Lariam (Mefloquine)

Do’s

• Before starting Lariam, read the Medication Guide provided by your pharmacist and carry the information wallet card with you at all times. 
• The dosage for the treatment of mild to moderate acute malaria caused by mefloquine-susceptible strains of P. falciparum or by Plasmodium vivax is based on the patient's weight. 
• Early vomiting may occur in children after taking Lariam. If vomiting occurs, call a healthcare provider right away to determine if another dose is needed. If vomiting continues, consult a healthcare provider for an alternative medication.
• When using Lariam to prevent malaria, it is usually taken once a week. The first dose should be taken one week before travel, or as directed by your healthcare provider. 
• Take the medication as prescribed for the full course of treatment, without missing any doses, and take it on the same day each week. Upon returning from the malaria area, continue taking the medication for 4 more weeks. If unable to finish this course of Lariam, contact your healthcare provider.
• Lariam should be taken by mouth as directed by your healthcare provider, with food or milk to prevent stomach upset. It should be consumed with a full glass (8 ounces or 240 milliliters) of water.
• If there is difficulty swallowing the medication, the tablet may be crushed and placed in a small amount of water, milk, or other beverage.
• Even when using Lariam for malaria prevention, it is still possible to contract the disease. Therefore, seek medical attention urgently if symptoms of malaria develop during the trip or on return home, even if the medication has been taken as prescribed.
• Always consult a healthcare provider for the appropriate use of Lariam, as it interacts with various medications and requires careful consideration of individual health conditions.

Don’ts

• Lariam should not be taken on an empty stomach.

Common Side Effects:

• Gastrointestinal effects: nausea, vomiting, loose stools or diarrhea, and abdominal pain
• Central Nervous System (CNS) effects: dizziness, vertigo
• Neuropsychiatric events: headache, somnolence, sleep disorders
• Rash and pruritus
• Myalgia
• Fever
• Chills
• Skin rash
• Fatigue
• Loss of appetite
• Tinnitus 

Severe Side Effects:

• Changes in heart rate
• Increased risk of seizures
• Potentially long-term mental health problems such as depression, hallucinations, and anxiety. 

This is not an exhaustive list, and other side effects may occur. If you experience any unusual or severe side effects while taking Lariam, contact your healthcare provider for medical advice.

Some people taking Lariam have experienced sudden serious psychiatric or nerve problems, some of which lasted long after they stopped taking the medication. These side effects can be permanent. Symptoms to watch out for include headache, ringing in the ears, dizziness, loss of balance, problems with coordination, anxiety, depression, paranoia, hallucinations, or thoughts about suicide or hurting oneself. Stop taking Lariam and call a healthcare provider immediately if any of these side effects are experienced.

Individuals with a recent history of depression, anxiety disorder, seizures, mental illness (such as schizophrenia), or psychosis should not take Lariam to prevent malaria. Discuss any concerns about taking Lariam with a healthcare provider, especially for those who have had sudden serious psychiatric or nerve problems in the past.

Other medications can affect the removal of mefloquine from the body, which may impact how Lariam works. Examples of such medications include rifamycins (such as rifabutin) and azole antifungals (such as itraconazole).

Lariam may have potential effects on the compromised cardiovascular system, and the benefits of Lariam therapy should be weighed against the possibility of adverse effects in patients with cardiac disease.

In some cases, early vomiting has been cited as a possible cause of treatment failure. If significant loss of the drug product is observed or suspected due to vomiting, specific actions should be taken as per the precautions mentioned.

The safety and effectiveness of Lariam to treat malaria in pediatric patients below the age of 6 months have not been established.

If you have any concerns about taking Lariam, discuss them with a healthcare provider to ensure the medication is suitable for your specific circumstances.