Mefloquine nausea

Adverse reactions include nausea, vomiting, dizziness, diarrhoea, abdominal pain, anxiety disorder, sinus bradycardia, ataxia. It is reported that mefloquine is teratogenic in nature so should not be given in first trimester of pregnancy. 

Weekly dosing with mefloquine for chemoprophylaxis may cause nausea, vomiting, dizziness, sleep and behavioral disturbances, epigastric pain, diarrhea, abdominal pain, headache, rash, and dizziness. Neuropsychiatric toxicities have received a good deal of publicity, but despite frequent anecdotal reports of seizures and psychosis, a number of controlled studies have found the frequency of serious adverse effects from mefloquine to be no higher than that with other common antimalarial chemoprophylactic regimens. Leukocytosis, thrombocytopenia, and aminotransferase elevations have been reported. 

A 48-year-old woman developed anxiety, tremor, depression, dry mouth, nausea, and marked weight loss (503). Physical examination, electrocardiography, chest X-ray, CT scan, and laboratory investigations were unremarkable. The Hamilton D score was 44 for 17 items. She had taken mefloquine 250 mg/week for 8 weeks for malaria prophylaxis, and after 2 weeks had started to feel unwell, with dysphoria, depression, and weakness. She was given fluoxetine 20 mg/day and alprazolam 1.5 mg/day. Her condition continued to deteriorate. The dose of fluoxetine was increased to 40 mg/day and flunitrazepam was added. She was later instead given milnacipran, a serotonin and noradrenaline reuptake... 

Adverse effects include nausea, dizziness, disturbance of balance, vomiting, abdominal pain, diarrhoea and loss of appetite. More rarely, hallucinations, seizures and psychoses occur. Mefloquine should be avoided in patients taking (i-adrenoceptor and calcium channel antagonists for it causes sinus bradycardia quinine can potentiate these and other... 

Lumefantrine was inferior to artesunate + mefloquine in an open, randomized comparison in 617 patients in Thailand with uncomplicated multidrug-resistant malaria tropica, but produced two to four times fewer adverse effects, such as nausea, vomiting, dizziness, sleep disorders, or other neurological symptoms (4). 

The frequency and spectrum of adverse events associated with mefloquine (750 and 500 mg 6 hours apart) has been assessed in 22 healthy volunteers who were monitored for 21 days after drug administration (13). More women than men reported severe adverse reactions. The most commonly reported adverse effects were vertigo (96%), nausea (82%), and headache (73%). The... 

The chemotherapeutic response of Plasmodium berghei to various combinations of mefloquine with other drugs (sulfadoxine + pyrimethamine, primaquine, floxacrine) have shown that the desired effects are purely additive (SEDA-13, 809), so the adverse effects too are probably only those of the individual compounds. Adverse reactions occurred in 46% of 400 patients treated with Fanimef (mefloquine + pyrimethamine + sulfadoxine) (SEDA-12, 693). Of note were dizziness (29%), nausea (9.5%), vomiting (7.3%), weakness/lassitude (5.8%), abdominal discomfort or pain (5.5%), diarrhea (3.8%), pruritus (3.0%), insomnia (2.0%), and headache (2.0%). 

Mefloquine is reasonably well tolerated. However, some patients may experience nausea, vomiting, diarrhea, abdominal pain, loss of appetite and dizzines. The prophylactic or therapeutic doses of mefloquine can occasionally give rise to serious neurological and psychiatric side effects [62,131-133],... 

The incidence of side effects with mefloquine is considered to be high. The effects are classified as neuropsychiatric, Gl, dermatologic, and cardiovascular. The neuropsychiatric effects may be serious (e.g., suicidal tendencies or seizures) or minor (e.g., dizziness, vertigo, ataxia, and headaches). Gastrointestinal side effects included nausea, vomiting, and diarrhea, whereas the dermatologic effects include rash, pruritus, and urticaria. Finally, cardiovascular side effects may include bradycardia, arrhythmias, and extrasystoles. 

Nervous system The literature on mefloquine neurotoxicity has been reviewed [9 ]. Nausea, dizziness, sleep disturbances, anxiety, and psychosis have been reported. Female patients and patients with a low body mass index are at greater risk. 

A single-dose study of this potentially very useful new antimalarial compound in volunteers (14 ) reported only transient dizziness and nausea at relatively high dosage. It is as yet, however, too early to make an accurate assessment of the potential of mefloquine for causing adverse effects, particularly as phototoxicity has been the major adverse effect caused by closely related drugs. 

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