Management
Seek expert advice
- mefloquine half-life is approximately 21 days - therefore elimination from the body is extremely slow
- mefloquine has no specific antidote
- mefloquine is non-dialysable
- there is a suggestion that oral activated charcoal may enhance elimination of mefloquine - this however has been incompletely studied
- often milder symptoms resolve spontaneously - therefore they require neither specific therapy or change of prophylactic drug
- if stopping mefloquine is indicated then mefloquine should be replaced with an alternative malaria chemoprophylaxis if the patient remains at risk of malaria transmission
- clinicians should seek expert advice if in doubt regarding management
- seizures secondary to mefloquine treatment should be treated with standard anti-convulsant therapy
- psychosis secondary to mefloquine often requires supervision by a psychiatrist
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