MEFLOQUINE

It is an antimicrobial agent which acts as a blood schizonticide. It is a 4-quinoline methanol hydrochloride. It is a potent and relatively fast-acting antimalarial agent. It is selectively active against the intraerythrocytic stages of the parasite life cycle, and has no activity against mature gametocytes or against intra-hepatic stages.

Indications

Used as a second line treatment in chloroquine resistant malaria, severe malaria due to P. falciparum and P.vivax including cerebral malaria.

Dosage

Adults: 15-25 mg per kg body weight. Upto 60 kg: Non immune patients: Loading dose- 3 tablets, after 6-8 hours-2 Tab. Semi immune patients: Loading dose - 3 tab. Over 60 kg: Non-immune patients : Loading dose-3tablets, after 6-8 hours-2 tab, after a further 6-8 hours 1 tablet. Semi-immune patients: Loading dose -3 tab after 6-8 hours 1 tab. Children: Under 45 kg. Single dose 25 mg per kg body weight = 1 tablet per 10 kg = 1/4 tab per 2.5 kg

Contra-Indications

Hypersensitivity to mefloquine or related compounds. A history of psychiatry illness seizure.

Special Precautions

Should be used during pregnancy only if the potential benefits justifies the potential risk to the fetus. Not recommended for use in patients with severe impaired hepatic and renal function, and patients suffering from epilepsy. Paediatrics: Reduced dose necessary. Safety in age below 15 years not established. Pregnancy: To be used, if clearly indicated. Lactation: Contraindicated; avoid breast feeding while on treatment. Elderly: No special problem.

Side Effects

Psychological changes e.g. depressive mood, confusion, anxiety, hallucination, paranoid reactions, dizziness or disturbed sense of balance, nausea, vomitting loose stools or diarrhoea.

Drug Interactions

Quinidine and quinine, chloroquine, halfantrine, beta blockers, typhoid vaccine and sodium valproate