Mefloquine

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Administration

  • Type: Antimalarial
  • Dosage Forms:
  • Routes of Administration: Oral
  • Common Trade Names:

Adult Dosing

  • Malaria (falciparum or vivax) treatment: 750 mg PO, then 500 mg PO 6-12h later OR single dose of 1250mg PO
    • Give with primaquine if treating p. vivax or p. ovale
  • Malaria (falciparum or vivax) prophylaxis: 250 mg weekly starting 2 weeks prior to travel to endemic area, continue 4 weeks after leaving

Pediatric Dosing

Safety/efficacy not established in patients <6mo, limited experience treating patients <20kg

  • Malaria (falciparum or vivax) treatment: 15 mg/kg PO, then 10 mg/kg PO 6-12h after initial dose (max total dose: 1250 mg)
    • Give with primaquine if treating p. vivax or p. ovale
  • Malaria (falciparum or vivax) prophylaxis:
    • <45kg: 5 mg/kg PO weekly (<45kg)
    • >45kg: 250 mg PO weekly
    • Start 2 weeks prior to travel to endemic area, continue 4 weeks after leaving

Special Populations

Contraindications

  • Allergy to class/drug
  • Use for malaria prophylaxis in patients with active or recent history of severe depression, anxiety, or psychotic disorders
  • Use for malaria prophylaxis in patients with history of seizures

Adverse Reactions

Serious

  • Seizures
  • Prolonged QT
  • Increased risk of suicide
  • Pneumonitis

Common

  • Weird dreams
  • Dizziness, headache, coordination problems
  • Somnolence, insomnia, anxiety
  • Nausea/vomiting, diarrhea, abdominal pain

Pharmacology

  • Half-life: 2-4 weeks
  • Metabolism:
  • Excretion: Mostly fecal

Mechanism of Action

  • Plasmodium schizonticide, acts in erythrocytic stages of plasmodium species

Comments

See Also

References