Mefloquine for malaria prevention

About mefloquine

Mefloquine tablets help to protect you from malaria when you travel to areas where this can be a problem. Malaria is a serious infection. It is common in tropical countries such as parts of Africa, Asia, South and Central America, and the Middle East. Malaria is a disease which is passed on to humans by infected mosquitoes. A parasite called plasmodium lives inside the stomachs of infected female mosquitoes and is passed on to humans by a bite. Mefloquine works by killing the parasites passed into your body from the bites of the infected mosquitoes.

Because the pattern of malaria varies with the part of the world you are travelling to, as well as the season and the type of activity you have planned, you should always obtain the latest advice about malaria prevention from your doctor, pharmacist or travel organiser. A backpacking trip may well require different preventative measures against malaria to those needed for a business trip to a city.

Mefloquine tablets are not available on the NHS, although you will require a prescription from a doctor to obtain them. You will be given a private (non-NHS) prescription to take to your local pharmacy, and you will be asked to pay for the tablets when they are supplied.

Mefloquine can sometimes be given to treat malaria in people who have become infected. This leaflet does not contain information about this, but your doctor can give you more information if you have been prescribed it for this reason.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking mefloquine it is important that your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breastfeeding.

• If you have epilepsy or have ever had fits (convulsions).

• If you have a heart condition.

• If you have ever had depression, severe anxiety, or any other mental health problem.

• If you have any problems with the way your liver works, or with the way your kidneys work.

• If you have had Blackwater fever (a complication of malaria infection).

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have ever had an allergic reaction to a medicine. It is particularly important that you tell your doctor if you have ever had a bad reaction to a medicine called quinine.
  

• Before you take mefloquine, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about mefloquine. It will also provide you with a full list of the side-effects which you may experience from taking it and what to do if you experience them.

• Take the tablets exactly as your doctor tells you to. The dose to prevent malaria in an adult is one 250 mg tablet once a week. Your dose will be printed on the label of the pack to remind you. (If you have malaria and you are taking mefloquine to treat it, your dose will be different to this.) If you are giving mefloquine to a child, the dose prescribed will depend on the weight of your child. Check the label carefully to make sure you are giving the correct dose.

• Start taking the course of tablets 2-3 weeks before you travel and continue to take them for four weeks after you return. Take the tablet on the same day of the week. If you develop any side-effects in the 2-3 weeks before you travel, speak with your doctor for further advice.

• Swallow the tablet with a drink of water during a mealtime (or just after a snack). If you prefer, the tablet can be crushed and mixed with a little food, such as jam or honey, to make it easier to swallow.

• If you forget to take a dose, take it as soon as you remember and then continue with your next dose on the usual day. Do not take two doses at the same time. You must complete the full course of tablets unless you are told otherwise by a doctor.

• These tablets will help prevent you from getting malaria, but it is also important that you take the following precautions against being bitten by mosquitoes:
  

  • Cover up bare areas of your arms and legs with long-sleeved, loose-fitting clothing, long trousers and socks. This is especially important if you are outside after sunset, as this is when mosquitoes feed.

  • Use an effective insect repellent spray on your clothing and any area of your skin which is bare. If you are also using a sunscreen, apply the sunscreen first and the insect repellent afterwards.

  • Spray the room with an insecticide each evening a couple of hours before you go to bed. Check your sleeping areas for mosquitoes - pay particular attention to furniture and areas under your bed where insects can hide.

  • If you are sleeping in an unscreened room, use a mosquito net impregnated with an insecticide.

• It is possible that mefloquine may make you feel dizzy and affect your balance. These effects may continue for a while, even after you have stopped mefloquine. Make sure you know how you react before you drive and before you use machines or tools.

• Your doctor will discuss with you the possibility of other unwanted side-effects. If you develop any changes in your moods, thoughts or behaviour, you should see your doctor before your next dose is due so that you can be given an alternative antimalarial medicine.

• If you have been advised to have an oral vaccine to protect you against typhoid, you should arrange to have this at least three days before you start taking mefloquine. This is because mefloquine can stop the vaccine from working properly.

• If you buy any other medicines to take, check with a pharmacist that they are safe to take alongside mefloquine.

• If you feel ill or develop a high temperature (fever) or flu-like symptoms while you are travelling or within one year (especially if it is within three months) of returning home, you should see your doctor straightaway. This is important, even if you have taken your antimalarial tablets correctly.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with mefloquine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. Speak with your doctor or pharmacist if any of the following continue or become troublesome.

If you experience any other symptoms which you think may be due to the tablets, discuss them with your doctor or pharmacist who will be able to advise you further.

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.