Mefloquine drug interactions

There was a high frequency of amphetamine abuse and withdrawal among patients from the Thai-Myanmar border area admitted to hospital with Plasmodium falciparum malaria (90). This co-morbidity can cause diagnostic confusion, alter malaria pathophysiology, and lead to drug interactions. Considering the potential neuropsychiatric adverse effects of mefloquine, an important component of current antimalarial treatment in Southeast Asia, it should be avoided in patients who abuse amphetamines. 

Schippers EF, Hugen PWH, den Hartigh J, Burger DM, Hoetelmans RMW, Visser LG, Kroon FP, No drug-drug interaction between nelfinavir or indinavir and mefloquine in HIV-1 infected patients, AIDS (2000) 14,2794-5,... 

Kang J, Chen XL, Wang L, et al. Interactions of the antimalarial drug mefloquine with the human cardiac potassium channels KvLQTl/minK and HERG. / Pharmacol Ex The. 2001 299(l) 290-296. 

An isolated report deseribes a 20-year-old woman, with a 7-year history of epilepsy (bilateral myoelonus and generalised tonic-clonic seizures) controlled with sodium valproate 1.3 g daily, who developed tonic-clonic seizures 8 hours after taking the second of 3 prophylactic doses of mefloquine 250 mg. It is not clear whether this resulted from a drug-drug or a drug-disease interaction. The manufacturers of mefloquine advise its avoidance in those with a history of convulsions as it may increase the risk of convulsions. In these patients mefloquine should he used only for curative treatment if compelling reasons exist. ... 

It has been underlined that the antimalarial activity of quinoline-based drugs (quinine, chloroquine, mefloquine) also depend on their interactions with heme, thus preventing aggregation of toxic heme released during proteolysis of hemoglobin by die parasite. In vitro, efficient quinolines block the aggregation... 

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