Mefloquine (Brand Name Lariam®) is an anti-malarial drug which is FDA-approved for use in regions where local strains of malaria have
developed resistance to other anti-malarial agents. In accordance with Health Affairs HA (Health Affairs) Policy 13-002 Guidance on
Medications for Prophylaxis of Malaria, 15 Apr 13, "In areas with chloroquineresistant malaria, either atovaquone-proguanil or doxycycline
are acceptable as first-line prophylactic medications. Mefloquine should be reserved for individuals with intolerance or contraindications
to both first-line medications. Before using mefloquine for prophylaxis, care should be taken to identify any contraindications on an
individual basis and ensure the U.S. Food and Drug Administration (FDA)-required patient information handouts are available for distribution."
On 29 July 2013, the U.S. Food and Drug Administration (FDA) issued a FDA Drug Safety Communication "advising the public about strengthened
and updated warnings regarding neurologic and psychiatric side effects associated with the antimalarial drug mefloquine hydrochloride.
A boxed warning, the most serious kind of warning about these potential problems, has been added to the drug label. FDA has revised the patient
Medication Guide dispensed with each prescription and wallet card to include this information and the possibility that the neurologic side
effects may persist or become permanent."
Below, we have provided information on Mefloquine/Lariam®, including clinical guidance, policies and directives,
training material, and other resources, to assist healthcare providers and Service members and their families.
Table of Contents
Policies and Directives
DoD / Joint Forces
VA (Veterans Administration)
Other Related Information
- Mefloquine Prescriptions in the Presence of Contraindications: Prevalence Among US military Personnel in Afghanistan, 2007, Pharmacoepidemiology and Drug Safety Volume 19 Issue 2, Pages 206 – 210, 2010
- Prevalence of Contraindications to Mefloquine Use Among USA Military Personnel Deployed to Afghanistan, Malaria Journal 2008, 7:30, 11 Feb 08
- Vestibular Dysfunction Among OEF/OIF Returnees PowerPoint Presentation, AFEB Meeting, 21 Sep 04
- The Risk of Severe Depression, Psychosis or Panic Attacks with Prophylactic Antimalarials, Drug Safety 2004; 27 (3): 203-213
- Tolerability of Malaria Chemoprophylaxis in Non-immune Travelers to Sub-Saharan Africa: Multicentre, Randomised, Double Blind, Four Arm Study; BMJ Vol 327, 8 Nov 03