38:
510:
29:
3633:
751:
996:
Available data suggests that mefloquine is safe and effective for use by pregnant women during all trimesters of pregnancy, and it is widely used for this indication. In pregnant women, mefloquine appears to pose minimal risk to the fetus, and is not associated with increased risk of birth defects or
1178:
In 2006, the
Australian military deemed mefloquine "a third-line drug" alternative, and over the five years from 2011 only 25 soldiers had been prescribed the drug, and only in cases of their intolerance for other alternatives. Between 2001 and 2012, 16,000 Canadian soldiers sent to Afghanistan were
916:
of mefloquine regarding the potential for neuropsychiatric side effects that may persist even after discontinuing administration of the medication. In 2013 the FDA stated "Neurologic side effects can occur at any time during drug use, and can last for months to years after the drug is stopped or can
1072:
company. Essentially, it is two drugs in one. Plasma concentrations of the (–)-enantiomer are significantly higher than those for the (+)-enantiomer, and the pharmacokinetics between the two enantiomers are significantly different. The (+)-enantiomer has a shorter half-life than the (–)-enantiomer.
1017:
Mefloquine is metabolized primarily through the liver. Its elimination in persons with impaired liver function may be prolonged, resulting in higher plasma levels and an increased risk of adverse reactions. The mean elimination plasma half-life of mefloquine is between two and four weeks. Total
1150:. Roughly 67% of participants in the mefloquine arm reported greater than or equal to one adverse event, versus 71% in the atovaquone-proguanil arm. In the mefloquine arm, 5% of the users reported severe events requiring medical attention, versus 1.2% in the atovaquone-proguanil arm.
1141:
The neuropsychiatric side effects of the antimalarial drug mefloquine are well documented. They include anxiety, depression, hallucinations, acute psychosis, and seizures. The incidence of these side effects is 1 in 13,000 with prophylactic use and 1 in 250 with therapeutic
1205:
told the same committee that the evidence she had read failed to support the conclusion of indelible side effects. Canadian soldiers who took mefloquine when deployed overseas have claimed they have been left with ongoing mental health problems.
688:. When used for prevention it is typically started before potential exposure and continued for several weeks after potential exposure. It can be used to treat mild or moderate malaria but is not recommended for severe malaria. It is taken
2331:
2299:
2267:
2235:
778:
for malaria prophylaxis as a first or second-line agent, depending on resistance patterns in the malaria found in the geographic region visited. It is typically taken for one to two weeks before entering an area with malaria.
1103:
However, mefloquine was not approved by the FDA for prophylactic use until 1989. This approval was based primarily on compliance, while safety and tolerability were overlooked. Because of the drug's very long half-life, the
1209:
In 2020 the UK Ministry of
Defence (MoD) admitted to a breach of duty regarding the use of Mefloquine. by acknowledging numerous instances of failure to assess the risks and warn of potential side effects of the drug.
1018:
clearance is through the liver, and the primary means of excretion is through the bile and feces, as opposed to only 4% to 9% excreted through the urine. During long-term use, the plasma half-life remains unchanged.
1088:
Mefloquine was the first Public-Private
Venture (PPV) between the US Department of Defense and a pharmaceutical company. WRAIR transferred all its phase I and phase II clinical trial data to Hoffman-LaRoche and
819:
malaria. It is one of several drugs recommended by the United States' Centers for
Disease Control and Prevention. It is not recommended for severe malaria infections, particularly infections from
207:
2338:
2306:
2274:
2242:
1183:. In autumn 2016, the UK military followed suit with their Australian peers after a parliamentary inquiry into the matter revealed that it can cause permanent side effects and brain damage.
2922:
2667:
McArdle JJ, Sellin LC, Coakley KM, Potian JG, Quinones-Lopez MC, Rosenfeld CA, et al. (December 2005). "Mefloquine inhibits cholinesterases at the mouse neuromuscular junction".
1680:
3703:
956:
Central nervous system events requiring hospitalization occur in about one in 10,000 people taking mefloquine for malaria prevention, with milder events (e.g., dizziness, headache,
586:
1659:
960:, and vivid dreams) in up to 25%. When some measure of subjective severity is applied to the rating of adverse events, about 11–17% of travelers are incapacitated to some degree.
162:
656:
1129:
By 1994, medical professionals were noting "severe psychiatric side effects observed during prophylaxis and treatment with mefloquine", and recommending that "the absence of
1164:, told in 2015 that he had received "a letter about once or twice a week" about ill-effects from the drug. In July 2016, Roche took this brand off the market in Ireland.
864:
Common side effects include vomiting, diarrhea, headaches, and a rash. Severe side effects requiring hospitalization are rare, but include mental health problems such as
695:
Common side effects include vomiting, diarrhea, headaches, sleep disorders, and a rash. Serious side effects include potentially long-term mental health problems such as
2710:
McArdle JJ, Sellin LC, Coakley KM, Potian JG, Hognason K (March 2006). "Mefloquine selectively increases asynchronous acetylcholine release from motor nerve terminals".
1004:(WHO) gives approval for the use of mefloquine in the second and third trimesters of pregnancy and use in the first trimester does not mandate termination of pregnancy.
2570:
1085:(WRAIR) in the 1970s shortly after the end of the Vietnam war. Mefloquine was number 142,490 of a total of 250,000 antimalarial compounds screened during the study.
1994:"FDA Drug Safety Communication: FDA approves label changes for antimalarial drug mefloquine hydrochloride due to risk of serious psychiatric and nerve side effects"
3673:
2409:
Hennequin C, Bourée P, Bazin N, Bisaro F, Feline A (October 1994). "Severe psychiatric side effects observed during prophylaxis and treatment with mefloquine".
60:
612:
787:
provide protection within one to two days and may be better tolerated. If a person becomes ill with malaria despite prophylaxis with mefloquine, the use of
2915:
2070:
1219:
771:
2555:
1809:
1021:
Liver function tests should be performed during long-term administration of mefloquine. Alcohol use should be avoided during treatment with mefloquine.
1146:
The first randomized, controlled trial on a mixed population was performed in 2001. Prophylaxis with mefloquine was compared to prophylaxis with
997:
miscarriages. Compared to other malaria chemoprophylaxis regimens, however, mefloqinone may produce more side effects in non-pregnant travelers.
2610:
2908:
1082:
640:
InChI=1S/C17H16F6N2O/c18-16(19,20)11-5-3-4-9-10(15(26)12-6-1-2-7-24-12)8-13(17(21,22)23)25-14(9)11/h3-5,8,12,15,24,26H,1-2,6-7H2/t12-,15+/m1/s1
2753:
Zhou C, Xiao C, McArdle JJ, Ye JH (June 2006). "Mefloquine enhances nigral gamma-aminobutyric acid release via inhibition of cholinesterase".
3587:
1133:
and minor side effects during an initial course of mefloquine should be confirmed before another course is prescribed." Other doctors at the
775:
735:
1676:
1197:
told a parliamentary committee that faulty science supported the assertion that the drug has indelible noxious side effects. An expert from
1976:
1841:
1108:
originally recommended a mefloquine dosage of 250 mg every two weeks; however, this caused an unacceptably high malaria rate in the
2541:
1652:
1137:
noted in a case of "a 47-year-old, previously healthy
Japanese tourist" who had severe neuropsychiatric side-effects from the drug that
1226:. Administration of mefloquine seemed to eliminate the virus from the patient's body and prevented further neurological deterioration.
3698:
2487:"Atovaquone-proguanil versus mefloquine for malaria prophylaxis in nonimmune travelers: results from a randomized, double-blind study"
1186:
In early
December 2016, the German defence ministry removed mefloquine from the list of medications it would provide to its soldiers.
2363:
3230:
1483:
1456:
632:
1937:
1000:
Mefloquine is also safe and effective for use during breastfeeding, though it appears in breast milk in low concentrations. The
2556:"Did Lariam send Cambridge student Alana Cutland to her death… and what anti-malarials should children take on their gap year?"
307:
192:
92:
2900:
3678:
3459:
1179:
given the drug as a preventative measure. In 2013, the US Army banned mefloquine from use by its special forces such as the
3023:
1134:
1093:. FDA approval as a treatment for malaria was swift. Most notably, phase III safety and tolerability trials were skipped.
3623:
988:
Mefloquine is contraindicated in those with a previous history of seizures or a recent history of psychiatric disorders.
3658:
3653:
1998:
1971:
1572:
1365:
905:
409:
1858:
3604:
2188:"Pregnancy and fetal outcomes after exposure to mefloquine in the pre- and periconception period and during pregnancy"
1105:
489:
111:
1157:
3693:
3303:
1527:
1499:
1311:
1001:
734:
Mefloquine was developed by the United States Army in the 1970s and came into use in the mid-1980s. It is on the
1190:
1096:
The drug was first approved in
Switzerland in 1984 by Hoffmann-LaRoche, who brought it to market with the name
1090:
37:
1802:
3592:
3454:
3431:
3198:
938:
148:
3442:
3318:
3274:
770:
to multiple medications, and is one of several anti-malarial medications recommended by the United States
766:
Mefloquine is useful for the prevention of malaria in all areas except for those where parasites may have
458:
3448:
1233:
1033:
976:, can increase these effects. Combining mefloquine with halofantrine can cause significant increases in
934:
889:
809:
597:
2380:
2186:
Schlagenhauf P, Blumentals WA, Suter P, Regep L, Vital-Durand G, Schaerer MT, et al. (June 2012).
3683:
3668:
3368:
2646:
2059:
1237:
1202:
1147:
784:
276:
1112:
volunteers who participated in the approval study, so the drug regimen was switched to once a week.
505:
3688:
2935:
689:
324:
155:
2571:"Canadian soldiers allege anti-malaria medication left them with intense rage, suicidal ideations"
2485:
Overbosch D, Schilthuis H, Bienzle U, Behrens RH, Kain KC, Clarke PD, et al. (October 2001).
478:
3663:
3348:
3130:
2778:
2735:
2692:
2638:
2595:
2038:
950:
913:
739:
122:
2999:
1357:
70:
1963:
1834:
3079:
2990:
2869:
2824:
2770:
2727:
2684:
2630:
2508:
2467:
2426:
2217:
2168:
2127:
2030:
1919:
1773:
1724:
1634:
1479:
1473:
1452:
1446:
1427:
1194:
1130:
1037:
969:
946:
865:
696:
244:
231:
219:
50:
827:. Mefloquine does not eliminate parasites in the liver phase of the disease, and people with
3137:
3116:
2859:
2849:
2814:
2762:
2719:
2676:
2622:
2498:
2457:
2418:
2207:
2199:
2158:
2117:
2107:
2022:
1909:
1901:
1763:
1755:
1714:
1624:
1614:
1535:
1507:
1417:
1409:
852:
831:
malaria should be treated with a second drug that is effective for the liver phase, such as
815:
526:
254:
418:
398:
333:
3637:
2889:
2089:
2087:
843:
767:
602:
262:
2422:
1888:
Price RN, Uhlemann AC, Brockman A, McGready R, Ashley E, Phaipun L, et al. (2004).
813:
malaria, and is deemed a reasonable alternative for uncomplicated chloroquine-resistant
719:. It is therefore not recommended in people with a history of mental health problems or
509:
3598:
3569:
3257:
3108:
2939:
2864:
2837:
2395:
2212:
2187:
2163:
2146:
2122:
2095:
1914:
1889:
1768:
1743:
1719:
1702:
1629:
1602:
1422:
1397:
1236:
through both postsynaptic and presynaptic actions. The postsynaptic action to inhibit
1173:
1069:
972:. Combining mefloquine with other drugs that cause similar effects, such as quinine or
1905:
1890:"Mefloquine resistance in Plasmodium falciparum and increased pfmdr1 gene copy number"
3647:
3573:
3541:
3238:
3041:
3033:
2931:
2723:
2680:
1198:
1161:
909:
869:
824:
728:
700:
84:
2782:
2739:
2696:
2642:
3559:
3545:
3394:
3374:
3207:
3193:
3070:
3046:
3015:
3004:
2980:
2943:
2042:
1759:
1180:
1041:
977:
788:
469:
175:
170:
1260:
358:
28:
2096:"Mefloquine safety and tolerability in pregnancy: a systematic literature review"
1448:
The evolution of drug discovery : from traditional medicines to modern drugs
850:
and other parts of
Southeast Asia. The mechanism of resistance is by increase in
3513:
3423:
3399:
3384:
3379:
3333:
3282:
3243:
3151:
3125:
3120:
3051:
2974:
2963:
2462:
2445:
1285:
1230:
1222:
being successfully treated with mefloquine. Mefloquine can also act against the
1109:
804:
780:
294:
Primarily bile and feces; urine (9% as unchanged drug, 4% as primary metabolite)
78:
1413:
3505:
3436:
3364:
3343:
3328:
3221:
3141:
3056:
1564:
930:
832:
681:
562:
389:
2819:
2802:
2626:
1532:
World Health
Organization model list of essential medicines: 22nd list (2021)
3389:
3338:
3287:
3262:
3251:
3177:
3146:
2952:
2854:
2836:
Schlagenhauf P, Adamcova M, Regep L, Schaerer MT, Rhein HG (December 2010).
2803:"Controversies and misconceptions in malaria chemoprophylaxis for travelers"
2766:
2112:
1866:
1742:
Tickell-Painter M, Maayan N, Saunders R, Pace C, Sinclair D (October 2017).
1677:"Malaria - Chapter 3 - 2014 Yellow Book | Travelers' Health | CDC"
1619:
1601:
Schlagenhauf P, Adamcova M, Regep L, Schaerer MT, Rhein HG (December 2010).
973:
918:
724:
289:
64:
2873:
2828:
2774:
2731:
2688:
2634:
2611:"Mefloquine in the treatment of progressive multifocal leukoencephalopathy"
2512:
2221:
2172:
2131:
2034:
1993:
1923:
1777:
1728:
1638:
1504:
World Health
Organization model list of essential medicines: 21st list 2019
1431:
20:
2471:
2430:
2364:"Roche Submission to Committee Secretary Senate Foreign Affairs Australia"
968:
Mefloquine may cause abnormalities with heart rhythms that are visible on
3097:
2609:
Gofton TE, Al-Khotani A, O'Farrell B, Ang LC, McLachlan RS (April 2011).
2203:
1223:
1045:
957:
926:
922:
893:
885:
847:
720:
716:
369:
106:
2446:"Central anticholinergic syndrome with the antimalarial drug mefloquine"
1540:
1512:
378:
3531:
3172:
2838:"The position of mefloquine as a 21st century malaria chemoprophylaxis"
2542:"Germany bans drug linked to brain damage, ramps up pressure on Canada"
1603:"The position of mefloquine as a 21st century malaria chemoprophylaxis"
942:
881:
873:
792:
758:
Mefloquine is used to both prevent and treat certain forms of malaria.
712:
704:
685:
344:
2026:
888:. Mefloquine is therefore not recommended in people with a history of
1153:
In August 2009, Roche stopped marketing Lariam in the United States.
1119:
877:
708:
449:
2503:
2486:
1286:"Lariam 250 mg tablets - Summary of Product Characteristics (SmPC)"
438:
1744:"Mefloquine for preventing malaria during travel to endemic areas"
1065:
750:
749:
585:
576:
268:
2094:
González R, Hellgren U, Greenwood B, Menéndez C (February 2014).
429:
225:
2904:
238:
101:
1115:
By 1991, Hoffman was marketing the drug on a worldwide basis.
1703:"Mefloquine for malaria chemoprophylaxis 1992-1998: a review"
494:
1160:, who was later appointed Minister for Veterans Affairs by
201:
133:
2013:
AlKadi HO (2007). "Antimalarial drug toxicity: a review".
2755:
The Journal of Pharmacology and Experimental Therapeutics
1478:(23rd ed.). Oxford: Elsevier/Saunders. p. 569.
1398:"A lesson learnt: the rise and fall of Lariam and Halfan"
1516:. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
214:
2067:
Medicines for the Prevention of Malaria While Traveling
1451:(1. Aufl. ed.). Weinheim: Wiley-VCH. p. 136.
736:
World Health Organization's List of Essential Medicines
663:
2337:. Hoffman La Roche Limited. p. 18. Archived from
3621:
2383:. Guardian News & Media Limited. 24 October 2002.
2305:. Hoffman La Roche Limited. p. 6. Archived from
2273:. Hoffman La Roche Limited. p. 4. Archived from
2241:. Hoffman La Roche Limited. p. 3. Archived from
1255:
1253:
1029:
Specifically it is used as mefloquine hydrochloride.
3558:
3530:
3504:
3468:
3421:
3412:
3357:
3317:
3296:
3273:
3229:
3220:
3186:
3160:
3107:
3096:
3087:
3078:
3069:
3032:
3014:
2989:
2973:
2962:
2951:
1240:changes transmission across synapses in the brain.
1122:, Canadian soldiers were being prescribed the drug
1044:. The drug is currently manufactured and sold as a
596:
574:
561:
525:
520:
488:
468:
448:
428:
408:
388:
368:
343:
323:
298:
288:
275:
261:
253:
191:
186:
161:
147:
121:
91:
77:
59:
49:
44:
2615:Journal of Neurology, Neurosurgery, and Psychiatry
2381:"'It's not a benign drug - it has ruined my life'"
1312:"Lariam brand of mefloquine hydrochloride tablets"
1218:In June 2010, the first case report appeared of a
846:to mefloquine is common around the west border in
1569:The American Society of Health-System Pharmacists
1362:The American Society of Health-System Pharmacists
774:for this purpose. It is also recommended by the
357:
2801:Chen LH, Wilson ME, Schlagenhauf P (May 2007).
2558:. Telegraph Media Group Limited. 3 August 2019.
1139:
332:
3704:World Health Organization essential medicines
2916:
8:
1797:
1795:
1793:
1791:
1789:
1787:
620:FC(F)(F)c2cccc1c(cc(nc12)C(F)(F)F)(O)3NCCCC3
477:
110:
19:
2398:. Canvet Publications Ltd. Legion Magazine.
1748:The Cochrane Database of Systematic Reviews
1696:
1694:
1692:
1690:
1596:
1594:
1592:
1590:
1352:
1040:centres, which means it has four different
823:, which should be treated with intravenous
3418:
3226:
3104:
3093:
3084:
3075:
2986:
2970:
2959:
2923:
2909:
2901:
2071:Centers for Disease Control and Prevention
2054:
2052:
1350:
1348:
1346:
1344:
1342:
1340:
1338:
1336:
1334:
1332:
1261:"Mefloquine (Lariam) Use During Pregnancy"
1220:progressive multifocal leukoencephalopathy
917:be permanent." Neurologic effects include
772:Centers for Disease Control and Prevention
508:
397:
2863:
2853:
2818:
2596:"Lariam (Mefloquine) in the Armed Forces"
2502:
2461:
2211:
2162:
2121:
2111:
1913:
1767:
1718:
1628:
1618:
1539:
1511:
1421:
1391:
1389:
1387:
1385:
1383:
417:
2536:
2534:
2532:
2530:
2528:
2526:
2524:
2522:
1472:Farrar J, Hotez PJ, Junghanss T (2013).
1402:Journal of the Royal Society of Medicine
3628:
2375:
2373:
1559:
1557:
1555:
1553:
1551:
1249:
637:
617:
504:
377:
312:
83:
1083:Walter Reed Army Institute of Research
876:and neurological side effects such as
803:Mefloquine is used as a treatment for
707:and neurological side effects such as
18:
1534:. Geneva: World Health Organization.
1506:. Geneva: World Health Organization.
776:Infectious Disease Society of America
457:
69:
7:
3674:Drugs developed by Hoffmann-La Roche
2896:. U.S. National Library of Medicine.
2423:10.1001/archinte.1994.00420200116012
174:
2450:The New England Journal of Medicine
2147:"Malaria: prevention in travellers"
1815:from the original on 2 October 2013
1575:from the original on 7 January 2012
437:
348:
1720:10.1111/j.1708-8305.1999.tb00843.x
795:for treatment may be ineffective.
55:Lariam, Mephaquin, Mefliam, others
14:
1938:"Mefloquine hydrochloride tablet"
754:Mefloquine (Lariam) 250mg tablets
3631:
2724:10.1016/j.neuropharm.2005.09.011
2681:10.1016/j.neuropharm.2005.06.011
2444:Speich R, Haller A (July 1994).
1982:from the original on 2014-06-30.
1847:from the original on 2015-02-09.
1683:from the original on 2014-12-26.
1665:from the original on 2015-03-19.
549:
543:
537:
36:
27:
1368:from the original on 2015-12-08
723:. It appears to be safe during
645:Key:XEEQGYMUWCZPDN-DOMZBBRYSA-N
3460:piperaquine/dihydroartemisinin
1760:10.1002/14651858.CD006491.pub4
929:. Psychiatric effects include
555:
531:
1:
3024:trimethoprim/sulfamethoxazole
2544:. iPolitics. 9 December 2016.
2411:Archives of Internal Medicine
1906:10.1016/S0140-6736(04)16767-6
1135:University Hospital of Zurich
1081:Mefloquine was formulated at
271:; main metabolite is inactive
3422:Fixed-dose (co-formulated)
2569:Haines A (18 October 2019).
2491:Clinical Infectious Diseases
2394:Adams S (6 September 2017).
2192:Clinical Infectious Diseases
1999:Food and Drug Administration
1972:Food and Drug Administration
1701:Schlagenhauf P (June 1999).
906:Food and Drug Administration
676:, sold under the brand name
2463:10.1056/NEJM199407073310120
1106:Centers for Disease Control
992:Pregnancy and breastfeeding
3720:
1707:Journal of Travel Medicine
1544:. WHO/MHP/HPS/EML/2021.02.
1475:Manson's tropical diseases
1414:10.1177/014107680710011411
1358:"Mefloquine Hydrochloride"
1171:
900:Neurologic and psychiatric
521:Chemical and physical data
3699:Trifluoromethyl compounds
3582:
3304:sulfadoxine/pyrimethamine
2332:"Lariam product monogram"
2300:"Lariam product monogram"
2268:"Lariam product monogram"
2236:"Lariam product monogram"
1803:"Lariam medication guide"
1528:World Health Organization
1500:World Health Organization
1189:In autumn 2016, Canadian
1002:World Health Organization
684:used to prevent or treat
653:
628:
608:
303:
35:
26:
2820:10.1001/jama.297.20.2251
2627:10.1136/jnnp.2009.190652
949:, unusual behavior, and
839:Resistance to mefloquine
807:-sensitive or resistant
3455:artesunate/pyronaridine
3432:artemether/lumefantrine
2894:Drug Information Portal
2855:10.1186/1475-2875-9-357
2767:10.1124/JPET.106.101923
2113:10.1186/1475-2875-13-75
1620:10.1186/1475-2875-9-357
1396:Croft AM (April 2007).
939:auditory hallucinations
738:. It is available as a
3443:artesunate/amodiaquine
2145:Croft AM (July 2010).
1144:
755:
315:-(2-piperidyl)methanol
3679:Medical controversies
3477:artesunate/mefloquine
3449:artesunate/mefloquine
2151:BMJ Clinical Evidence
1859:"Malaria Information"
1234:synaptic transmission
935:visual hallucinations
890:psychiatric disorders
810:Plasmodium falciparum
753:
3489:quinine/tetracycline
3161:4-Methanolquinolines
2936:antiprotozoal agents
2069:. Atlanta, Georgia:
1808:. Hoffman La Roche.
1238:acetylcholinesterase
1148:atovaquone-proguanil
785:atovaquone/proguanil
3659:Antimalarial agents
3654:American inventions
3486:quinine/doxycycline
3483:quinine/clindamycin
3471:(not co-formulated)
2344:on 17 December 2011
2312:on 17 December 2011
2280:on 17 December 2011
2248:on 17 December 2011
1653:"www.idsociety.org"
921:, loss of balance,
886:ringing in the ears
717:ringing in the ears
680:among others, is a
234:(Prescription only)
210:(Prescription only)
23:
16:Pharmaceutical drug
3609:Never to phase III
3469:Other combinations
3349:dihydroartemisinin
3131:hydroxychloroquine
2204:10.1093/cid/cis215
1229:Mefloquine alters
1193:Brigadier General
1036:molecule with two
970:electrocardiograms
951:suicidal ideations
914:prescription label
904:In 2013, the U.S.
762:Malaria prevention
756:
740:generic medication
3619:
3618:
3554:
3553:
3526:
3525:
3522:
3521:
3500:
3499:
3496:
3495:
3408:
3407:
3313:
3312:
3216:
3215:
3065:
3064:
2991:Cryptosporidiosis
2813:(20): 2251–2263.
2712:Neuropharmacology
2669:Neuropharmacology
2417:(20): 2360–2362.
2198:(11): e124–e131.
2027:10.1159/000109767
1900:(9432): 438–447.
1445:Ravina E (2011).
1195:Hugh Colin MacKay
1131:contraindications
1066:Hoffmann-La Roche
1064:)-enantiomers by
1038:asymmetric carbon
984:Contraindications
799:Malaria treatment
671:
670:
587:Interactive image
490:CompTox Dashboard
242:
229:
217:
205:
137:
104:
3711:
3694:Racemic mixtures
3636:
3635:
3634:
3627:
3419:
3227:
3105:
3094:
3085:
3076:
2987:
2971:
2960:
2942:antiparasitics (
2925:
2918:
2911:
2902:
2897:
2877:
2867:
2857:
2832:
2822:
2787:
2786:
2761:(3): 1155–1160.
2750:
2744:
2743:
2707:
2701:
2700:
2675:(8): 1132–1139.
2664:
2658:
2657:
2655:
2654:
2645:. Archived from
2606:
2600:
2599:
2592:
2586:
2585:
2583:
2581:
2566:
2560:
2559:
2552:
2546:
2545:
2538:
2517:
2516:
2506:
2497:(7): 1015–1021.
2482:
2476:
2475:
2465:
2441:
2435:
2434:
2406:
2400:
2399:
2396:"Cure or curse?"
2391:
2385:
2384:
2377:
2368:
2367:
2360:
2354:
2353:
2351:
2349:
2343:
2336:
2328:
2322:
2321:
2319:
2317:
2311:
2304:
2296:
2290:
2289:
2287:
2285:
2279:
2272:
2264:
2258:
2257:
2255:
2253:
2247:
2240:
2232:
2226:
2225:
2215:
2183:
2177:
2176:
2166:
2142:
2136:
2135:
2125:
2115:
2091:
2082:
2081:
2079:
2078:
2064:
2056:
2047:
2046:
2010:
2004:
2003:
1990:
1984:
1983:
1981:
1968:
1960:
1954:
1953:
1951:
1949:
1934:
1928:
1927:
1917:
1885:
1879:
1878:
1876:
1874:
1865:. Archived from
1855:
1849:
1848:
1846:
1839:
1831:
1825:
1824:
1822:
1820:
1814:
1807:
1799:
1782:
1781:
1771:
1754:(10): CD006491.
1739:
1733:
1732:
1722:
1698:
1685:
1684:
1673:
1667:
1666:
1664:
1657:
1649:
1643:
1642:
1632:
1622:
1598:
1585:
1584:
1582:
1580:
1561:
1546:
1545:
1543:
1524:
1518:
1517:
1515:
1496:
1490:
1489:
1469:
1463:
1462:
1442:
1436:
1435:
1425:
1393:
1378:
1377:
1375:
1373:
1354:
1327:
1326:
1324:
1322:
1308:
1302:
1301:
1299:
1297:
1282:
1276:
1275:
1273:
1271:
1257:
1156:Retired soldier
1032:Mefloquine is a
816:Plasmodium vivax
667:
666:
659:
589:
569:
557:
551:
545:
539:
533:
513:
512:
498:
496:
481:
461:
441:
421:
401:
381:
361:
351:
350:
336:
280:
240:
237:
227:
224:
216:
213:
203:
200:
178:
135:
132:
114:
103:
100:
87:
73:
40:
31:
24:
22:
3719:
3718:
3714:
3713:
3712:
3710:
3709:
3708:
3644:
3643:
3642:
3632:
3630:
3622:
3620:
3615:
3614:
3599:Clinical trials
3578:
3561:
3550:
3533:
3518:
3492:
3470:
3464:
3414:
3404:
3353:
3320:
3309:
3292:
3269:
3231:DHFR inhibitors
3212:
3182:
3156:
3109:Aminoquinolines
3099:
3089:
3061:
3028:
3010:
2978:
2965:
2954:
2947:
2929:
2888:
2885:
2880:
2842:Malaria Journal
2835:
2800:
2796:
2794:Further reading
2791:
2790:
2752:
2751:
2747:
2709:
2708:
2704:
2666:
2665:
2661:
2652:
2650:
2608:
2607:
2603:
2594:
2593:
2589:
2579:
2577:
2568:
2567:
2563:
2554:
2553:
2549:
2540:
2539:
2520:
2484:
2483:
2479:
2443:
2442:
2438:
2408:
2407:
2403:
2393:
2392:
2388:
2379:
2378:
2371:
2362:
2361:
2357:
2347:
2345:
2341:
2334:
2330:
2329:
2325:
2315:
2313:
2309:
2302:
2298:
2297:
2293:
2283:
2281:
2277:
2270:
2266:
2265:
2261:
2251:
2249:
2245:
2238:
2234:
2233:
2229:
2185:
2184:
2180:
2144:
2143:
2139:
2100:Malaria Journal
2093:
2092:
2085:
2076:
2074:
2062:
2058:
2057:
2050:
2012:
2011:
2007:
1992:
1991:
1987:
1979:
1966:
1962:
1961:
1957:
1947:
1945:
1936:
1935:
1931:
1887:
1886:
1882:
1872:
1870:
1869:on 28 June 2016
1857:
1856:
1852:
1844:
1837:
1833:
1832:
1828:
1818:
1816:
1812:
1805:
1801:
1800:
1785:
1741:
1740:
1736:
1700:
1699:
1688:
1675:
1674:
1670:
1662:
1655:
1651:
1650:
1646:
1607:Malaria Journal
1600:
1599:
1588:
1578:
1576:
1563:
1562:
1549:
1526:
1525:
1521:
1498:
1497:
1493:
1486:
1471:
1470:
1466:
1459:
1444:
1443:
1439:
1395:
1394:
1381:
1371:
1369:
1356:
1355:
1330:
1320:
1318:
1310:
1309:
1305:
1295:
1293:
1284:
1283:
1279:
1269:
1267:
1259:
1258:
1251:
1246:
1216:
1203:Barbara Raymond
1191:Surgeon General
1176:
1170:
1079:
1027:
1015:
1010:
994:
986:
966:
902:
862:
860:Adverse effects
841:
801:
764:
748:
662:
660:
657:(what is this?)
654:
649:
646:
641:
636:
635:
624:
621:
616:
615:
603:Racemic mixture
592:
567:
554:
548:
542:
536:
516:
492:
484:
464:
444:
424:
404:
384:
364:
347:
339:
319:
316:
311:
310:
278:
255:Pharmacokinetic
249:
182:
150:
143:
124:
117:
17:
12:
11:
5:
3717:
3715:
3707:
3706:
3701:
3696:
3691:
3686:
3681:
3676:
3671:
3666:
3661:
3656:
3646:
3645:
3641:
3640:
3617:
3616:
3613:
3612:
3611:
3610:
3607:
3596:
3590:
3584:
3583:
3580:
3579:
3577:
3576:
3570:Blastocystosis
3566:
3564:
3556:
3555:
3552:
3551:
3549:
3548:
3538:
3536:
3528:
3527:
3524:
3523:
3520:
3519:
3517:
3516:
3510:
3508:
3502:
3501:
3498:
3497:
3494:
3493:
3491:
3490:
3487:
3484:
3481:
3478:
3474:
3472:
3466:
3465:
3463:
3462:
3457:
3452:
3446:
3440:
3434:
3428:
3426:
3416:
3410:
3409:
3406:
3405:
3403:
3402:
3397:
3392:
3387:
3382:
3377:
3372:
3361:
3359:
3355:
3354:
3352:
3351:
3346:
3341:
3336:
3331:
3325:
3323:
3315:
3314:
3311:
3310:
3308:
3307:
3300:
3298:
3297:Co-formulation
3294:
3293:
3291:
3290:
3285:
3279:
3277:
3271:
3270:
3268:
3267:
3266:
3265:
3260:
3258:chlorproguanil
3247:
3246:
3241:
3235:
3233:
3224:
3218:
3217:
3214:
3213:
3211:
3210:
3204:
3203:
3202:
3201:
3190:
3188:
3184:
3183:
3181:
3180:
3175:
3170:
3164:
3162:
3158:
3157:
3155:
3154:
3149:
3144:
3134:
3133:
3128:
3123:
3113:
3111:
3102:
3091:
3082:
3073:
3067:
3066:
3063:
3062:
3060:
3059:
3054:
3049:
3044:
3038:
3036:
3030:
3029:
3027:
3026:
3020:
3018:
3012:
3011:
3009:
3008:
2995:
2993:
2984:
2968:
2957:
2949:
2948:
2940:Chromalveolata
2932:Antiparasitics
2930:
2928:
2927:
2920:
2913:
2905:
2899:
2898:
2884:
2883:External links
2881:
2879:
2878:
2833:
2797:
2795:
2792:
2789:
2788:
2745:
2718:(3): 345–353.
2702:
2659:
2621:(4): 452–455.
2601:
2587:
2561:
2547:
2518:
2504:10.1086/322694
2477:
2436:
2401:
2386:
2369:
2355:
2323:
2291:
2259:
2227:
2178:
2137:
2083:
2048:
2021:(6): 385–391.
2005:
1985:
1955:
1929:
1880:
1850:
1826:
1783:
1734:
1713:(2): 122–133.
1686:
1668:
1644:
1586:
1547:
1519:
1491:
1484:
1464:
1457:
1437:
1408:(4): 170–174.
1379:
1328:
1303:
1292:. 3 April 2019
1277:
1248:
1247:
1245:
1242:
1215:
1212:
1174:Somalia affair
1169:
1166:
1078:
1075:
1070:pharmaceutical
1026:
1023:
1014:
1011:
1009:
1006:
993:
990:
985:
982:
965:
962:
908:(FDA) added a
901:
898:
870:hallucinations
861:
858:
840:
837:
800:
797:
763:
760:
747:
744:
701:hallucinations
669:
668:
651:
650:
648:
647:
644:
642:
639:
631:
630:
629:
626:
625:
623:
622:
619:
611:
610:
609:
606:
605:
600:
594:
593:
591:
590:
582:
580:
572:
571:
565:
559:
558:
552:
546:
540:
534:
529:
523:
522:
518:
517:
515:
514:
506:DTXSID50860636
501:
499:
486:
485:
483:
482:
474:
472:
466:
465:
463:
462:
454:
452:
446:
445:
443:
442:
434:
432:
426:
425:
423:
422:
414:
412:
406:
405:
403:
402:
394:
392:
386:
385:
383:
382:
374:
372:
366:
365:
363:
362:
354:
352:
341:
340:
338:
337:
329:
327:
321:
320:
318:
317:
314:
306:
305:
304:
301:
300:
296:
295:
292:
286:
285:
282:
273:
272:
265:
259:
258:
251:
250:
248:
247:
235:
222:
211:
197:
195:
189:
188:
184:
183:
181:
180:
167:
165:
159:
158:
153:
151:administration
145:
144:
142:
141:
139:
129:
127:
119:
118:
116:
115:
97:
95:
89:
88:
81:
75:
74:
67:
57:
56:
53:
47:
46:
42:
41:
33:
32:
15:
13:
10:
9:
6:
4:
3:
2:
3716:
3705:
3702:
3700:
3697:
3695:
3692:
3690:
3687:
3685:
3682:
3680:
3677:
3675:
3672:
3670:
3667:
3665:
3662:
3660:
3657:
3655:
3652:
3651:
3649:
3639:
3629:
3625:
3608:
3606:
3603:
3602:
3600:
3597:
3594:
3591:
3589:
3586:
3585:
3581:
3575:
3574:metronidazole
3571:
3568:
3567:
3565:
3563:
3557:
3547:
3543:
3542:Balantidiasis
3540:
3539:
3537:
3535:
3529:
3515:
3512:
3511:
3509:
3507:
3503:
3488:
3485:
3482:
3480:artesunate/SP
3479:
3476:
3475:
3473:
3467:
3461:
3458:
3456:
3453:
3450:
3447:
3444:
3441:
3438:
3435:
3433:
3430:
3429:
3427:
3425:
3420:
3417:
3411:
3401:
3398:
3396:
3393:
3391:
3388:
3386:
3383:
3381:
3378:
3376:
3373:
3370:
3366:
3363:
3362:
3360:
3356:
3350:
3347:
3345:
3342:
3340:
3337:
3335:
3332:
3330:
3327:
3326:
3324:
3322:
3319:Sesquiterpene
3316:
3305:
3302:
3301:
3299:
3295:
3289:
3286:
3284:
3281:
3280:
3278:
3276:
3272:
3264:
3261:
3259:
3256:
3255:
3254:
3253:
3249:
3248:
3245:
3242:
3240:
3239:pyrimethamine
3237:
3236:
3234:
3232:
3228:
3225:
3223:
3219:
3209:
3206:
3205:
3200:
3197:
3196:
3195:
3192:
3191:
3189:
3185:
3179:
3176:
3174:
3171:
3169:
3166:
3165:
3163:
3159:
3153:
3150:
3148:
3145:
3143:
3139:
3136:
3135:
3132:
3129:
3127:
3124:
3122:
3118:
3115:
3114:
3112:
3110:
3106:
3103:
3101:
3095:
3092:
3086:
3083:
3081:
3077:
3074:
3072:
3068:
3058:
3055:
3053:
3050:
3048:
3045:
3043:
3042:pyrimethamine
3040:
3039:
3037:
3035:
3034:Toxoplasmosis
3031:
3025:
3022:
3021:
3019:
3017:
3013:
3006:
3002:
3001:
2997:
2996:
2994:
2992:
2988:
2985:
2982:
2981:Coccidiostats
2976:
2972:
2969:
2967:
2961:
2958:
2956:
2950:
2945:
2941:
2937:
2933:
2926:
2921:
2919:
2914:
2912:
2907:
2906:
2903:
2895:
2891:
2887:
2886:
2882:
2875:
2871:
2866:
2861:
2856:
2851:
2847:
2843:
2839:
2834:
2830:
2826:
2821:
2816:
2812:
2808:
2804:
2799:
2798:
2793:
2784:
2780:
2776:
2772:
2768:
2764:
2760:
2756:
2749:
2746:
2741:
2737:
2733:
2729:
2725:
2721:
2717:
2713:
2706:
2703:
2698:
2694:
2690:
2686:
2682:
2678:
2674:
2670:
2663:
2660:
2649:on 2012-03-21
2648:
2644:
2640:
2636:
2632:
2628:
2624:
2620:
2616:
2612:
2605:
2602:
2597:
2591:
2588:
2576:
2572:
2565:
2562:
2557:
2551:
2548:
2543:
2537:
2535:
2533:
2531:
2529:
2527:
2525:
2523:
2519:
2514:
2510:
2505:
2500:
2496:
2492:
2488:
2481:
2478:
2473:
2469:
2464:
2459:
2455:
2451:
2447:
2440:
2437:
2432:
2428:
2424:
2420:
2416:
2412:
2405:
2402:
2397:
2390:
2387:
2382:
2376:
2374:
2370:
2365:
2359:
2356:
2340:
2333:
2327:
2324:
2308:
2301:
2295:
2292:
2276:
2269:
2263:
2260:
2244:
2237:
2231:
2228:
2223:
2219:
2214:
2209:
2205:
2201:
2197:
2193:
2189:
2182:
2179:
2174:
2170:
2165:
2160:
2156:
2152:
2148:
2141:
2138:
2133:
2129:
2124:
2119:
2114:
2109:
2105:
2101:
2097:
2090:
2088:
2084:
2072:
2068:
2061:
2055:
2053:
2049:
2044:
2040:
2036:
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1964:"www.fda.gov"
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1162:Boris Johnson
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1158:Johnny Mercer
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856:copy number.
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825:antimalarials
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821:P. falciparum
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48:
45:Clinical data
43:
39:
34:
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25:
3546:tetracycline
3439:/piperaquine
3395:pyronaridine
3375:tetracycline
3275:Sulfonamides
3250:
3208:halofantrine
3199:+ artemether
3194:lumefantrine
3167:
3071:Aconoidasida
3047:sulfadiazine
3016:Isosporiasis
3005:nitazoxanide
2998:
2893:
2890:"Mefloquine"
2845:
2841:
2810:
2806:
2758:
2754:
2748:
2715:
2711:
2705:
2672:
2668:
2662:
2651:. Retrieved
2647:the original
2618:
2614:
2604:
2590:
2578:. Retrieved
2574:
2564:
2550:
2494:
2490:
2480:
2456:(1): 57–58.
2453:
2449:
2439:
2414:
2410:
2404:
2389:
2358:
2346:. Retrieved
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2326:
2314:. Retrieved
2307:the original
2294:
2282:. Retrieved
2275:the original
2262:
2250:. Retrieved
2243:the original
2230:
2195:
2191:
2181:
2154:
2150:
2140:
2103:
2099:
2075:. Retrieved
2066:
2060:"Mefloquine"
2018:
2015:Chemotherapy
2014:
2008:
1997:
1988:
1970:
1958:
1946:. Retrieved
1941:
1932:
1897:
1893:
1883:
1871:. Retrieved
1867:the original
1863:Traveldoctor
1862:
1853:
1829:
1819:27 September
1817:. Retrieved
1751:
1747:
1737:
1710:
1706:
1671:
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1610:
1606:
1577:. Retrieved
1568:
1541:10665/345533
1531:
1522:
1513:10665/325771
1503:
1494:
1474:
1467:
1447:
1440:
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1401:
1370:. Retrieved
1361:
1319:. Retrieved
1315:
1306:
1294:. Retrieved
1289:
1280:
1268:. Retrieved
1264:
1228:
1217:
1208:
1188:
1185:
1181:Green Berets
1177:
1155:
1152:
1145:
1140:
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1123:
1118:By the 1992
1117:
1114:
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1008:Pharmacology
999:
995:
987:
967:
955:
903:
878:poor balance
863:
851:
842:
828:
820:
814:
808:
802:
789:halofantrine
765:
757:
746:Medical uses
733:
709:poor balance
694:
677:
673:
672:
661:
655:
470:NIAID ChemDB
459:ChEMBL416956
284:2 to 4 weeks
277:Elimination
193:Legal status
187:Legal status
93:License data
3684:Piperidines
3669:Drug safety
3595:from market
3514:clindamycin
3400:piperaquine
3385:clindamycin
3380:doxycycline
3369:+ proguanil
3334:artemisinin
3283:sulfadoxine
3244:cycloguanil
3222:Antifolates
3152:tafenoquine
3126:chloroquine
3121:amodiaquine
3088:Individual
3052:clindamycin
3000:thiazolides
2975:Conoidasida
1948:8 September
1296:8 September
1231:cholinergic
1110:Peace Corps
1091:Smith Kline
1013:Elimination
805:chloroquine
781:Doxycycline
570: g·mol
299:Identifiers
79:MedlinePlus
51:Trade names
3689:Quinolines
3648:Categories
3506:Babesiosis
3437:arterolane
3365:atovaquone
3344:artesunate
3329:artemether
3252:biguanides
3168:mefloquine
3142:primaquine
3100:inhibitors
3057:atovaquone
2653:2011-10-16
2077:2019-03-30
1244:References
1172:See also:
1068:, a Swiss
947:depression
931:nightmares
866:depression
844:Resistance
833:primaquine
768:resistance
697:depression
682:medication
674:Mefloquine
575:3D model (
563:Molar mass
419:TML814419R
390:ChemSpider
334:53230-10-7
325:CAS Number
308:IUPAC name
267:Extensive
263:Metabolism
112:Mefloquine
21:Mefloquine
3664:Chirality
3605:Phase III
3593:Withdrawn
3390:mepacrine
3339:artemotil
3288:sulfalene
3263:proguanil
3178:quinidine
3147:pamaquine
1321:9 October
1265:Drugs.com
1025:Chemistry
974:quinidine
919:dizziness
725:pregnancy
598:Chirality
290:Excretion
279:half-life
149:Routes of
123:Pregnancy
71:Monograph
65:Drugs.com
3638:Medicine
3560:Stramen-
3321:lactones
3098:Hemozoin
2874:21143906
2829:17519415
2783:22205111
2775:16501066
2740:13245990
2732:16288931
2697:28938736
2689:16081111
2643:19877728
2635:20562463
2580:16 April
2513:11528574
2348:24 April
2316:24 April
2284:24 April
2252:24 April
2222:22495078
2173:21418669
2132:24581338
2035:17934257
1977:Archived
1942:DailyMed
1924:15288742
1842:Archived
1810:Archived
1778:29083100
1729:10381965
1681:Archived
1660:Archived
1639:21143906
1573:Archived
1565:"Lariam"
1530:(2021).
1502:(2019).
1432:17404338
1366:Archived
1316:DailyMed
1270:31 March
1224:JC virus
1214:Research
1168:Military
1124:en masse
1056:)- and (
1048:of the (
1046:racemate
958:insomnia
927:tinnitus
923:seizures
894:epilepsy
882:seizures
848:Cambodia
829:P. vivax
721:epilepsy
713:seizures
690:by mouth
664:(verify)
370:DrugBank
163:ATC code
156:By mouth
138: B3
125:category
107:DailyMed
3415:nations
3173:quinine
3080:Malaria
2964:Apicom-
2865:3224336
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1077:History
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943:anxiety
912:to the
874:anxiety
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568:378.318
527:Formula
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345:PubChem
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171:P01BC02
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3451:(ASMQ)
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3090:agents
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703:, and
678:Lariam
613:SMILES
479:005218
450:ChEMBL
439:D04895
245:℞-only
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2736:S2CID
2693:S2CID
2639:S2CID
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