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