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Mefloquine (Lariam)

Description

Mefloquine is a powerful antimalarial remedy, characterized by an extremely powerful effect. The medication aims at blocking the intercellular pathogens that provoke malaria in a human organism. Mefloquine provides a particularly strong effect in treating malaria exciters that resist a good range of other medications, including chloroquine and proguanil as well as pyrimethamine.

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Mefloquine: indications for use

The pills are typically prescribed for perioral malaria treatment when less powerful medicaments are ineffective. Mefloquine course is also prescribed in case of P.vivax malaria malaria type as well as types characterized by combined diseases. The prophylaxis course is recommended to be appointed to those individuals departing in dangerous malaria regions, characterized by particularly high risk of contracting strains of P. falciparum, resistant to other antimalarial remedies.

The urgent therapy (self-help) is recommended to be resorted to as an emergency measure, in the event malaria is suspected when urgent medical assistance can hardly be obtained.

The volume of distribution of the preparation equals 20 l/kg of weight, which indicates the high level of penetration into various tissues. Mefloquine is accumulated in erythrocytes, where malarial parasites exceed plasma concentration in two times approximately. The medication enters breast milk, that’s why the treatment course must be avoided during lactation.

Mefloquine as a complex of preventive treatment

The weekly mefloquine dosage should be taken at a particular interval and on the same day of the week. The first intake should be scheduled preferably 7+ days before the arrival to the area of particular malaria risk.

In case of good individual tolerance it may be recommended to take a weekly dose within 3 days in a row and switch to the standard administration plan. To minimize the risk of contracting the malaria-type diseases, the treatment course should not be abandoned for 28 days since the arrival from an endemic region. If an individual is on other medicaments, the prophylaxis treatment is recommended to be enrolled in 3 weeks prior to departure.

Mefloquine: administration

Mefloquine has a bitter and slightly pungent taste; the tablets should be swallowed entirely, preferably after food intake, with a full glass of liquid. If the medication is assigned to children or those individuals who cannot swallow the tablet entirely, the pill can be crushed and dissolved in a small amount of water, milk or other beverage.

The recommended therapeutic dose of mefloquine total for non-immune individuals is 20-25 mg/kg. For those with partial immunity the lower dosage of 15 mg/kg may be sufficient.

Thus, non-immune persons weighing more than 45 kg should be appointed 1250-1500 mg of mefloquine approximately (5-6 tablets or capsules), and those with partial immunity to the same body weight should take 750-1000 mg (4 and 1/3 tablets).

Mefloquine: precautions

The treatment course must be abandoned or never picked up in case of:

• Hypersensitivity to mefloquine and any components of the drug or a closely related drugs (quinine/quinidine)
• Joint appointment with halofantrine/reception of halofantrine after mefloquine therapy for 15 weeks after discontinuation of the latter
• Co-administration with ketoconazole, receiving ketoconazole after mefloquine therapy for 15 weeks after discontinuation of the latter.
• Depression, psychosis, schizophrenia, anxiety, seizures (the medical history of the patient should be revised).

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