Mefloquine

CLINICAL USE

Malaria prophylaxis and treatment

DOSE IN NORMAL RENAL FUNCTION

Prophylaxis: 250 mg weekly Treatment: Non-immune patients 20–25 mg/kg in —2–3 divided doses; maximum 1.5 gPartially-immune patients 15 mg/kg in —2–3 divided doses

PHARMACOKINETICS

Molecular weight :414.8 (as hydrochloride)

%Protein binding :98

%Excreted unchanged in urine : 9 (+4% metabolites)

Volume of distribution (L/kg) :20

half-life – normal/ESRD (hrs) :21 days

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Use with caution Prophylaxis: Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in GFR <10 mL/min

HD :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Not dialysed. Dose as in GFR <10 mL/min

CAV/VVHD :Not dialysed. Dose as in GFR=10–20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anti-arrhythmics: increased risk of ventricular arrhythmias with amiodarone – avoid concomitant use

Antibacterials: increased risk of ventricular arrhythmias with moxifloxacin – avoid concomitant use

Anti-epileptics: antagonism of anticonvulsant effect

Antimalarials: increased risk of convulsions with chloroquine, hydroxychloroquine and quinine; avoid concomitant use with artemether and lumefantrine

Antipsychotics: increased risk of ventricular arrhythmias, avoid concomitant use with pimozide

Atomoxetine: increased risk of ventricular arrhythmiasIvabradine: increased risk of ventricular arrhythmias

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

Start prophylaxis 1–3 weeks before arriving in malarial area and continue for 4 weeks after leaving the malarial areaIncreased risk of convulsions in patients with epilepsy.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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