Lariam - Mefloquine

Lariam (Mefloquine hydrochloride). Roche Products Ltd. UK Summ of product characteristics, September 2005. 

Lariam (Mefloquine hydrochlcride). Roche Pharmaceuticals US Prescribir information. May 2004. 

The success of quinine inspired the search for other antimalarials. The greatest impetus for the development of synthetic dmgs came this century when the two World Wars intermpted the supply of cinchona bark to the combatants. A stmcturally related 4-quinolinemethanol is mefloquine (65, Lariam [51773-92-3]) which now serves as an effective alternative agent for chloroquine-resistant P. falciparum. This is a potent substance that requires less than one-tenth the dose of quinine to effect cures. There are some untoward side effects associated with this dmg such as gastrointestinal upset and dizziness, but they tend to be transient. Mefloquine is not recommended for use by those using beta-blockers, those whose job requires fine coordination and spatial discrimination, or those with a history of epilepsy or psychiatric disorders. A combination of mefloquine with Fansidar (a mixture of pyrimethamine and sulfadoxine) is known as Fansimef but its use is not recommended. Resistance to mefloquine has been reported even though the compound has not been in wide use. 

Mefloquine (Lariam) is a 4-quinohnemethanol derivative used both prophylactically and acutely against resistant P. falciparum malaria. It is ineffective against the hver stage of P vivax malaria. 

Clinical Use. Mefloquine (Lariam) has emerged as one of the most important antimalarial agents.61 This drug is especially important in the prevention and treatment of malaria that is resistant to traditional antimalarial drugs such as chloroquine and quinine.50 Mefloquine is often the drug of choice for antimalarial prophylaxis, especially in areas of the world where chloroquine-resistant strains of malaria are common.23 Mefloquine can be used alone, but combining this... 

Borruat FX, Nater B, Robyn L, Genton B. Prolonged visual illusions induced by mefloquine (Lariam) a case report. J Travel Med 2001 8(3) 148-9. 

Besser R, Kramer G. Verdacht auf anfaUfordernde Wirkung von Mefloquin (Lariam). [Suspected convulsive side-effect of mefloquine (Lariam).] Nervenarzt 1991 62(12) 760-1. 

In areas where chloroquine-resistant P. falciparum strains exist, travelers should receive mefloquine (Lariam) for prophylaxis. The adult dose of mefloquine is 250 mg once weekly beginning 1 week prior to departure and continuing for the fuU period of exposure, followed by 250 mg for 4 weeks after last exposure. The pediatric dose of mefloquine for prophylaxis is... 

Mefloquine (Lariam) P. falciparum malaria Incidence 1 7% Patients given doses in 10-13, 15,23,24, 25,... 

Mefloquine hydrochloride (lariam) is available for oral administration only. Tablets marketed in the U.S. contain 250 mg mefloquine hydrochloride, equivalent to 228 mg mefloquine base (this may vary in Canada and elsewhere). The dosing below is expressed in mg salt. Adults and children >45 kg body weight take 250 mg weekly starting 1-2 weeks before entering an endemic area and ending 4 weeks after leaving. Pediatric doses, taken by the same schedule, are 5 mg/kg for children up to 15 kg (may have to be prepared by a pharmacist) 62.5 mg (1/4 tablet) for 15-19 kg 125 mg (V2 tablet) for 20-30 kg 187.5 mg /k tablet) for 31 5 kg. Note Mefloquine is not recommended for children weighing <5 kg or individuals with a history of seizures, severe neuropsychiatric disturbances, sensitivity to quinoline antimalarials, or cardiac conduction abnormalities. 

Mefloquine hydrochloride (lariam, mephaquine). The adult dose is 750 mg of the salt taken by mouth followed 6-12 hours later by 500 mg. The corresponding pediatric dose for children weighing less than 45 kg is 15 mg of the salt per kg followed 6-12 hours later by 10 mg of the salt per kg. Note The pediatric dosage is not approved by the FDA.) The initial dose should be... 

Chloroquine and other aminoquinolines are used in the prophylaxis or therapy of malaria and other parasitic diseases. Chloroquine and hydroxychloroquine are also used in the treatment of rheumatoid arthritis. Drugs in this class include chloroquine phosphate (Aralen ), amodiaquine hydrochloride (Camoquin ), hydroxychloroquine sulfate (Plaquenil ), mefloquine (Lariam" ), primaquine phosphate, and quinacrine hydrochloride (Atabrine ). Chloroquine overdose is common, especially in countries where malaria is prevalent, and the mortality rate is 10-30%. Quinine toxicity is described on p 326. 

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