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Mefloquine is an antimalarial medication used to treat and prevent malaria, a parasitic illness caused by mosquito bites. Malaria is transmitted by Plasmodium falciparum and Plasmodium Vivax.
The active ingredient in Mefloquine belongs to a class of drugs called quinolines that stop the parasite from metabolizing and utilizing hemoglobin leading to its death. You are advised to start taking the medication a week before visiting an area where you’re likely to get malaria.
Mefloquine functions by interfering with the parasite’s life cycle within red blood cells. It concentrates primarily on the digestive vacuole of the parasite, which is necessary for the breakdown of hemoglobin. Mefloquine blocks this mechanism, preventing the parasite from getting the nutrients it needs to live and proliferate.
The drug prevents the parasite from detoxifying and breaking down hemoglobin, which leads to the buildup of toxic byproducts and eventually causes death. By doing so Mefloquine helps to prevent and treat malaria.
Labelled Warnings of Mefloquine
Mefloquine may cause mental and nervous side effects in both children and adults. These symptoms are not easily noticeable in children and can be fatal. Watch out for signs like anxiety and visual disturbances, particularly in children who can’t speak.
Stop using Mefloquine and see a doctor if you suffer from severe neuropsychiatric symptoms such as paranoia, hallucinations depression, psychosis, anxiety, or suicidal thoughts.
Mefloquine can cause severe neurologic side effects, including dizziness, loss of balance, and ringing in the ears.
This medication only decreases your chances of getting malaria but does not offer any guarantees that you will not get infected.
Mefloquine Precautions and Warnings
- Pregnancy and Breastfeeding: Do not use Mefloquine during pregnancy unless your doctor has ascertained that its benefits outweigh the risks. The medication also secretes in milk so nursing mothers should avoid taking it.
- Risk of Seizures: This medication may increase the chances of seizures. Individuals who have a history of seizures or taking medications that lower the seizure threshold should avoid taking mefloquine.
- Heart problems: Mefloquine can cause arrhythmias and other adverse cardiac effects. Individuals with heart-related conditions and those with cardiac problems need to be closely monitored while taking this medication.
- Negative Neuropsychiatric Effects: Use Mefloquine with caution if you have a history of mental illness. This medication has been associated with significant negative neuropsychiatric effects, including suicidal thoughts, sadness, anxiety, hallucinations, and psychosis.
- Liver Capability: Because Mefloquine is processed in the liver, patients suffering from liver illness should use it with caution. Regular liver function tests may also be required.
- Dizziness and Balance Issues: Dizziness, vertigo, and balance issues are common side effects of Mefloquine. Avoid engaging in activities that call for attention like driving or operating machinery while under medication.
- Distortion in the Eyes: Mefloquine may cause blurred or difficult-to-focus vision. If you experience visual discomfort, notify your doctor immediately.
Mefloquine Side Effects
Mefloquine may cause certain side effects in some patients. If the side effects are severe or persist, don’t hesitate to call your doctor.
Common Side Effects
- Indigestion
- Stomach discomfort, upset, or pain
- Headache
- Diarrhea
- Emotional problems
- Skin rash with a general disease
- Acid or sour stomach
- Unusually warm skin
- Loss of appetite
- Nausea
Severe Side Effects
- Irregular, pounding, slow, or fast heartbeat or pulse
- Mental depression
- Cough or hoarseness
- Vision changes
- Confusion
- Blistering, loosening, peeling, or redness of the skin
- Aching joints and muscles
- Sores, ulcers, or white spots in the mouth or on the lips
- Lower back or side pain
- Hallucinations
- Fainting
- Yellow eyes and skin
Drug Interactions With Mefloquine
Certain medicines should not be used together as they might cause dangerous interactions. In some cases, the interactions are not severe and only require dosage adjustments. Notify your doctor before combining Mefloquine with the drugs below to help you carry out the necessary precautions.
| Drug | Interaction |
| Chloroquine | Concurrent use may enhance neuropsychiatric side effects such as depression, anxiety, and seizures. |
| Verapamil | May cause cardiac side effects such as bradycardia, hypotension, and QT prolongation. It may also potentiate neurological side effects. |
| Cimetidine | Combining the two can inhibit the metabolism of Mefloquine, leading to increased plasma levels and increased risk of side effects like hepatotoxicity and cardiac abnormalities. |
| Fluoxetine | May cause serotonin syndrome, characterized by symptoms like increased heart rate, agitation, hallucinations, and insomnia. |
| Warfarin | Heightens the risk of bleeding complications because Mefloquine affects the metabolism of warfarin. |
| Phenytoin | Increases frequency and severity of seizures. Also, Mefloquine alters plasma levels of antiseptics, rendering them less effective. |
| Ritonavir | Concurrent use raises the plasma concentration of Mefloquine, increasing the risk of side effects like severe neuropsychiatric reactions and QT prolongation. |
Strengths and Dosages of Mefloquine
The dosage will depend on whether you’re taking Mefloquine to treat or prevent malaria.
Dosage to Treat Malaria
| Age | Strength | No. of times per day |
| Children 6 months and older | 20 mg to 25 mg per kg of body weight | Once or twice a day after 6 to 8 hours interval |
| Adults | 1250 mg | Once per day |
Dosage to Prevent Malaria
| Age | Strength | Frequency |
| Adults weighing 45 Kg or more | 250 mg (1 Tablet) | Start 1 week before traveling
Take once per week, on the same day, up to 4 weeks after leaving the region. |
| Children 30 to 45 Kg | 187.5 mg (¾ tablet) | Start 1 week before traveling
Take once per week, on the same day, up to 4 weeks after leaving the region. |
| Children 20 to 30 Kg | 125 mg (½ tablet) | Start 1 week before traveling
Take once per week, on the same day, up to 4 weeks after leaving the region. |
| Children 10 to 19 Kg | 62.5 mg (¼ tablet) | Start 1 week before traveling
Take once per week, on the same day, up to 4 weeks after leaving the region. |
| Children 5 to 9 Kg | 5 mg per kg of body weight | |
| Children weighing less than 5 kg | Determined by your physician |
Mefloquine should be taken with 8 ounces of water, preferably with food. Take it on the same day every week if you’re taking it to prevent Malaria.
Patients who cannot swallow the medication, particularly children and those who have difficulties swallowing, can crush the tablet and mix it with a little water, milk, or any beverage.
If vomiting occurs less than 30 minutes after taking the medication, a second dose should be administered. Consider taking a half-dose if vomiting occurs 30 to 60 minutes after administration. Notify your doctor if vomiting occurs after taking an additional dose.
Mefloquine Alternatives
Mefloquine, just like any medication, is not a fit for every patient due to differences in tolerability, drug interactions, and resistance patterns. Doctors can prescribe alternative medication to prevent and treat malaria. Some alternatives include:
- Doxy 100
- Proguanil
- Chloroquine
- Hydroxychloroquine
- Malarone
- Pyronaridine
- Halofantrine
- Quinine
- Tafenoquine
- Doxycycline
- Artemisinin
- Proguanil
- Coartem
Mefloquine FAQs
What is Mefloquine?
Mefloquine is a medication used in the prevention and treatment of malaria, which is transmitted through the bites of infected female mosquitoes referred to as plasmodium falciparum.
How does Mefloquine work?
This medication works by interfering with the growth and reproduction of the malaria parasite by altering its ability to digest hemoglobin in the red blood cells. As a result, it disrupts the parasite’s process of detoxifying heme, resulting in the heme building up to toxic levels hence killing the parasite.
Can I drink alcohol while taking Mefloquine?
No. Avoid drinking alcohol while taking Mefloquine because it might cause side effects such as nausea, dizziness, and gastrointestinal conditions.
How long does it take for Mefloquine to be effective?
Mefloquine starts working a few hours after ingestion, but it may take several days to be fully effective, especially if you’re treating an active infection.
What are the side effects of Mefloquine?
You may experience vomiting, anxiety, difficulty sleeping, dizziness, diarrhea, vision problems, and depression when taking Mefloquine.
Can I take Mefloquine on an empty stomach?
No. Mefloquine should be taken with food to help reduce the risk of experiencing stomach upset and improve absorption of the medicine.
Who should not take Mefloquine?
Avoid taking Mefloquine if you’re suffering from schizophrenia, depression, generalized anxiety disorder, or psychosis.
What should I do if I throw up after taking Mefloquine?
Take another full dose if you vomit less than 30 minutes after taking your dose. Take a half-dose if you vomit after 30 to 60 minutes of taking your dose. If you vomit after taking an extra dose, contact your physician immediately.
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IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.
