Serious adverse events of mefloquine in relation to blood level and gender.

Abstract

Abstract. Mefloquine is widely used for prophylaxis in areas with chloroquine-resistant falciparum malaria. As the use of mefloquine has increased, so have the reports on its adverse effects. We sought to evaluate the possible association between serum levels of mefloquine and serious side effects caused by this drug by means of a casecontrol design study. The study population included 17 patients who presented to emergency rooms or travel clinics with symptoms suggesting serious adverse effects of mefloquine and 28 controls (healthy people, still taking mefloquine after travel). The mean age of the patients and the controls was 31.5 Ϯ 11.6 years and 34 Ϯ 12.2 years, respectively. The percentage of women among the patients was higher than in the control population (76% versus 40%, respectively; P ϭ 0.03). Most of the complaints were related to the central nervous system (13 of 17); 5 patients interrupted their trip and 2 others were hospitalized. No difference in the level of mefloquine in the blood was found between the patients and the control groups. Also, no significant difference was found between mefloquine levels in the blood of men and women. These results suggest that blood levels of mefloquine do not correlate with its severe adverse events. Women tended to be more susceptible than men, despite having similar blood levels of the drug.

Neuropsychiatric events during prophylactic use of mefloquine before travelling

“…A possible explanation for differences between males and females might be that females are more aware of neuropsychiatric disturbances than males and communicate this more easily than males. Another explanation for differences between males and females might be a gender-specific difference in bioavailability or metabolism of mefloquine, although such a difference was not demonstrated in one small study [17]. The fact that individuals with a history of mefloquine use did not demonstrate neuropsychiatric abnormalities on the POMS may be explained by the phenomenon of 'depletion of susceptibles'.…”

Therapeutic Efficacy and Effects of Artesunate-Mefloquine and Mefloquine Alone on Malaria-Associated Anemia in Children with Uncomplicated Plasmodium falciparum Malaria in Southwest Nigeria

“…This rate may be an underestimate because younger children are less likely to volunteer adverse effects compared with older children. Adverse effects of MQ, for therapy or prophylaxis, are usually more frequent in girls [45][46][47][48][49][50] but may be unrelated to drug levels. 48 It was surprising that adverse effects were more common in male children and the reasons are unclear.…”

“…Adverse effects of MQ, for therapy or prophylaxis, are usually more frequent in girls [45][46][47][48][49][50] but may be unrelated to drug levels. 48 It was surprising that adverse effects were more common in male children and the reasons are unclear. Sex-related difference in drug metabolism has been described for a number of drugs 51 but not for MQ when administered with or without artesunate in non-pregnant women.…”

Effect of antimalarial drugs on the bioavailability of the methylenediphosphonic acid labeled with technetium99m (99mTc-MDP) in Wistar rats

“…It is indicated in severe malaria including cerebral malaria, and it ensures both suppression and cure of infections with multidrug resistant P. falciparum. It has no effect on gametocytes of P. falciparum and it does not eliminate exoerythrocytic (intrahepatic) stages of P. vivax (Schwartz et al, 2001). The exact mechanism of action of mefloquine is unknown.…”