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Lariam (mefloquine)

Use
Prevention of malaria in areas where the malaria parasites are resistant against chloroquine plus Paludrine (proguanil). Mefloquine is an alternative to Malarone (atovaquon + proguanil) and Doxycycline.
Mefloquine can also be used for standby, emergency treatment of suspected malaria.

Prevention
Lariam is taken once a week from 1 week before departure and until 4 weeks after departure from the area with malaria risk.
Dose: Lariam tablets of 250 mg:
  • Adults > 45 kg body weight - 1 tablet per week
  • Children 30 - 44 kg body weight - 3/4 tablet per week
  • Children 20 - 29 kg body weight - 1/2 tablet week
  • Children 10 - 19 kg body weight - 1/4 tablet per weight

    Side effects ususally starts within the first three doses of Lariam and it is therefore advisable to start prophylaxis at least 3 week before departure test test the travellers tolerance to lariam. This also gives the physician time to change to another drug, show Lariam not be tolerated.

    Standby, emergency treatment:
  • Adults and children > 45 kg body weight: 3 tablets in a single dose and 1 tablet after 6 to 8 hours.
  • Children 30-45 kg body weight: 2 tablets in a single dose
  • Children 15-30 kg body weight: 1 tablet.
    Seek qualified medical assistance as soon as possible and inform the doctor that you have taken Lariam.

    Pregnancy
    Malaria during pregnancy is a risk for both the mother and the child and pregnant women have an increased risk of severe malaria.

    Lariam should not be used routinely during pregnancy. The World Health Organization regards Lariam as save to use after the 16. week of pregnancy, but the experice are limited.
    If you use Lariam it is strongly advised that you use an effective prevention when you take Lariam and 3 months after stopping the tablets.

    Breast feeding
    Lariam should not be used.

    Side effects
    Nausea, Vertigo, sleeplessness, nightmares, vomiting and diarrhoea are the most common side effects. More rerely are seen rash, itching, headache, disorientation, confusion, low blood sugar, anxiety, hallucinations and problems with coordinationg fine movements. Cardiac arrytmias, depression, seizures and psycoses have been reported.
    Approximately 35 of users experience side effects severe enough to terminate the use of Lariam and 60% to 70% have no problems with Lariam.

    Who cannot use Lariam?
    People with impaired liver and kidney function and travellers with previous serious side effects to lariam. Travelelrs with seizures and current or previous depression or other psychiatric illness must not use lariam under any circumstances. Cardiac arrythmias constitute a relative contraindication. Caution is needed for persons using the fine coordination of their fingers like airline pilots.


    Other medication
    Talk to your doctor about how lariam and your other medications interact and inform your doctor about your medications including non-prescription drugs and herbal medicine.
    Lariam interact with cardiac medication like digoxin, quinidine, betablockers and calciumblockers. If is doubt obtaion an ECG before departure and do not use Lariam if the is any suspicicon of prolonged Q-T time.

    Please note
    Mo malaria drug is 100% safe - even if taken exactly according to the prescription. Drugs for malaria prophylaxis reduce the risk of malaria with between 80% and 95% depending on area and mode of travel. Traditional prevention of mosquito bites are therefore also important to prevent being infected with malaria.

    The UK HPA recommendations
    Guidelines malaria prevention in travellers from the United Kingdom 2008

    Edited 27. December 2008