Mefloquine, Oral

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KEY POINTS

• This medicine is taken by mouth to treat or prevent malaria. Take it exactly as directed.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause dizziness, balance problems, mental health problems, or other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antimalaria

Generic and brand names: mefloquine, oral

What is this medicine used for?

This medicine is taken by mouth to treat malaria. It is also used to prevent malaria when you travel in areas where the disease is common.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Heart disease or heart rhythm problems
• Liver problems
• Long QT syndrome (problems with electrical activity in the heart muscle)
• Mental health problems such as depression, anxiety, or schizophrenia
• Seizures

Vaccinations should be given at least 3 days before you start taking this medicine. Talk with your healthcare provider about this.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant while taking this medicine. Avoid becoming pregnant when you travel in areas where malaria is common. Use an effective birth control method while you are taking this medicine and for 3 months after you stop taking this medicine. Do not become pregnant for at least 3 months after the last dose of this medicine. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill.

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as directed by your healthcare provider. Do not take it on an empty stomach. Take the medicine with food or after a meal. Drink a large glass of water with each dose. The tablet may be crushed and mixed with milk or water to make it easier to swallow.

Check with your healthcare provider before using this medicine in children under age 6 months.

If you are taking this medicine to prevent malaria, you may need to start taking it a week or more before you travel. You will keep taking the medicine while you travel and for several weeks after you leave the area. Carefully follow your healthcare provider’s instructions.

If you vomit after taking this medicine, contact your healthcare provider to see if you should take another dose.

It is important that you keep taking this medicine for the full time your provider ordered. If you have serious side effects and cannot take the medicine, contact your healthcare provider right away. You need to get another medicine to protect you from malaria.

What if I miss a dose?

If you take this medicine once every 7 days and miss a dose, take it as soon as you remember then skip another 7 days until your next dose. If you take one or more doses a day and miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: severe nausea or vomiting, severe diarrhea, irregular heartbeat, severe dizziness, headache, change in behavior, seizures.

What should I watch out for?

If you take this medicine for a long time, you need to have blood tests or checkups regularly to see how this medicine affects you. Have your eyes examined more often while you are taking this medicine. Talk with your healthcare provider about this. Keep all appointments.

Call your healthcare provider right away if you start having:

• New or increased depression or thoughts of suicide
• Changes in mood or behavior such as becoming irritable, mistrustful, or anxious
• Hallucinations

This medicine may cause dizziness or affect your sense of balance even after you stop taking it. Do not drive or operate machinery unless you are alert and steady on your feet.

If you are taking this medicine to treat malaria, contact your provider if your symptoms don't improve within a few days or if they get worse.

Do not take any other medicines unless they are approved by the healthcare provider who prescribed this one.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine. Carry the drug information card in your wallet for as long as you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Some side effects may happen even after you stop taking this medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Severe dizziness or fainting, confusion, depression, thoughts of suicide, anxiety, restlessness, hallucinations; fever, cough, or sore throat; seizures; mouth sores; fast, slow, or irregular heartbeat; chest pain; unusual bruising or bleeding; changes in vision or hearing; yellowing of your eyes or skin; dark urine; light-colored bowel movements; severe nausea or vomiting, unexplained loss of appetite, or severe stomach pain; loss of balance or ringing in your ears; unusual tiredness or weakness; memory problems; severe skin rash, peeling, or blisters.

Other: Headache, mild nausea or stomach pain, mild dizziness, diarrhea, tiredness, muscle pains, bad dreams, trouble sleeping.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alpha blockers such as alfuzosin (Uroxatral) and silodosin (Rapaflo)
• Antibiotics such as azithromycin (Zithromax, Zmax), bedaquiline (Sirturo), ciprofloxacin (Cipro), clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), ofloxacin, pentamidine (NebuPent, Pentam), rifabutin (Mycobutin), rifampin (Rifadin), and rifapentine (Priftin)
• Antidepressants such as amitriptyline, citalopram (Celexa), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac), imipramine (Tofranil), nefazodone, nortriptyline (Pamelor), and trazodone
• Antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend)
• Antihistamines or medicines for hay fever, allergies, or colds such as brompheniramine, chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), and hydroxyzine (Vistaril)
• Antipsychotic medicines such as asenapine (Saphris), chlorpromazine, clozapine (Clozaril, FazaClo), haloperidol (Haldol), iloperidone (Fanapt), paliperidone (Invega), pimozide (Orap), quetiapine (Seroquel), thioridazine, and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), gabapentin (Neurontin), oxcarbazepine (Trileptal), phenobarbital, phenytoin (Dilantin, Phenytek), primidone (Mysoline), and valproic acid (Depacon, Depakene, Depakote)
• Antiviral medicines such as ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira) and simeprevir (Olysio)
• Apomorphine (Apokyn)
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), pindolol, and sotalol (Betapace, Sorine)
• Cancer medicines such as abiraterone (Zytiga), arsenic trioxide (Trisenox), bosutinib (Bosulif), crizotinib (Xalkori), dabrafenib (Tafinlar), degarelix (Firmagon), enzalutamide (Xtandi), idelalisib (Zydelig), lapatinib (Tykerb), mitotane (Lysodren), nilotinib (Tasigna), pazopanib (Votrient), sunitinib (Sutent), tamoxifen, toremifene (Fareston), vandetanib (Caprelsa), and vemurafenib (Zelboraf)
• Cholesterol-lowering medicines such as atorvastatin (Lipitor), lomitapide (Juxtapid), and lovastatin (Altoprev)
• Cimetidine (Tagamet)
• Colchicine (Colcrys)
• Conivaptan (Vaprisol)
• Dexamethasone
• Diabetes medicines such as glipizide (Glucotrol), glyburide (Glynase), metformin (Fortamet, Glucophage, Riomet), pioglitazone (Actos), repaglinide (Prandin), and rosiglitazone (Avandia)
• Doxepin (Silenor)
• Eliglustat (Cerdelga)
• Fingolimod (Gilenya)
• Heart medicines such as amiodarone (Cordarone, Pacerone), digoxin (Lanoxin), diltiazem (Cardizem, Cartia, Tiazac), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), flecainide, nicardipine (Cardene), nifedipine (Adalat CC, Procardia), procainamide, propafenone (Rythmol), quinidine, ranolazine (Ranexa), and verapamil (Calan, Covera, Verelan)
• HIV medicines such as atazanavir (Reyataz), cobicistat (Tybost), darunavir (Prezista), delavirdine (Rescriptor), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir, nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), saquinavir (Invirase), and tipranavir (Aptivus)
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune) and tacrolimus (Astagraf, Prograf, Protopic)
• Ivacaftor (Kalydeco)
• Ledipasvir/sofosbuvir (Harvoni)
• Live vaccines such as typhoid (You may need to receive your vaccines at least 3 days before starting this medicine.)
• Medicines to treat breathing or lung problems such as arformoterol (Brovana) and formoterol (Perforomist)
• Medicines to treat or prevent blood clots such as apixaban (Eliquis), dabigatran (Pradaxa), dipyridamole (Persantine), rivaroxaban (Xarelto), and warfarin (Coumadin)
• Methadone (Dolophine, Methadose)
• Mifepristone (Korlym, Mifeprex)
• Nausea medicines such as aprepitant (Emend), dolasetron (Anzemet), and ondansetron (Zofran)
• Other malaria medicines such as artemether/lumefantrine (Coartem), chloroquine, primaquine, and quinine
• Propranolol (Hemangeol, Inderal, InnoPran)
• St. John’s wort
• Tetrabenazine (Xenazine)

Do NOT eat or drink products that contain grapefruit, Seville oranges, and tangelos at any time while you are taking this medicine. These fruits and juices affect the way this medicine works and increase your risk of serious side effects. Talk with your healthcare provider or pharmacist about this.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.