Active Ingredient: Mefloquine
Mefloquine is especially indicated for therapy of plasmodium falciparum malaria in which the pathogen has become resistant to other antimalarial agents.
Following treatment of P. vivax malaria with mefloquine, relapse prophylaxis with an 8-amino-quinoline derivative, for example primaquine, should be considered in order to eliminate parasites in the hepatic phase.
For this indication, competent medicine agencies globally authorize below treatments:
Oral
20 - 25 mg per kg of body weight
From 6.667 To 8.333 mg per kg of body weight 3 time(s) per day every day for 3 day(s)
The recommended total therapeutic dose of mefloquine is 20–25 mg/kg.
The recommended total therapeutic dosages of mefloquine tablets relative to body weight are presented in the following table:
| Body Weight | Total dose |
|---|---|
| <20 kg* | ¼ tablet/2.5–3 kg |
| 1 tablet/10–12 kg | |
| 20–30 kg | 2–3 tablets |
| >30–45 kg | 3–4 tablets |
| >45–60 kg | 4–5 tablets |
| >60 kg** | 6 tablets |
* Experience with mefloquine in infants less than 3 months old or weighing less than 5 kg is limited.
** There is no specific experience with total dosages of more than 6 tablets in very heavy patients.
In order to limit the occurrence and severity of adverse reactions, the total therapeutic dose may be split into 2–3 doses (e.g. 3 + 1, 3 + 2 or 3 + 2 + 1 tablets) taken 6–8 hours apart.
A second full dose should be given to patients who vomit less than 30 minutes after receiving the drug. If vomiting occurs 30–60 minutes after a dose, an additional half-dose should be given.
If a full treatment course with mefloquine does not lead to improvement within 48–72 hours, alternative treatments should be considered.
Mefloquine can be given for severe acute malaria after an initial course of intravenous quinine lasting at least 2–3 days. Interactions leading to adverse events can largely be prevented by allowing an interval of at least 12 hours after the last dose of quinine.
Artemisinin combination therapy (ACT) is recommended as the standard of care for treatment of P. falciparum malaria, regardless of region of acquisition. Mefloquine is a recommended partner molecule for inclusion in ACT.
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