Lariam (Mefloquine) 250mg Tablet (UK)

Lariam is an anti-malarial medication used to help prevent malaria when travelling to countries with a malaria risk. Each tablet contains the active ingredient mefloquine 250mg.

Take Lariam tablets with plenty of water, and preferably with food. Swallow the tablets whole, do not suck or chew them.

• the tablets should be taken once weekly, always on the same day.
• You should start taking the tablets at least 1 week and up to 2 - 3 weeks before departure. You should continue taking the tablets throughout your stay and for 4 weeks after your return. If you forget to take a dose, take one as soon as you remember, then go on as before.
• For effective prevention you must take the full course of tablets.
• No anti-malarial tablets are completely effective. Malaria can occur during or after preventative medication. If you develop a fever or flu-like symptoms during your travels or within 2 to 3 months after you leave the malarious area, check with a doctor immediately.

Below is an example which gives the recommended dose for a 2-week stay in an area where malaria is present:

Adult dose:

One tablet weekly

Adults weighing less than 45kg (99lbs) should take the children's dose (see below).

Whether you are an adult or a child you should not take the tablets for more than 12 months.

Children's dose:

The tablets are not recommended for children under 3 months of age, i.e., those who weigh less than 5kg (11lbs). For children over this weight, the dose is shown in the table below. The tablets can be divided by breaking along the score lines. As in adults, the dose should be taken once weekly on the same day, and continued for 4 weeks after return.

1. Weight: 5 - 19kg (11 - 42lbs) Age: (Approx) 3 months - 5 years Dose: ¼ tablet
2. Weight: 20 - 30kg (44 - 66lbs) Age: (Approx) 6 - 8 years Dose: ½ tablet
3. Weight: 31 - 45kg (68 - 99lbs) Age: (Approx) 9 - 14 years Dose: ¾ tablet

Do not take Lariam:

• If you suffer from or have ever suffered from fits, mental complaints (anxiety disorder, schizophrenia, psychosis) or severe changes of mood (such as depression), thoughts of suicide, you should not take Lariam (Mefloquine) for the prevention of malaria.
• If you have severe liver problems.
• If you are pregnant or breast-feeding, unless your doctor tells you to take Lariam.
• If you are allergic to Lariam, any of the ingredients it contains or to similar medicines such as quinine, quinidine or chloroquine.
• If you are also taking any other anti-malarial medicines such as quinine, quinidine or chloroquine.
• If you have recently (in the last 3 days) received an oral vaccine to help prevent you from catching typhoid or similar diseases as taking Lariam may stop the vaccine from working properly.
• If you have ever had blackwater fever (a complication of malaria that affects the blood and kidneys.

Make sure your doctor knows if you:

• have a history of psychiatric illness
• have heart trouble
• are taking any medicines for heart trouble, high blood pressure; blood clotting disorders or diabetes; antihistamines for allergy; tricyclic antidepressants; phenothiazines, used for treatment of some psychiatric disorders, or any medicine for the treatment of epilepsy (e.g. sodium valproate, carbamazepine, phenobarbital, phenytoin).
• have kidney problems
• If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine

Halofantrine (which is used to treat malaria) and Lariam taken at the same time can slow the heart beat to a dangerous level. Therefore, to help avoid the possibility of a heart attack, you must not take halofantrine if you are already taking, or have recently taken, Lariam.

Pregnancy and breast-feeding:

If you are a woman of child-bearing age, you should take reliable contraceptive precautions whilst you are taking Lariam (Mefloquine) and for 3 months after the last dose.

Normally pregnant women should not take these tablets. It is important to tell your doctor if you are pregnant or think you could be pregnant, as she or he may decide that you should not use this medicine.

If you are taking these tablets it is recommended that you do not breast-feed.

Storage

• The tablets should be stored in a dry place.
• Store in the original package to protect from moisture.

Keep this medicine out of the reach and sight of children.

Return any left over medicine to your pharmacist. Only keep it if your doctor tells you to.

Remember this medicine is for you. Only a doctor can prescribe it for you. Never give it to others. It may harm them even if their symptoms are the same as yours.

The medicine must not be used after the date (EXP) printed on the pack.

If you are concerned about any unwanted effects please seek medical advice as soon as possible but before taking your next tablet. If necessary, the doctor may advise you to stop taking Lariam and take an alternative antimalarial agent.

Lariam can stay in the body for a long time after taking the last dose and therefore some adverse reactions may occur or persist for more than several weeks.

Most common unwanted effects (may affect up to 1 in 10): feeling or actually being sick, dizziness, vertigo, loss of balance, headache, sleepiness, sleep problems, diarrhoea, stomach ache. If you feel dizzy, do not drive or carry out tasks requiring a high degree of co-ordination.

Less common unwanted effects:

Effects on nervous system: psychiatric reactions which may be disabling and last for more than several weeks. These include unusual changes in mood or behaviour, feelings of worry or anxiety, depression, feelings of persecution, crying, aggression, restlessness, forgetfulness, agitation, confusion, panic and hallucinations. If you experience any of these effects you should immediately stop taking Lariam and consult a doctor.

Other neurological reactions include fits, "pins and needles", weakness, visual disturbances, ringing in the ears, hearing impairment, co-ordination problems and shaking of the hands and fingers. There have also been rare reports of suicidal tendencies and suicide.

Effects on circulation: changes to blood pressure or heart rate, palpitations (awareness or thumping of your heart beat), chest pain.

Effects on skin/scalp: fluid retention, skin rash, itching, hair loss. In rare cases, skin reactions may be serious.

Other effects: feeling of weakness, breathlessness, muscle cramps, joint pains, muscle pains, tiredness, fever or chills, sweating, loss of appetite, indigestion, a change in the level of certain factors (e.g. white blood cells, platelets, enzymes) in your blood. There have also been rare reports of allergic reactions.

When should I seek advice? If you are taking Lariam and you experience any of the following symptoms tell a doctor straight away: Suicidal thoughts, self-endangering behaviour, severe anxiety, feelings of mistrust towards others (paranoia), seeing or hearing things that are not there, depression, feeling restless, unusual behaviour, feeling confused.

Stop Lariam immediately if you experience suicidal thoughts, severe anxiety or self-endangering behaviour and seek medical attention without delay.