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Tolerability of prophylactic Lariam regimens
E Boudreau1, B Schuster, J Sanchez
1Pharmaceutical Systems Incorporated, Gaithersburg, MD.
Tropical Medicine and Parasitology : Official Organ of Deutsche Tropenmedizinische Gesellschaft and of Deutsche Gesellschaft Fur Technische Zusammenarbeit (GTZ)
|September 1, 1993
Summary
Both mefloquine regimens were well tolerated by US Marines, with no functional impairment. Mefloquine use was associated with increased sleep disturbances and transient depressive feelings compared to chloroquine.
Area of Science:
- Tropical Medicine
- Clinical Pharmacology
- Military Health
Background:
- Mefloquine is a key antimalarial drug for malaria prevention.
- Understanding the tolerance and side effects of different mefloquine regimens is crucial for military personnel deployed to malaria-endemic areas.
Purpose of the Study:
- To compare the tolerance of two prophylactic mefloquine regimens against chloroquine in US Marines.
- To evaluate potential side effects including dizziness, incoordination, sleep disturbances, and mood changes.
Main Methods:
- Randomized double-blind clinical trial involving 359 US Marines.
- Comparison of weekly mefloquine (250 mg) vs. loading dose mefloquine (250 mg daily for 3 days, then weekly) vs. weekly chloroquine (300 mg).
- Assessment included daily/weekly physician interviews, computerized questionnaires, and actigraphy for sleep monitoring.
Main Results:
- Both mefloquine regimens were well tolerated with no functional compromise from dizziness or incoordination.
- Sleep disturbances and increased dream activity were more frequent in mefloquine groups.
- Transient depressive feelings were observed more in mefloquine groups initially but resolved over time.
Conclusions:
- Weekly mefloquine and loading dose mefloquine are well-tolerated prophylactic antimalarial options for US Marines.
- Monitoring for sleep disturbances and mood changes is recommended with mefloquine use.
- The loading dose regimen achieved steady-state plasma levels more rapidly than the weekly regimen.