Page 327 - ATP-P 11th Ed

Indications:
• Prevention of mild to moderate malaria caused by Plasmodium falciparum (including
chloroquine-resistant strains) and P. vivax
• Treatment of mild to moderate malaria caused by mefloquine-susceptible strains of
P. falciparum (both chloroquine-susceptible and resistant strains) and P. vivax
Adult dose:
• Prophylaxis: 250mg once weekly
° Initiate therapy 1 to 2 weeks prior to departure to endemic area.
° Dose must be administered on same day of week.
° Continue prophylaxis for 4 additional weeks upon return from endemic area.
• Treatment: 5 tablets (1250mg) to be given as a split dose taken 6–8hr apart.
• Do not take on empty stomach.
• Take with at least 240mL (8oz) glass water.
Pediatric dose:
• Prophylaxis:
° Children >45kg: one 250mg tablet should be taken in children
° Children <45kg: weekly dose decreases in proportion to body weight (3 to 5mg/kg SECTION 3
once weekly):
• 30–45kg: ¾ tablet
• >20–30kg: ½ tablet
• Up to 20kg: ¼ tablet
• Experience with mefloquine in infants <3 months or weighing <5mg is limited
° Initiate therapy 1 week prior to departure to endemic area.
° Dose must be administered on same day of week.
° Continue prophylaxis for 4 additional weeks upon return from endemic area.
• Treatment: 20–25mg/kg for nonimmune patients
° Splitting the dose into 2 doses taken 6–8 hours apart may reduce adverse effects.
° Treatment in children has been associated with early vomiting; if patient vomits within
30min of dose and a significant loss of drug is suspected by inspection of emesis, re-
dose patient with full dose; if vomiting occurs within 30 to 60 minutes, administer ½
the full dose.
° Do not administer on an empty stomach and give with ample water.
° For very young patients, dose may be crushed, mixed with water or sugar water and
may be administered via oral syringe.
° Experience in infants <3 months or <5kg is limited.
Contraindications:
• Hypersensitivity to related compounds (e.g., quinine, quinidine)
• Patients with:
° Active depression
° Recent history of depression

ATP-P Handbook 11th Edition 317