Your activity: 4 p.v.

Mefloquine: Drug information

Mefloquine: Drug information
(For additional information see "Mefloquine: Patient drug information" and see "Mefloquine: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
ALERT: US Boxed Warning
Neuropsychiatric effects:

Mefloquine may cause neuropsychiatric adverse reactions that can persist after mefloquine has been discontinued.

Mefloquine should not be prescribed for prophylaxis in patients with major psychiatric disorders. During prophylactic use, if psychiatric or neurologic symptoms occur, the drug should be discontinued, and an alternative medication should be substituted.

Pharmacologic Category
  • Antimalarial Agent
Dosing: Adult

Note: Dose expressed as mg of mefloquine hydrochloride. Due to geographical resistance and cross-resistance, consult current CDC or World Health Organization guidelines as appropriate.

Malaria, prophylaxis

Malaria, prophylaxis: Oral: 250 mg once weekly starting ≥2 weeks before arrival in endemic area, continuing weekly during travel and for 4 weeks after leaving endemic area (CDC Yellow Book 2020).

Malaria, uncomplicated, treatment

Malaria, uncomplicated, treatment (alternative agent):

Note: Use only if no other treatment options are available (CDC 2020). When available, artemisinin-based combination therapy is the preferred treatment for malaria; outside of the United States, mefloquine is available in a fixed-dosed combination product with artesunate (WHO 2022).

Oral: 750 as a single dose initially, followed 6 to 12 hours later with 500 mg as a single dose; for P. vivax or Plasmodium ovale malaria, use in combination with primaquine (CDC 2020).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

No dosage adjustment necessary; only a small amount of mefloquine is renally eliminated.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling; however, half-life may be prolonged and plasma levels may be higher in patients with hepatic impairment.

Dosing: Pediatric

(For additional information see "Mefloquine: Pediatric drug information")

Note: Dose is expressed in terms of the salt, mefloquine hydrochloride. Due to geographical resistance and cross-resistance, consult current CDC or WHO guidelines as appropriate.

Malaria, treatment; chloroquine-resistant

Malaria, treatment; chloroquine-resistant (independent of HIV status): Note: Therapy is recommended as a last-line option due to higher rate of severe neuropsychiatric reactions; consider other treatment regimens first (CDC 2013):

CDC Guidelines (CDC 2013; HHS [pediatric OI 2017]): Infants, Children, and Adolescents: Oral: 15 mg/kg once (maximum dose: 750 mg/dose) followed in 6 to 12 hours with 10 mg/kg once (maximum dose: 500 mg/dose); use in combination with other anti-malarial agents (refer to local resistance patterns and guidelines); if clinical improvement is not seen within 48 to 72 hours, an alternative therapy should be used for retreatment

Malaria; chemoprophylaxis

Malaria; chemoprophylaxis (independent of HIV status): Note: Begin ≥2 weeks before arrival in endemic area, administer on the same day each week, and continue weekly during travel and for 4 weeks after leaving endemic area (CDC 2018). Infants, Children, and Adolescents:

Weight-based dosing: Oral: 5 mg/kg/dose once weekly; maximum dose: 250 mg/dose (CDC 2018; HHS [pediatric OI 2017])

Fixed dosing (CDC 2018): Oral:

>9 to 19 kg: 62.5 mg (1/4 of 250 mg tablet) once weekly

>19 to 30 kg: 125 mg (1/2 of 250 mg tablet) once weekly

>30 to 45 kg: 187.5 mg (3/4 of a 250 mg tablet) once weekly

>45 kg: 250 mg once weekly

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

No dosage adjustment necessary; only a small amount of mefloquine is renally eliminated; not removed by hemodialysis.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling; however, half-life may be prolonged and plasma levels may be higher in patients with hepatic impairment; use with caution.

Dosing: Older Adult

Refer to adult dosing.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral, as hydrochloride:

Generic: 250 mg

Generic Equivalent Available: US

Yes

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral, as hydrochloride:

Generic: 250 mg

Medication Guide and/or Vaccine Information Statement (VIS)

An FDA-approved patient medication guide, which is available with the product information and at https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019591s026s028lbl.pdf#page=13, must be dispensed with this medication.

Administration: Adult

Oral: Administer with food and at least 240 mL of water. When used for malaria prophylaxis, dose should be taken once weekly on the same day each week. If vomiting occurs within 30 minutes after the dose, an additional full dose should be given; if it occurs within 30 to 60 minutes after dose, an additional half-dose should be given. If vomiting recurs, monitor closely and consider alternative treatment. Tablets may be crushed and suspended in a small amount of water, milk, or another beverage for persons unable to swallow tablets.

Administration: Pediatric

Oral: Administer with food and an ample amount of water, at least 240 mL of water for adults. If vomiting occurs within 30 minutes after a dose, repeat dose. If vomiting occurs within 30 to 60 minutes after a dose, an additional half-dose should be administered. If vomiting recurs, monitor closely and consider alternative treatment. Administering mefloquine on a full stomach may minimize nausea and vomiting. For patients unable to swallow tablets or unable to tolerate its bitter taste, crush tablets and mix with a small amount of water, milk, applesauce, chocolate syrup, jelly, or food immediately before administration. Pulverized dose of mefloquine can be enclosed in a gelatin capsule to mask bitter taste. When used for malaria prophylaxis, dose should be taken once weekly on the same day each week.

Use: Labeled Indications

Malaria, prophylaxis: Prophylaxis of Plasmodium falciparum and Plasmodium vivax malaria infections, including prophylaxis of chloroquine-resistant strains of P. falciparum.

Malaria, uncomplicated, treatment: Treatment of uncomplicated malaria caused by mefloquine-susceptible strains of P. falciparum (chloroquine-susceptible and -resistant strains) or by P. vivax. Note: The CDC and World Health Organization guidelines also include mefloquine as an option for treatment of uncomplicated malaria due to non-falciparum Plasmodium species (CDC 2020; WHO 2022).

Medication Safety Issues
Sound-alike/look-alike issues:

Mefloquine may be confused with Malarone

International issues:

Lariam [multiple international markets] may be confused with Levaquin [Argentina, Brazil, US, Venezuela]

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%: Central nervous system: Abnormal dreams (14%; Tickell-Painter 2017), insomnia (13%; Tickell-Painter 2017)

1% to 10%: Gastrointestinal: Vomiting (3%)

<1%, postmarketing, and/or case reports: Abdominal pain, abnormal sensory symptoms, abnormal T waves on ECG, aggressive behavior, agitation, agranulocytosis, alopecia, anaphylaxis, anorexia, aplastic anemia, arthralgia, asthenia, ataxia, atrioventricular block, auditory impairment, bradycardia, burning sensation, cardiac arrhythmia, cardiac conduction disturbance (transient), chest pain, chills, confusion, decreased hematocrit, depression, diarrhea, dizziness, drowsiness, dyspepsia, dyspnea, ECG changes, edema, emotional disturbance, emotional lability, encephalopathy, equilibrium disturbance, erythema, erythema multiforme, extrasystoles, fatigue, fever, first degree atrioventricular block, flushing, hallucination, headache, hepatic disease, hepatic failure, hyperhidrosis, hypersensitivity reaction, hypertension, hypotension, increased serum transaminases, insomnia, leukocytosis, leukopenia, loose stools, malaise, memory impairment, muscle cramps, myalgia, myasthenia, nausea, pain, palpitations, panic attack, paranoia, paresthesia, pneumonitis (possibly allergic), polyneuropathy, prolonged QT interval on ECG, pruritus, psychotic reaction, restlessness, seizure, sensorimotor neuropathy, sinus arrhythmia, sinus bradycardia, skin rash, Stevens-Johnson syndrome, suicidal ideation (causal relationship not established), syncope, tachycardia, telogen effluvium, thrombocytopenia, tinnitus, tremor, urticaria, vertigo, vestibular disturbance, visual disturbance

Contraindications

Hypersensitivity to mefloquine, related compounds (eg, quinine and quinidine), or any component of the formulation; prophylactic use in patients with a history of seizures or psychiatric disorder (including active or recent history of depression, generalized anxiety disorder, psychosis, schizophrenia, or other major psychiatric disorders)

Documentation of allergenic cross-reactivity for quinine derivatives is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.

Warnings/Precautions

Concerns related to adverse effects:

• Agranulocytosis/aplastic anemia: Agranulocytosis and aplastic anemia have been reported.

• Altered cardiac conduction: Mefloquine may cause alterations in the ECG including sinus bradycardia, sinus arrhythmia, first-degree AV block, QT-interval prolongation, and abnormal T waves. Use caution or avoid concomitant use of agents known to cause QT-interval prolongation (eg, halofantrine, quinine, quinidine).

• Hypersensitivity reactions: Hypersensitivity reactions have occurred.

• Neuropsychiatric effects: May cause neuropsychiatric adverse effects that can persist after mefloquine has been discontinued. During prophylactic use, if symptoms occur, discontinue therapy and substitute an alternative medication. Symptoms may develop early in the course of therapy. Due to the difficulty in identifying these symptoms in infants and children, monitor closely especially in pediatric patients. Psychiatric symptoms may include anxiety, paranoia, depression, hallucinations, and psychosis. Suicidal ideation and suicide have also been reported. Neurologic symptoms of dizziness or vertigo, tinnitus, and loss of balance may also occur and have been reported to be permanent in some cases. During prophylactic use, the occurrence of psychiatric symptoms such as acute anxiety, depression, restlessness, or confusion may be a prodrome to more serious neuropsychiatric adverse reactions. Use caution in activities requiring alertness and fine motor coordination (eg, driving, piloting planes, operating machinery) with neurologic symptoms.

Disease-related concerns:

• Cardiovascular disease: Use with caution in patients with significant cardiac disease; ECG changes (eg, sinus bradycardia, sinus arrhythmia, first-degree AV block, QT-interval prolongation, abnormal T waves) have been reported.

• Hepatic impairment: Use with caution in patients with hepatic impairment; elimination may be prolonged.

• Neuropsychiatric disorders: Do not prescribe for prophylaxis in patients with major psychiatric disorders including patients with active depression, a recent history of depression, generalized anxiety disorder, psychosis, schizophrenia; use is contraindicated in these patients. Use with caution in patients with a previous history of depression.

• Ocular effects: Eye disorders (including optic neuropathy and retinal disorders) have been reported during treatment. If visual symptoms develop during treatment, prompt ophthalmologic evaluation is warranted; discontinuation of therapy may be necessary.

Plasmodium falciparum infections: Appropriate use: In cases of life-threatening, serious, or overwhelming malaria infections due to Plasmodium falciparum, patients should be treated with intravenous antimalarial drug. Mefloquine may be given orally to complete the course.

Plasmodium vivax infections: Appropriate use: In cases of acute Plasmodium vivax infection treated with mefloquine, patients should subsequently be treated with an 8-aminoquinoline derivative (eg, primaquine) to avoid relapse.

• Seizure disorder: When using for treatment, use with caution in patients with a history of seizures; may increase risk of seizures. Prophylactic use is contraindicated in patients with seizure disorder.

Special populations:

• Pediatric: Early vomiting leading to treatment failure in children has been reported in some studies; consider alternate therapy if a second dose is not tolerated.

Other warnings/precautions:

• Appropriate use: Not recommended for the treatment of malaria acquired in certain parts of Southeast Asia due to drug resistance (CDC 2020).

• Prolonged use: If mefloquine is to be used for a prolonged period, liver function tests, evaluations for neuropsychiatric effects, and ophthalmic examinations should be performed periodically.

Metabolism/Transport Effects

Substrate of CYP3A4 (major); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Aminoquinolines (Antimalarial): May enhance the adverse/toxic effect of Mefloquine. Specifically, the risk for QTc-prolongation and the risk for convulsions may be increased. Management: Avoid concurrent use, and delay administration of mefloquine until at least 12 hours after the last dose of an aminoquinoline antimalarial. Risk X: Avoid combination

Antiseizure Agents: Mefloquine may diminish the therapeutic effect of Antiseizure Agents. Mefloquine may decrease the serum concentration of Antiseizure Agents. Management: Mefloquine is contraindicated for malaria prophylaxis in persons with a history of seizures. If antiseizure drugs are being used for another indication, monitor antiseizure drug concentrations and treatment response closely with concurrent use. Risk D: Consider therapy modification

Artemether and Lumefantrine: Antimalarial Agents may enhance the adverse/toxic effect of Artemether and Lumefantrine. Management: Artemether/lumefantrine (combination product) should not be used with other antimalarials unless there is no other treatment option. If combined, monitor patients for increased toxicities of both agents, including QTc interval prolongation. Risk D: Consider therapy modification

CarBAMazepine: Mefloquine may diminish the therapeutic effect of CarBAMazepine. CarBAMazepine may decrease the serum concentration of Mefloquine. Mefloquine may decrease the serum concentration of CarBAMazepine. Management: Mefloquine is contraindicated for malaria prophylaxis in persons with a history of seizures. If carbamazepine is being used for another indication, monitor for decreased concentrations and efficacy of both carbamazepine and mefloquine. Risk D: Consider therapy modification

Celiprolol: Mefloquine may enhance the bradycardic effect of Celiprolol. Risk C: Monitor therapy

ChlorproMAZINE: Antimalarial Agents may increase the serum concentration of ChlorproMAZINE. Risk C: Monitor therapy

CYP3A4 Inducers (Moderate): May decrease the serum concentration of Mefloquine. Risk C: Monitor therapy

CYP3A4 Inducers (Strong): May decrease the serum concentration of Mefloquine. Risk C: Monitor therapy

CYP3A4 Inhibitors (Strong): May increase the serum concentration of Mefloquine. Risk C: Monitor therapy

Dapsone (Systemic): Antimalarial Agents may enhance the adverse/toxic effect of Dapsone (Systemic). Specifically, concomitant use of antimalarial agents with dapsone may increase the risk of hemolytic reactions. Dapsone (Systemic) may enhance the adverse/toxic effect of Antimalarial Agents. Specifically, concomitant use of dapsone with antimalarial agents may increase the risk for hemolytic reactions. Management: Closely monitor patients for signs/symptoms of hemolytic reactions with concomitant use of dapsone and antimalarial agents, particularly in patients deficient in glucose-6-phosphate dehydrogenase (G6PD), methemoglobin reductase, or with hemoglobin M. Risk D: Consider therapy modification

Dapsone (Topical): Antimalarial Agents may enhance the adverse/toxic effect of Dapsone (Topical). Specifically, the risk of hemolytic reactions may be increased. Management: Closely monitor for signs/symptoms of hemolytic reactions with concomitant use of topical dapsone and antimalarial agents. Patients with glucose-6-phosphate dehydrogenase deficiency may be at particularly high risk for adverse hematologic effects. Risk D: Consider therapy modification

Fosphenytoin-Phenytoin: Mefloquine may diminish the therapeutic effect of Fosphenytoin-Phenytoin. Fosphenytoin-Phenytoin may decrease the serum concentration of Mefloquine. Mefloquine may decrease the serum concentration of Fosphenytoin-Phenytoin. Management: Mefloquine is contraindicated for malaria prophylaxis in persons with a history of seizures. If fosphenytoin/phenytoin is being used for another indication, monitor for decreased concentrations and efficacy of both phenytoin and mefloquine. Risk D: Consider therapy modification

Halofantrine: Mefloquine may enhance the QTc-prolonging effect of Halofantrine. Risk X: Avoid combination

Haloperidol: QT-prolonging Agents (Indeterminate Risk - Caution) may enhance the QTc-prolonging effect of Haloperidol. Risk C: Monitor therapy

Ketoconazole (Systemic): May increase the serum concentration of Mefloquine. Risk X: Avoid combination

PHENobarbital: Mefloquine may diminish the therapeutic effect of PHENobarbital. PHENobarbital may decrease the serum concentration of Mefloquine. Mefloquine may decrease the serum concentration of PHENobarbital. Management: Mefloquine is contraindicated for malaria prophylaxis in persons with a history of seizures. If phenobarbital is being used for another indication, monitor for decreased concentrations and efficacy of both phenobarbital and mefloquine. Risk D: Consider therapy modification

Primidone: Mefloquine may diminish the therapeutic effect of Primidone. Primidone may decrease the serum concentration of Mefloquine. Mefloquine may decrease the serum concentration of Primidone. Management: Mefloquine is contraindicated for malaria prophylaxis in persons with a history of seizures. If primidone is being used for another indication, monitor for decreased concentrations and efficacy of both primidone/phenobarbital and mefloquine. Risk D: Consider therapy modification

QT-prolonging Agents (Highest Risk): QT-prolonging Agents (Indeterminate Risk - Caution) may enhance the QTc-prolonging effect of QT-prolonging Agents (Highest Risk). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor therapy

QuiNIDine: May enhance the adverse/toxic effect of Mefloquine. Specifically, the risk for QTc-prolongation and the risk for convulsions may be increased. Management: Avoid concurrent use, and delay administration of mefloquine until at least 12 hours after the last dose of quinidine. Risk X: Avoid combination

Quinidine (Non-Therapeutic): May enhance the adverse/toxic effect of Mefloquine. Risk X: Avoid combination

QuiNINE: May enhance the adverse/toxic effect of Mefloquine. Specifically, the risk for QTc-prolongation and the risk for convulsions may be increased. Management: Avoid concurrent use, and delay administration of mefloquine until at least 12 hours after the last dose of quinine. Risk X: Avoid combination

Warfarin: Mefloquine may enhance the anticoagulant effect of Warfarin. Risk C: Monitor therapy

Food Interactions

Food increases bioavailability by ~40%. Management: Take with food and at least 8 ounces of water. Maintain adequate nutrition and hydration, unless instructed to restrict fluid intake.

Pregnancy Considerations

Mefloquine crosses the placenta; however, clinical experience with mefloquine has not shown an increased risk of adverse effects in pregnant patients.

Malaria infection in patients who are pregnant may be more severe than in patients who are not pregnant and has a high risk of maternal and perinatal morbidity and mortality. Malaria infection during pregnancy can lead to miscarriage, premature delivery, low birth weight, congenital infection, and/or perinatal death. Therefore, patients who are pregnant and patients who are likely to become pregnant are advised to avoid travel to malaria-risk areas. When travel is unavoidable, patients who are pregnant should take precautions to avoid mosquito bites and use effective prophylactic medications (CDC 2020; CDC Yellow Book 2020).

When other treatment options are not available, mefloquine may be used for the treatment of chloroquine-resistant uncomplicated malaria in pregnancy. In patients who are pregnant with severe malaria, mefloquine may be used as interim oral therapy when the preferred IV agent is not readily available and other oral agents are not available (discontinue once IV treatment is initiated) (consult current CDC guidelines) (CDC 2020).

Breastfeeding Considerations

Mefloquine is present in breast milk.

Mefloquine concentrations in breast milk are ~3% to 4% of a 250 mg dose. The manufacturer recommends that caution be exercised when administering mefloquine to patients who are breastfeeding. Mefloquine is considered acceptable for use in patients who are breastfeeding (CDC Yellow Book 2020).

Dietary Considerations

Take with food and with at least 240 mL of water.

Monitoring Parameters

When use is prolonged, periodic liver function tests, evaluations for neuropsychiatric effects, and ocular examinations

Mechanism of Action

Mefloquine is a quinoline-methanol compound structurally similar to quinine; mefloquine's effectiveness in the treatment and prophylaxis of malaria is due to the destruction of the asexual blood forms of the malarial pathogens that affect humans, Plasmodium falciparum, P. vivax

Pharmacokinetics

Absorption: Well absorbed; interpatient variability with rate observed (WHO, 2010); more complete absorption when administered as a suspension compared with tablets

Distribution: Distributes into tissues, erythrocytes, blood, urine, CSF

Vd: Children 4 to 10 years: Mean: ~18 to 19 L/kg (Price 1999); Adults: ~20 L/kg

Protein binding: ~98%

Metabolism: Extensively hepatic primarily by CYP3A4 to 2,8-bis-trifluoromethyl-4-quinoline carboxylic acid (inactive) and other metabolites

Bioavailability: Increased by food

Half-life elimination: Children 4 to 10 years: Mean range: 11.6 to 13.6 days (range: 6.5 to 33 days) (Price 1999); Adults: ~3 weeks (range: 2 to 4 weeks); may be decreased during infection (2 weeks) (WHO 2010)

Time to peak, plasma: ~17 hours (range: 6 to 24 hours)

Excretion: Primarily bile and feces; urine (9% of total dose as unchanged drug, 4% of total dose as primary metabolite)

Pricing: US

Tablets (Mefloquine HCl Oral)

250 mg (per each): $10.59 - $13.55

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Brand Names: International
  • Eloquine (ET, TR);
  • Lariam (AE, AT, AU, BE, BF, BG, BH, BJ, CI, CL, CY, DE, ET, FI, FR, GB, GH, GM, GN, GR, HK, HN, HU, IL, IQ, IR, IT, JO, KE, KR, KW, LB, LR, LU, LY, MA, ML, MR, MT, MU, MW, NE, NG, NL, NO, OM, PE, PH, PL, PT, QA, RU, SA, SC, SD, SE, SG, SI, SK, SL, SN, SY, TN, TR, TZ, UA, UG, UY, VN, YE, ZA, ZM, ZW);
  • Larimef (BD, IN);
  • Malariquin (EG);
  • Malarium (BD);
  • Malarivent T (EG);
  • Mefliam (ZA);
  • Meflon (BD);
  • Melophar (AE);
  • Mephaquin (BB, BM, BS, BZ, CH, EC, GY, HK, JM, JP, PE, PT, SG, SR, TT, VN);
  • Mequin (TH);
  • Tropicur (AR);
  • Vexam (BD)


For country code abbreviations (show table)
  1. Centers for Disease Control and Prevention. CDC Yellow Book 2020: Health Information for International Travel. Oxford University Press; 2019. http://wwwnc.cdc.gov/travel/page/yellowbook-home-2014
  2. Centers for Disease Control and Prevention (CDC), “Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children: Recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics,” MMWR Recomm Rep, 2009, 58(RR-11):1-166. Available at http://aidsinfo.nih.gov/contentfiles/Pediatric_OI.pdf [PubMed 19730409]
  3. Centers for Disease Control and Prevention (CDC). Treatment of malaria: guidelines for clinicians (United States). https://www.cdc.gov/malaria/diagnosis_treatment/clinicians1.html. Updated May 29, 2020. Accessed June 8, 2020.
  4. Centers for Disease Control and Prevention. CDC Yellow Book 2018: Health Information for International Travel. New York: Oxford University Press; 2017. https://wwwnc.cdc.gov/travel/yellowbook/2018/table-of-contents.
  5. DHHS Panel on Opportunistic Infections in HIV-Exposed and HIV-Infected Children. Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children. Department of Health and Human Services. November 2013. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/oi_guidelines_pediatrics.pdf.
  6. Dubos F, Delattre P, Demer M, et al, “Safety of Mefloquine in Infants With Acute Falciparum Malaria,” Pediatr Infect Dis J, 2004, 23(7):679-81. [PubMed 15247612]
  7. Fryauff DJ, Owusu-agyei S, Utz G, et al, “Mefloquine Treatment for Uncomplicated Falciparum Malaria in Young Children 6-24 months of Age in Northern Ghana,” Am J Trop Med Hyg, 2007, 76 (2):224-31. [PubMed 17297028]
  8. Horowitz H and Carbonaro CA, “Inhibition of the Salmonella Typhi Oral Vaccine Strain, Ty21a, by Mefloquine and Chloroquine,” J Infect Dis, 1992, 166(6):1462-4. [PubMed 1431270]
  9. Mefloquine [prescribing information]. Berkeley Heights, NJ: Hikma Pharmaceuticals USA Inc; January 2021.
  10. Panisko DM and Keystone JS, “Treatment of Malaria - 1990,” Drugs, 1990, 39(2):160-89. [PubMed 2183998]
  11. Price R, Simpson JA, Teja-Isavatharm P, et al. Pharmacokinetics of mefloquine combined with artesunate in children with acute falciparum malaria. Antimicrob Agents Chemother. 1999;43(2):341-346. [PubMed 9925529]
  12. Tickell-Painter M, Maayan N, Saunders R, Pace C, Sinclair D. Mefloquine for preventing malaria during travel to endemic areas. Cochrane Database Syst Rev. 2017;10:CD006491. [PubMed 29083100]
  13. White NJ, “The Treatment of Malaria,” N Engl J Med, 1996, 335(11):800-6. [PubMed 8703186]
  14. World Health Organization (WHO). Guidelines for the treatment of malaria. 2010, World Health Organization, Geneva. http://www.who.int/malaria/publications/atoz/9789241549127/en/.
  15. World Health Organization (WHO). Guidelines for the treatment of malaria. 2022, World Health Organization, Geneva. https://www.who.int/teams/global-malaria-programme/guidelines-for-malaria. Published June 3, 2022.
  16. Wyler DJ, “Malaria Chemoprophylaxis for the Traveler,” N Engl J Med, 1993, 329(1):31-7. [PubMed 8505942]
Topic 9602 Version 285.0