Mefque
✅ Estää malarian
✅ Effective against chloroquine-resistant malaria
✅ Convenient once-weekly dosage
✅ Well-tolerated by most individuals
✅ Sopii pitkäaikaiseen käyttöön
Mefque contains Mefloquine.
✓ Lääketieteellinen tarkistus Morgan Ellis — Farmasian tutkija · 8 vuoden kokemus · Viimeisin arvio: toukokuu 2026
Pikavastaus
Mefque sisältää mefloquine 250 mg (Cipla). It is a once-weekly chemoprophylaxis option for chloroquine-resistant malaria in sub-Saharan Africa, India, Southeast Asia (excluding the Thai-Cambodia / Thai-Myanmar borders), and the Amazon. Adult dose: 250 mg once weekly, started 2–3 weeks before travel (to identify intolerance and reach steady state), continued during travel, and continued 4 weeks after return. Take with a full meal and water. Mandatory pre-travel test dose 3 weeks before departure — if neuropsychiatric side effects occur, switch to doxycycline or atovaquone-proguanil before flying. Contraindicated in patients with current or past depression, generalised anxiety disorder, psychosis, schizophrenia, bipolar disorder, seizure disorders, or significant cardiac conduction abnormality.
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Miksi tilata MedsBasesta
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About Mefque
Mefque is a 250 mg mefloquine hydrochloride tablet manufactured by Cipla under WHO-GMP certified conditions. Mefloquine was developed by the US Walter Reed Army Institute of Research in the 1970s and remains one of the three modern options (with doxycycline and atovaquone-proguanil) for prophylaxis in chloroquine-resistant areas. Its long half-life enables once-weekly dosing — convenient on long trips.
How mefloquine works
Mefloquine is a 4-quinolinemethanol antimalarial. Like chloroquine it interferes with parasite haem detoxification in the food vacuole, but is active against many chloroquine-resistant strains because it does not depend on the same parasite transport mechanism. It also has activity against blood-stage P. falciparum, P. vivax, P. ovale, and P. malariae. Mefloquine has substantial CNS penetration — desirable for parasitological efficacy, but the source of its neuropsychiatric side-effect profile.
Half-life is ~ 2–3 weeks. Once-weekly dosing reaches steady state by week 7–9; this is why most authorities recommend a 2–3 week pre-travel start.
Käyttöaiheet ja annostelu
| Käyttöaihe | Annos | Aikataulu |
|---|---|---|
| Chemoprophylaxis, adult | 250 mg once weekly | Start 2–3 weeks before entering malaria area; continue weekly during exposure; continue 4 weeks after return. |
| Paediatric chemoprophylaxis (≥ 5 kg) | 5 mg/kg once weekly (max 250 mg) | Same start / continue / stop schedule. Halved tablet for smaller children — exact mg/kg matters. |
| Acute uncomplicated chloroquine-resistant P. falciparum malaria, adult | 750 mg single dose, then 500 mg 6–12 h later (1 250 mg total) | Treatment doses cause significantly more side effects than prophylactic doses. Modern WHO preference is artemisinin combination therapy where available. |
| Standby emergency self-treatment of presumptive malaria | 750 mg + 500 mg as above | For travellers in areas without rapid medical access who develop a febrile illness compatible with malaria. Not a substitute for medical evaluation. |
Sivuvaikutukset
- Common (10–25 %): nausea, dizziness, vivid dreams, mild insomnia, headache.
- Less common (5–10 %): anxiety, mood change, fatigue, GI upset, mild hair loss, photosensitivity.
- Epätavallisia mutta tärkeitä: depression (sometimes severe), suicidal ideation, paranoia, hallucinations, panic attacks, dissociative symptoms — these often persist after stopping the drug.
- Harvinainen mutta vakava: seizures, encephalopathy, AV-block, bradycardia, severe cutaneous reactions (Stevens-Johnson, toxic epidermal necrolysis), agranulocytosis, severe hepatotoxicity, severe vestibular disturbance.
- Raskaus: can be used in second and third trimester for prophylaxis and treatment; first-trimester data are reassuring but limited. Use the lowest effective dose.
Lääkevuorovaikutukset
| Vuorovaikutus | Vaikutus | Hoito |
|---|---|---|
| Quinine / chloroquine / hydroxychloroquine | Lisääntyvä kardiotoksisuus + alentunut kouristuskynnys | Vältä yhdistelmää – käytä yhtä malarialääkettä. |
| Anticonvulsants (carbamazepine, phenytoin, valproate) | Mefloquine can lower the seizure threshold + reduces anticonvulsant levels via CYP3A4 | Mefloquine contraindicated in seizure disorder. |
| Beta-blockers / calcium channel blockers / digoxin | Additive bradycardia / AV-block | Cardiology review; consider alternative antimalarial. |
| Halofantriini | Severe QTc prolongation, fatal arrhythmia reported | Ehdoton vasta-aihe. |
| Ketoconazole / strong CYP3A4 inhibitors | Raise mefloquine level + QTc effect | Vältä yhdistelmää. |
| Rifampicin / rifabutin / strong CYP3A4 inducers | Lower mefloquine level — risk of prophylaxis failure | Vältä yhdistelmää; valitse vaihtoehtoinen malariahoito. |
| QT-prolonging drugs (azithromycin, ondansetron, antipsychotics, SSRIs / TCAs) | Lisää QT-ajan pitenemistä | Avoid in patients with electrolyte disturbance or pre-existing long QT. |
| Live oral typhoid vaccine (Ty21a) | Mefloquine inactivates the live vaccine | Complete vaccine series at least 12 hours before mefloquine. |
Vastu- ja varoitusmerkinnät
- Ehdoton: hypersensitivity to mefloquine or related quinoline antimalarials; current or past major depression, generalised anxiety disorder, psychosis, schizophrenia, bipolar disorder, seizure disorder; severe cardiac conduction abnormality (high-grade AV-block, severe bradycardia); concurrent halofantrine.
- Erittäin varovainen: prior depression / anxiety not currently active, recent traumatic brain injury, severe hepatic or renal impairment, vestibular disorders.
- Raskaus: compatible after the first trimester; first-trimester data limited but reassuring. Untreated falciparum malaria in pregnancy is far more dangerous.
- Imetyksen aikana: compatible — secreted in breast milk in low amounts insufficient for infant prophylaxis.
Säilytys
Store below 30 °C in a dry place, in original packaging. Keep out of reach of children.
Usein Kysytyt Kysymykset
Why start Mefque 2–3 weeks before travel?
Two reasons: to detect early neuropsychiatric intolerance (so you can switch antimalarial before flying) and to allow blood levels to climb toward steady state. Some authorities recommend 3 weeks; minimum is 2 weeks.
Who should NOT take mefloquine?
Anyone with current or past depression, generalised anxiety disorder, psychosis, schizophrenia, bipolar disorder, seizure disorder, severe cardiac conduction abnormality, recent traumatic brain injury, or strong family history of severe psychiatric illness. These patients should choose doxycycline (Cendox) or atovaquone-proguanil instead.
What if I get vivid dreams?
Vivid dreams alone are common (15–20 %) and often tolerable. Severe nightmares, sleep disturbance, anxiety, or mood change are reasons to switch antimalarial — do this BEFORE flying, while you still have alternatives available.
Is mefloquine still in widespread use?
Yes for prophylaxis in pregnancy (where atovaquone-proguanil is less established and doxycycline is contraindicated) and for travellers wanting once-weekly dosing on long trips. Many travel-medicine clinics now prefer atovaquone-proguanil where cost and side-effect profile are concerns; mefloquine remains a valid choice after a careful test dose.
Can I take Mefque and drink alcohol?
Moderate alcohol is acceptable. Heavy drinking amplifies CNS effects (dizziness, anxiety, mood disturbance) and should be avoided.
Does mefloquine cause permanent brain damage?
Most side effects resolve after stopping the drug. A minority of patients describe persistent symptoms (“post-mefloquine syndrome”). The mechanism is unclear and the prevalence is debated. The 3-week pre-travel test dose exists specifically to identify patients who should not continue the drug before persistent effects develop.
Can I take Mefque in pregnancy?
Yes — mefloquine is one of the preferred antimalarial prophylactics in pregnancy after the first trimester. First-trimester data are reassuring but limited. Untreated falciparum malaria in pregnancy is far more dangerous than mefloquine.
What if I miss a weekly dose?
Take it as soon as you remember. If it is more than 3 days late, take it and resume the original day-of-the-week schedule the following week. Do not double up.
Why does the dose differ for treatment vs prophylaxis?
Prophylaxis prevents the parasite from establishing infection — modest steady-state blood levels suffice. Treatment must clear an established parasitic load — much higher peak doses are needed (1 250 mg total over 12 hours), with proportionally higher side effects.
Should I take Mefque with food?
Yes — taking with a full meal substantially reduces nausea and improves absorption. Avoid taking on an empty stomach.
Can I take mefloquine for malaria treatment if I get sick on the trip?
Self-treatment of presumptive malaria is reserved for travellers in remote areas without medical access. If you can reach medical care, do that — modern artemisinin combination therapy is safer and more effective for established infection. Mefloquine treatment doses cause significantly more side effects than prophylactic doses.
Muut malarialääkkeet
- Cendox 100 mg — Doxycycline — daily alternative for travellers with neuropsychiatric contraindication to mefloquine
- Lariago 250 mg — Chloroquine — for the few remaining chloroquine-sensitive destinations only
- HCQS 200/400 mg — Hydroxychloroquine — alternative aminoquinoline with autoimmune crossover
- Primakiini 15 mg — Radical cure for P. vivax / P. ovale relapsing malaria — G6PD test required
- Kiniini 300 mg — Quinine — second-line treatment for chloroquine-resistant P. falciparum
Lisää vaihtoehtoja malaria-tableteissa
Luokiteltu MedsBase-tilausmäärän mukaan — mitä muut asiakkaat tässä kategoriassa valitsevat.
| Vahvuus | 250 mg |
|---|---|
| Määrä | 4 tablettia, 8 tablettia, 12 tablettia, 24 tablettia |
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