Indications
Larimef Tablet is used for:
Malaria
Adult Dose
Oral
Acute Malaria
Adult: 5 tablets (Total 1250 mg) as a single oral dose. OR
750 mg orally as initial dose, followed by 500 mg orally 6 to 12 hours after initial dose. Total dose 1,250 mg.
Malaria prophylaxis
250 mg once weekly, taken 1-3 wk before exposure and continuing for 4 wk after leaving the endemic area.
Dosing Considerations
If a full-treatment course does not lead to improvement within 48-72 hr, mefloquine should not be used for retreatment; an alternative therapy should be used
Similarly, if previous prophylaxis with mefloquine failed, mefloquine should not be used for curative treatment
Child Dose
Oral
Acute Malaria
<6 months old: Safety and efficacy not established
Child: >6 months: 20-25 mg/kg PO as single dose. Maximum total dose: 1250 mg. OR
15 mg/kg as initial dose, followed by 10 mg/kg po given 6-12 hours after initial dose. Total dose= 25 mg/kg
Malaria prophylaxis
Child:
5 to <10 kg: 31.25 mg (1/8 tablet) PO qWeek
10 to <20 kg: 62.5 mg (1/4 tablet) PO qWeek
20 to <30 kg: 125 mg (1/2 tablet) PO qWeek
30-45 kg: 187.5 mg (3/4 tablet) PO qWeek
>45 kg: 250 mg (1 tablet) PO qWeek
Start 1-2 weeks before arrival in endemic area; continue 4 weeks after leaving endemic area
Renal Dose
Administration
Should be taken with food. Best taken w/ meals & a full glass of water.
Should be taken on the same day of each week.
Contra Indications
Hypersensitivity to related compounds (e.g. quinine and quinidine); history of blackwater fever;, prophylactic use in patients w/ history of psychiatric (including depression) or convulsive disorders; retreatment w/ mefloquine. Severe hepatic impairment. Concomitant use w/ halofantrine.
Precautions
Epilepsy; delay admin until at least 12 hr after the last dose of quinine/quinine-related compounds (monitoring of cardiac and neurological functions is warranted). Avoid driving or operating machines during and up to 3 wk after mefloquine use. Pregnancy, lactation; cardiac conduction disturbances; children <3 mth or 5 kg.
Lactation: Minimally excreted in human breast milk; based on a study in a few subjects, low concentrations (3% to 4%) excreted; caution advised
Pregnancy-Lactation
Pregnancy Category: B
Lactation: Minimally excreted in human breast milk; based on a study in a few subjects, low concentrations (3% to 4%) excreted; caution advised
Interactions
Increased risk of ECG abnormalities w/ quinine or chloroquine, antihistamines, TCAs and phenothiazines. May increase risk of seizure w/ quinidine or quinine. Concomitant use w/ valproic acid, phenobarbital, carbamazepine and phenytoin may cause loss of seizure control and lower plasma levels of anticonvulsants. Increased risk of QT prolongation and arrhythmia w/ ketoconazole. Concomitant use w/ digoxin, Ca-channel blockers, antiarrhythmics and ?-blockers may increase the risk of cardiotoxicity. Increased risk of ventricular arrhythmias w/ amiodarone. Concomitant use w/ TCAs, SSRIs, buprion, antipsychotic, tramadol may increase the risk of convulsions. Increased plasma levels w/ metoclopromide. May compromise adequate immunisation by live typhoid vaccine. Vaccinations w/ attenuated live bacteria should be completed at least 3 days prior the 1st dose of mefloquine.
Potentially Fatal: Avoid concomitant use w/ halofantrine as potentially fatal cardiac arrhythmias may occur.
Side Effects
Side effects of Mefloquine :
1-10%
Anxiety, Difficulty concentrating, Headache, Insomnia, Lightheadedness, Vertigo, Vomiting, Diarrhea, Stomach pain, Nausea, Visual disturbances, Tinnitus
Frequency Not Defined
Suicidal depression, Psychiatric Sx, Pneumonitis, Seizure, Abnormal ECG
Potentially Fatal: Seizures, thrombocytopenia, leucopenia, AV block, encephalopathy.
Mode of Action
Mefloquine is a 4-methanolquinine antimalarial agent and a blood schizontocide which acts by interfering w/ the parasite's ability to metabolise and utilise erythrocyte Hb. It is active against most Plasmodium sp and is used for prophylaxis and treatment against malaria.
Note
Larimef 250mg Tablet generic name is Mefloquine. Larimef 250mg Tablet is manufactured by Healthcare Pharmaceuticals Ltd.Larimef is availble in all over Bangladesh.
Mes BD drug index information on Larimef Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.