Mefloquine

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Half-life
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15-33 days (metabolites).

Indication
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Standard treatment of malaria and malaria prophylaxis in areas with chloroquine-resistant Plasmodium falciparum strains.

Notice! When visiting malaria-endemic countries, the WHO recommends carrying mefloquine as a stand-by therapy for self-treatment at the first signs of infection, unless mefloquine has already been taken for prophylaxis!

Limited indication
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Breastfeeding, children < 5 years, activities requiring fine coordination, visual field failure, pre-existing retinopathy, cardiac arrhythmia, severe liver or kidney dysfunction.

Dosage and method of use
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  • Malaria prophylaxis (Southeast Africa, Southeast Asia): 1 time a week on the same day of the week, intake up to 4 weeks after returning from the endemic area:
    • > 45 kg bw: 250 mg p.o.
    • 31-45 kg bw: 187,5 mg.
    • 20-30 kg bw: 125 mg.
    • 15-19 kg bw: 62,5 mg.

Remember! In order to reach more rapidly effective blood concentrations during short trips of up to 3 weeks, it is advisable to take 250 mg/day on 3 consecutive days before the start of the trip and then to continue the above scheme!

  • Malaria therapy:
    • Pat. > 60 kg KG: Initial 750 mg p.o., after 6-8 hours 500 mg, after another 6-8 hours 250 mg.
    • Pat. > 45 kg KG: Initial 750 mg p.o., after 6-8 hours 500 mg.
    • Pat. < 45 kg bw: 25 mg/kg bw.

Undesirable effects
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Teratogenicity, dizziness, loss of balance, nausea, visual disturbances, fever, chills, anxiety, hallucinations, seizures, headaches, muscle pain, extrasystole, blood formation disorders, gastrointestinal disorders, cholestasis, transaminase, allergic skin reactions, photosensitization.

Interactions
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Quinidine, quinine, glucocorticoids and halofantrine increase cardiotoxicity, chloroquine and valproic acid provoke seizures.

Contraindication
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Pregnancy, epilepsy, quinine intolerance, intake of calcium antagonists.

Preparations
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Lariam

Note(s)
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Remember! Due to pronounced teratogenicity and a very long half-life, women of childbearing age must use effective contraception until 3 months after the last tablet intake!

Patientinformation
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Remember! The preparation has a strong influence on the fine coordination. Aircraft crews and other persons performing activities requiring fine coordination and spatial discrimination (e.g. pilots) should refrain from such activities during and for at least 2 weeks after application!

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Last updated on: 29.10.2020