TM Owner Teva Pharmaceuticals
Mefloquine (Teva) 250 mg Tablet
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Indications & Clinical Uses
- Mefloquine (Teva) 250 mg tablets contain mefloquine hydrochloride, a generic antimalarial manufactured by Teva Pharmaceuticals and approved by the US FDA.
- It is used to treat mild to moderate malaria caused by Plasmodium falciparum, including strains resistant to chloroquine, and P. vivax, and to prevent malaria in adults and children travelling to areas with chloroquine-resistant malaria.
- Patients treated for P. vivax malaria require a follow-up course of primaquine to clear the dormant liver stage and prevent relapse.
- For prevention, dosing usually begins one to three weeks before travel, continues weekly during exposure, and continues for four weeks after leaving the malaria area.
- Mefloquine is also sold under brand names such as Lariam; the originator and generic products contain the same active ingredient and carry the same warnings.
Side Effects
- Mefloquine commonly causes dizziness, headache, nausea, vomiting, diarrhoea, abdominal pain, tiredness, loss of appetite, muscle aches and, very commonly, vivid or abnormal dreams and difficulty sleeping.
- Mefloquine (Teva)'s label carries a boxed warning: mefloquine can cause neuropsychiatric reactions, including anxiety, paranoia, depression, hallucinations, psychosis and, rarely, suicidal thoughts or behaviour, which can begin during treatment and persist for months or longer after the last dose.
- Dizziness, ringing in the ears (tinnitus) and loss of balance have occasionally been reported as permanent.
- Heart rhythm changes can occur, especially if combined with other heart-affecting medicines.
- Stop Mefloquine (Teva) and seek urgent medical help immediately if you develop anxiety, confusion, depression, restlessness or unusual behaviour, as these can be early warning signs requiring the drug to be stopped.
Precautions & Warnings
- Do not take Mefloquine (Teva) if you have a current or recent history of depression, generalised anxiety disorder, psychosis, schizophrenia or another major psychiatric disorder, or a history of convulsions, as mefloquine can trigger or worsen these.
- Use with caution if you have liver disease or a heart rhythm problem.
- Mefloquine can affect coordination and balance, so avoid driving or operating machinery if you feel dizzy, and avoid tasks requiring fine spatial judgement, such as flying or diving, during and shortly after treatment.
- Effective contraception is recommended during treatment and for three months afterwards.
- Mefloquine may be used in pregnancy if the risk of malaria outweighs the risk to the fetus; discuss breastfeeding with your healthcare provider, since the drug passes into breast milk.
- Take this tablet by mouth with food and a full glass of water, and complete the full prescribed course, whether for treatment or prevention.
Avoid Interactions
- Tell your healthcare provider about all medicines you take before starting Mefloquine (Teva).
- Do not take it with halofantrine, or within 15 weeks of stopping halofantrine, because the combination can cause fatal heart rhythm disturbances (QT prolongation); use ketoconazole with the same caution.
- Combining mefloquine with quinine, quinidine or chloroquine increases the risk of seizures and heart rhythm problems; wait at least 12 hours after a last dose of quinine before starting mefloquine.
- Mefloquine can lower the blood levels of anticonvulsant medicines such as valproic acid, carbamazepine and phenytoin, increasing seizure risk in people with epilepsy.
- Rifampicin substantially lowers mefloquine levels and may reduce its protective effect.
- Live oral typhoid vaccine should ideally be completed at least three days before starting mefloquine.
- Use beta-blockers and other heart-rate-affecting medicines cautiously alongside Mefloquine (Teva).
References
Frequently Asked Questions
Mefloquine (Teva) (mefloquine hydrochloride) 250 mg tablets treat mild to moderate malaria, including chloroquine-resistant Plasmodium falciparum, and prevent malaria before and during travel to affected areas. People with P. vivax malaria also need a follow-up course of primaquine. Mefloquine (Teva) is a US FDA-approved generic manufactured by Teva Pharmaceuticals.
For prevention, one 250 mg Mefloquine (Teva) tablet is taken once weekly, starting one to three weeks before travel and continuing for four weeks after leaving the malaria area. For treatment, a higher total dose is split over one to two days. Take it with food and plenty of water.
Common Mefloquine (Teva) side effects include dizziness, headache, nausea, vomiting, diarrhoea and vivid dreams. Its label carries a boxed warning for neuropsychiatric reactions, including anxiety, depression, hallucinations and, rarely, suicidal thoughts, which can persist after stopping. Seek urgent help for confusion, severe anxiety or unusual behaviour.
Do not take Mefloquine (Teva) if you have current or recent depression, anxiety disorder, psychosis or a history of seizures. Avoid halofantrine, and use ketoconazole, quinine and chloroquine with caution, since combining them raises the risk of dangerous heart rhythm changes or seizures. Tell your healthcare provider about all other medicines.
If you miss a weekly Mefloquine (Teva) dose, take it as soon as you remember, then return to your normal weekly schedule. Do not take two doses close together. Missing doses reduces protection against malaria, so set a reminder for the same day each week while travelling.
Mefloquine, the active ingredient in Mefloquine (Teva), can be used in pregnancy if the risk of malaria is judged to outweigh the risk to the baby, and available data have not shown clear harm. Effective contraception is advised during treatment and for three months afterwards.
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