alternative before your next dose is due.

Be careful if you drive or do anything that requires you to be alert. Avoid any other dangerous activities until you know how this medication affects you.

How does mefloquine work?
Malaria is caused by a family of parasites known as plasmodium. Mefloquine kills the parasites and prevents them from multiplying within the body.

Fast facts

Drug schedule: Schedule 4
Available as: mefloquine is available as tablets
What does it do? Mefloquine is used to prevent and to treat acute infections of malaria
Overdose risk: high
Dependence risk: low
Is mefloquine available as a generic? yes
Is mefloquine available on prescription only? yes

User information

Onset of effect: for prevention of malaria it needs to be taken at least 2-3 days before entering a risk area to ensure efficacy.
Duration of action: up to 21 days.
Dietary advice: take mefloquine with a meal and at least 250 ml of water.
Stopping this medicine: it is advised not to discontinue treatment before the recommended course has been completed.
Prolonged use: although mefloquine may be taken for up to a year for the prevention of malaria, periodic liver and eye examinations are recommended.

Special precautions
Consult your doctor before using this drug if:

  • you are allergic to drugs such as quinine and quinidine
  • you have epilepsy or a history of convulsions
  • you have heart disease
  • you have, or have had depression, generalised anxiety disorder, psychosis, or schizophrenia
  • you have liver or kidney disease
  • you are taking any other medication

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.
Porphyria: avoid. This medication may cause serious adverse effects. Consult your doctor before use.
Elderly: caution is advised in the elderly as side effects are more likely to occur.
Driving and hazardous work: be careful if you drive or do anything that requires you to be alert. This is because this medication affects your central nervous system and may impair your thinking or reactions.
Alcohol: keep alcohol consumption low.

Possible side effects

Side Effect
Frequency
Consult your doctor

Common
Rare
Only if severe
In all cases
nausea/vomiting
X

X

stomach pain
X

X

diarrhoea
X

X

loss of appetite
X

X

headache
X

X

dizziness
X

X

muscle pain

X
X

fever/chills

X
X

ringing in the ears

X
X

depression

X

X
anxiety

X

X
panic attacks

X

X
hallucinations

X

X
confusion

X

X
agitation

X

X
agression

X

X
chest pain

X

X
palpitations

X

X
hearing distrubances

X

X

Interactions

Drug interactions

carbamazepine decreased effect of carbamazepine
phenobarbital decreased effect of phenobarbital
phenytoin decreased effect of phenytoin
valproic acid decreased effect of valproic acid
ketoconazole increased levels/effects of mefloquine
doxycycline increased levels/effects of mefloquine
isoniazid increased levels/effects of mefloquine
diclofenac increased levels/effects of mefloquine
erythromycin increased levels/effects of mefloquine
nevirapine reduced levels/effects of mefloquine
quinine increased risk of neuro- and cardio-toxicity and convulsion
chloroquine increased risk of neuro- and cardio-toxicity and convulsion
propranolol and other beta-blockers increased risk of disturbed heart rhythms
verapamil and other calcium channel blockers increased risk of disturbed heart rhythms
verapamil increased risk of disturbed heart rhythms
digoxin increased risk of disturbed heart rhythms
halofantrine risk of fatal cardiac reactions

Disease interactions
Consult your doctor before using this drug if you have epilepsy or a history of convulsions, you have heart disease, you have, or have had depression, generalised anxiety disorder, psychosis, or schizophrenia, or if you have serious liver or kidney disease.

Overdose action
An overdose of this medication can be fatal. Seek immediate emergency medical attention.

Recommended dosage
Adults: 250mg once a week. Treatment should be started one week before entering the risk area, and should only be stopped 4 weeks after returning.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
 

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