| Download the amazing global Makindo app: Android | Apple | |
|---|---|
| MEDICAL DISCLAIMER: Educational use only. Not for diagnosis or management. See below for full disclaimer. |
Mefloquine (Larium)
⚠️ Mefloquine (Lariam®) is an antimalarial drug used for prophylaxis and treatment. It must be prescribed with caution as it can trigger serious neuropsychiatric side effects. Avoid in patients with a history of psychiatric disorders or seizures.
📖 About
- Used in both prophylaxis and treatment of malaria (especially chloroquine-resistant P. falciparum).
- 🔗 Always check BNF for the latest prescribing advice.
- Convenient weekly dosing makes it attractive for travellers, but tolerability limits use.
🧬 Mode of Action
- Exact mechanism not fully known.
- Interferes with parasite haem polymerisation, leading to accumulation of toxic haem and parasite death.
- Structurally related to quinine and acts on intra-erythrocytic stages of the parasite.
💊 Indication & Dose
- Treatment: Mild–moderate acute malaria due to mefloquine-susceptible P. falciparum or P. vivax. US CDC regimen: 1250 mg PO once OR 750 mg orally, then 500 mg 6–12 hrs later.
- Prophylaxis: 250 mg orally once weekly, starting 1 week before travel, continued during exposure and for 4 weeks after leaving endemic area.
🔄 Interactions
- Many important interactions – especially with anticonvulsants, antidepressants, and other antimalarials (BNF reference essential).
- Concurrent use with halofantrine may cause cardiotoxicity (QT prolongation).
⚠️ Cautions
- Use only when alternatives are unsuitable if there is a risk of psychiatric illness.
- Patients should be informed of potential side effects before starting.
- Consider baseline ECG in those with cardiac disease.
🚫 Contraindications
- History of psychiatric disorders (depression, anxiety, psychosis).
- History of seizures or epilepsy.
- Severe hepatic impairment.
💥 Side Effects
- Neuropsychiatric: Anxiety, depression, nightmares, insomnia, psychosis (can persist after drug stopped).
- Neurological: Dizziness, balance disorders, headache, visual disturbances.
- GI: Nausea, diarrhoea, vomiting, abdominal discomfort.
- Other: Skin rashes, pruritus, alopecia.
📚 References
🔄 Revision Notes
- Reinforce: psychiatric contraindications are absolute.
- Not first-line for prophylaxis in UK travellers; alternatives include doxycycline or atovaquone-proguanil.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
|
|
Categories
- A Level
- About
- Acute Medicine
- Anaesthetics and Critical Care
- Anatomy
- Anatomy and Physiology
- Biochemistry
- Book
- Cardiology
- Collections
- CompSci
- Crib Sheets
- Crib sheets
- Dental
- Dermatology
- Differentials
- Drugs
- ENT
- Education
- Electrocardiogram
- Embryology
- Emergency Medicine
- Endocrinology
- Ethics
- Foundation Doctors
- GCSE
- Gastroenterology
- General Practice
- Genetics
- Geriatric Medicine
- Guidelines
- Gynaecology
- Haematology
- Hepatology
- Immunology
- Infectious Diseases
- Infographic
- Investigations
- Lists
- Mandatory Training
- Medical Students
- Microbiology
- Nephrology
- Neurology
- Neurosurgery
- Nutrition
- OSCE
- OSCEs
- Obstetrics
- Obstetrics Gynaecology
- Oncology
- Ophthalmology
- Oral Medicine and Dentistry
- Orthopaedics
- Paediatrics
- Palliative
- Pathology
- Pharmacology
- Physiology
- Procedures
- Psychiatry
- Public Health
- Radiology
- Renal
- Respiratory
- Resuscitation
- Revision
- Rheumatology
- Statistics and Research
- Stroke
- Surgery
- Toxicology
- Trauma and Orthopaedics
- USMLE
- Urology
- Vascular Surgery