Drug Name

Lariam (Mefloquine)

Drug Uses

This medication is used to treat and prevent malaria.

How Taken

Obtain a Medication Guide that must be provided by your pharmacist. Read the Medication Guide before you first start taking lariam and each time you obtain a refill. If you have any questions, regarding the information, ask your doctor or pharmacist. Carry the information wallet card with you at all times. Take by mouth, usually once a week, with food or milk to prevent stomach upset; or as directed by your doctor. Also take with a full glass (8 oz. or 240 ml) of water. Do not take this on an empty stomach. For children who cannot swallow the tablets whole, lariam may be crushed and placed in a small amount of water, milk or sugar water. It should be given with food and should not be taken on an empty stomach. The doctor will tell you the correct dose to use for your child.

The dose is based on your child's weight. For children, early vomiting may occur after taking lariam. If vomiting occurs in your child within 30 minutes of taking the drug, give another full dose. If vomiting occurs 30 minutes to 1 hour after a dose, give a half-dose. If vomiting continues, check with your doctor for a different medication to use in place of lariam. When using to prevent malaria, the first dose of this medication should be taken one week before travel, or as directed by your doctor. Take this medication as prescribed for full course of treatment. It is important you not miss any doses and that you take the drug on a regularly scheduled basis.

Remember to take it on the same day each week. Upon returning from a malaria area, you should keep taking this medication for 4 more weeks. If you are unable to finish this course of mefloquine, contact your doctor. If this medication is being used for prevention of malaria, it is important to understand that it is still possible to contract the disease. Notify your doctor immediately if you develop a fever. Malaria is best treated if therapy is started early.

Drug Class and Mechanism

Mefloquine is an orally administered antimalarial drug, used as a prophylaxis against and treatment for malaria. It also goes by the trade name Lariam (manufactured by Roche Pharmaceuticals) and chemical name mefloquine hydrochloride (formulated with HCl).

Missed Dose

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature at 77 degrees F (25 degrees C) away from sunlight and moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in bathroom. Keep all medicines away from children and pets.

Warnings/Precautions

Before taking lariam, tell your doctor or pharmacist if you are allergic to it; or to quinine or quinidine; or if you have any other allergies.

This medication should not be used if you have the following medical conditions:

• active or recent depression,
• anxiety disorder,
• psychiatric disorders,
• seizure disorders.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems, liver problems. This medication may cause dizziness or loss of balance. Use caution when driving or engaging in activities, requiring alertness. Use with caution in children. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This drug passes into breast milk. Breast-feeding is not recommended while using this drug.

Possible Side Effects

This medication may cause

• stomach upset,
• stomach pain,
• nausea,
• vomiting,
• diarrhea,
• fever,
• hair loss,
• ringing in the ears,
• dizziness,
• drowsiness,
• headache,
• insomnia,
• strange dreams, or lightheadedness.

These effects should subside as your body adjusts to the medication. If these symptoms persist or become severe, contact your doctor or pharmacist promptly.

Tell your doctor immediately if any of these unlikely but serious side effects occur:

• fast, slow, or irregular heartbeat,
• seizures,
• muscle pain,
• loss of coordination,
• numbness and tingling of hands or feet,
• vision changes.

If any of the following highly unlikely, but serious side effects occur; call your doctor immediately; you may need to stop using mefloquine and start another medication for malaria prevention: unexplained anxiety, mood changes, depression (sometimes severe, including rare thoughts of suicide), hallucinations, restlessness, confusion. A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs.

Symptoms of a serious allergic reaction include:

• rash,
• itching,
• swelling,
• severe dizziness,
• trouble breathing.

If you notice other effects not listed above, contact your doctor or pharmacist.

More Information

Important to wear protective clothing, insect repellent, and use bednets when trying to prevent malaria. Periodic eye examinations and laboratory tests (e.g., liver function tests) should be performed to monitor your progress or check for side effects. Consult your doctor or pharmacist for more details.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Other Useful Information:

Calcium: A mineral found mainly in the hard part of bones, where it is stored. Calcium is added to bones by cells called osteoblasts and is removed from bones by cells called osteoclasts. Calcium is essential for healthy bones. It is also important for muscle contraction, heart action, nervous system maintenance, and normal blood clotting. Food sources of calcium include dairy foods, some leafy green vegetables such as broccoli and collards, canned salmon, clams, oysters, calcium-fortified foods, and tofu. According to the National Academy of Sciences, adequate intake of calcium is 1,200 milligrams a day (four glasses of milk) for men and women 51 and older, 1,000 milligrams a day for adults 19 through 50, and 1,300 milligrams a day for children 9 through 18. The upper limit for calcium intake is 2.5 grams daily.

Cavities: Holes in the two outer layers of a tooth called the enamel and the dentin. The enamel is the outermost white hard surface and the dentin is the yellow layer just beneath enamel. Both layers serve to protect the inner living tooth tissue called the pulp, where blood vessels and nerves reside. Small cavities may not cause pain, and may be unnoticed by the patient. Larger cavities can collect food, and the inner pulp of the affected tooth can become irritated by bacterial toxins, foods that are cold, hot, sour, or sweet - causing toothache.

Naturopathy: A system of therapy based on preventative care, and on the use of heat, water, light, air, and massage as primary therapies for disease. Some naturopaths use no medications, either pharmaceutical or herbal. Some recommend herbal remedies only. A few who are licensed to prescribe may recommend pharmaceuticals in those cases where they feel their use is warranted.

Naturopathy is an American healthcare profession. It was founded in the US as a formal healthcare system at the turn of the 20th century by medical practitioners from various natural therapeutic disciplines. By the early 1900s, more than 20 naturopathic medical schools existed, and naturopathic physicians were licensed in most States. Today there are more than 1,000 licensed naturopathic doctors in the US.

As practiced today, naturopathic medicine integrates traditional natural therapeutics -- including botanical medicine, clinical nutrition, homeopathy, acupuncture, traditional oriental medicine, hydrotherapy, and naturopathic manipulative therapy -- with modern scientific medical diagnostic science and standards of care. The medical research base of naturopathic practice consists of empirical documentation of treatments using case history observations, medical records, and summaries of practitioners' clinical experiences.

At present, the two accredited naturopathic medical schools in the US have active research departments. Naturopathic researchers have investigated the pharmacology and physiological effects of nutritional and natural therapeutic agents, and naturopathic physicians have been active in the investigation of new homeopathic remedies and in the natural treatment of women's health problems. The most recently completed naturopathic study in women's health tested the clinical and endocrine effects of a botanical formula as an alternative to estrogen replacement therapy.

Blood: The familiar red fluid in the body that contains white and red blood cells, platelets, proteins, and other elements. The blood is transported throughout the body by the circulatory system. Blood functions in two directions: arterial and venous. Arterial blood is the means by which oxygen and nutrients are transported to tissues while venous blood is the means by which carbon dioxide and metabolic by-products are transported to the lungs and kidneys, respectively, for removal from the body.

Blood pressure: The blood pressure is the pressure of the blood within the arteries. It is produced primarily by the contraction of the heart muscle. It's measurement is recorded by two numbers. The first (systolic pressure) is measured after the heart contracts and is highest. The second (diastolic pressure) is measured before the heart contracts and lowest. A blood pressure cuff is used to measure the pressure. Elevation of blood pressure is called "hypertension".

Brain: That part of the central nervous system that is located within the cranium (skull). The brain functions as the primary receiver, organizer and distributor of information for the body. It has two (right and left) halves called "hemispheres."

Disease: Illness or sickness often characterized by typical patient problems (symptoms) and physical findings (signs). Disruption sequence: The events that occur when a fetus that is developing normally is subjected to a destructive agent such as the rubella (German measles) virus.

Doctor: In a medical context, any medical professional with an MD, a PhD, or any other doctoral degree. The term doctor is quite nonspecific. A doctor may, for example, be a physician, psychologist, biomedical scientist, dentist, or veterinarian. In a nonmedical context, a professor of history might be addressed as doctor, an eminent theologian might be named a doctor of a church, and a person awarded an honorary doctorate by a college or university might also be called a doctor.

The word "doctor" comes from the Latin "docere" meaning to teach. A doctor was a teacher, especially a learned or authoritative one.