Mefloquine

Uses	Malaria
Therapy	Anti-Malarial
Side Effects	Diarrhoea, nausea, vomiting, abdominal pain

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Molecule Description

Mefloquine is a medicine used to treat acute malaria. It works by attacking the malaria parasite in the blood, stopping it from growing and spreading. Do not take Mefloquine if you are allergic to mefloquine or if you have a history of mental health issues like depression, anxiety, psychosis, or seizures. Common side effects include nausea, vomiting, stomach pain, dizziness, and diarrhoea. If you experience unusual mood changes or balance issues, please notify your doctor immediately. Take Mefloquine with or without food and swallow the medicine whole with water. Take it exactly as prescribed by your doctor. Store it in a cool, dry place away from sunlight and out of children's reach. If you miss a dose, take it as soon as you remember, unless it's almost time for the next one. Do not double up on doses. Mefloquine can interact with many medications, especially those used to treat seizures, irregular heartbeats, or fungal infections. Avoid taking it with halofantrine, ketoconazole, or quinine. It may reduce the effect of certain vaccines and seizure medications. Speak to your doctor if you're pregnant, breastfeeding, or have liver or mental health problems before starting this medicine. Avoid driving if you feel dizzy or off balance.

Uses

Mefloquine is used in the treatment of acute malaria infections.

Contraindications

When should one not use Mefloquine

If you are allergic to mefloquine or any other ingredients of Mefloquine.
If you have active depression or a recent history of depression, generalised anxiety disorder, psychosis, schizophrenia or other major psychiatric disorders, or a history of convulsions.

Side effects

Common side effects of this drug are:

Diarrhoea
Nausea
Vomiting
Abdominal pain
Dizziness or vertigo

Precautions and Warnings

Pregnancy

Mefloquine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Breast Feeding

Mefloquine is excreted into human breast milk in very small amounts. It is advisable to consult with a healthcare provider to assess the risks and benefits in each individual case.

Driving

Mefloquine can cause dizziness, vertigo, and loss of balance, which may impair your ability to perform tasks that require alertness and coordination, such as driving or operating machinery.

Alcohol

No known interactions with alcohol.

Other General Warnings

Talk to your doctor if

You have a history of mental health disorders such as depression, anxiety, schizophrenia, or psychosis.
You have a history of seizures or epilepsy.
You have liver disease.
You are pregnant or breastfeeding.
You have a history of gastrointestinal issues, such as colitis; inform your doctor before taking Mefloquine, as it may increase the risk of Clostridium difficile-associated diarrhoea.
You are planning to receive certain vaccinations, such as oral live typhoid vaccines; you should complete them at least 3 days before starting Mefloquine, as the vaccine's effectiveness may be reduced.
You are taking medications like halofantrine, ketoconazole, quinine, quinidine, or chloroquine. Inform your doctor, as combining them with mefloquine can lead to serious heart rhythm problems or seizures.
You are using anticonvulsants like valproic acid, carbamazepine, phenobarbital, or phenytoin; mefloquine may reduce their effectiveness. Your doctor may need to adjust the dosage of these medications.
You are taking medications that affect heart rhythm, such as antiarrhythmics, beta-blockers, calcium channel blockers, antihistamines, tricyclic antidepressants, or phenothiazines. Consult your doctor before using mefloquine, as it can increase the risk of heart rhythm problems.

Mode of Action

How Does It Work?

Mefloquine is an antimalarial medication that targets the malaria parasite during its blood stage. This action helps prevent the parasite from multiplying and causing illness. Its exact mechanism of action is not known.

Interactions

Interactions with other medicines

Halofantrine should not be taken with Mefloquine or within 15 weeks due to the risk of serious heart rhythm problems.
Combining Mefloquine with ketoconazole can increase mefloquine levels, raising the risk of heart issues.
Using Mefloquine with quinine, quinidine, or chloroquine can increase the risk of seizures and heart problems.
Mefloquine may reduce the effectiveness of anticonvulsants like valproic acid, carbamazepine, phenobarbital, or phenytoin.
Taking Mefloquine with live oral typhoid vaccines may reduce their effectiveness.
Rifampin can lower mefloquine levels, making it less effective.
CYP3A4 inhibitors like fluconazole can increase mefloquine levels, raising the risk of side effects.

Dosage

Overdose

If you think you have taken too much of this medicine, contact your doctor immediately or visit the nearest hospital.

Missed a Dose

If you missed a dose of the medicine, take it as soon as you remember. If it is time for your next dose, then skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to compensate for the missed one.

Frequently Asked Questions (FAQs)

When taking malaria medications, it's important to avoid certain foods and drinks that can interfere with the drug's effectiveness or worsen side effects. Specifically, you should limit or avoid sugary and processed foods, high-fat foods, alcohol, caffeine, and raw or undercooked foods.

Yes, a well-balanced diet consisting of cereals, pulses, vegetables, fruits, milk and milk products, fish (in stews), chicken (in soups or stews), sugar, and honey, among other foods, is recommended for a malarial patient. This diet provides adequate nutrition while maintaining fluid balance.

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References:

U.S. Food and Drug Administration. Mefloquine hydrochloride tablets [package insert]. Silver Spring (MD): FDA; 2010 [cited 2026 Jun 10].

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