Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Lariam.
Anemia: Mefloquine may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired or pale skin, contact your doctor as soon as possible.
Dizziness/reduced alertness: Dizziness, a disturbed sense of balance, and other problems with the nervous system have been reported during and after the use of mefloquine. In some cases, these side effects have become permanent. Use caution when performing tasks requiring mental alertness and coordination (such as driving or operating machinery).
Drug interactions: Taking mefloquine at the same time as other medications, including quinine, quinidine, and chloroquine, may cause heart rhythm problems, cardiac arrest, or increase the risk of seizures. Do not take these medications at the same time as mefloquine. Halofantrine and ketoconazole may affect the electrical activity of the heart and cause QT prolongation. Do not take halofantrine or ketoconazole while taking mefloquine for the prevention or treatment of malaria, or for 15 weeks after the last dose of mefloquine.
Heart conditions: Mefloquine can cause heart rhythm problems. If you develop an abnormal or irregular heartbeat or palpitations while taking mefloquine to prevent malaria, contact a doctor as soon as possible. If you have heart rhythm problems, you should discuss with your doctor how Lariam may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Lariam, and whether any special monitoring is needed.
Liver disease: People with liver disease may experience higher blood levels of Lariam. If you have liver disease, talk to your doctor about the benefits and risks of using Lariam.
Mental problems: Some people taking mefloquine may experience psychiatric symptoms (including depression, generalized anxiety disorder, paranoia, hallucinations, and psychotic behaviour). In rare cases, they may have thoughts of suicide. If you have a history of psychiatric disturbances (including depression, generalized anxiety disorder, schizophrenia, or other major psychiatric disorders), you should not take Lariam.
If you are taking mefloquine to prevent malaria and you experience a sudden onset of anxiety, depression, thoughts of self-harm or suicide, restlessness or irritability, or confusion (which are possible signs of more serious mental problems), contact a doctor or health care provider as soon as possible. You may need to stop taking mefloquine and use another malaria prevention medication instead.
Nervous System Problems: Some people taking mefloquine may experience serious nervous system problems. If you experience dizziness, Vertigo or a spinning sensation, loss of balance, ringing in your ears, difficulty sleeping, or seizures, contact your doctor immediately. These side effects may occur at any time while you are taking mefloquine and in some cases have lasted for months or years after stopping mefloquine. In some people side effects of dizziness, vertigo, loss of balance and ringing in the ears have become permanent.
Seizure disorder: Mefloquine may increase the risk of seizures in people who have Epilepsy. People with a history of seizures should not take mefloquine to prevent malaria, and should only take mefloquine to treat malaria if the benefits outweigh the risks.
Stopping the medication: If you are told by a doctor or other health care provider that you need to stop taking mefloquine because of side effects or other reasons, you will need to take another malaria prevention medication. Leave the malaria area if you cannot get another medication. However, leaving the malaria area may not protect you from getting malaria; you still need to take a malaria prevention medication.
Pregnancy: If possible, it is best if pregnant women avoid travelling to areas where they risk malaria exposure. Lariam should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Lariam, contact your doctor immediately. Women of childbearing age should use reliable birth control while taking mefloquine and for 3 months after the last dose has been taken.
Breast-feeding: Lariam passes into breast milk. If you are a breast-feeding mother and are taking mefloquine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using Lariam have not been established for children less than 3 months old or weighing less than 5 kg.
