Lariam (generic name Mefloquine) is a type of antimalarial used to prevent and treat certain types of malaria.
Malaria is a mosquito-borne disease of the plasmodium family. When a mosquito bites you, plasmodia get into your blood, make their way to the liver and reproduce before being released back into the blood to kill your red blood cells. If left undiagnosed or untreated, malaria can be fatal.
Lariam contains the active ingredient mefloquine, which works by attacking the parasites after they have passed through the liver into the blood.
Lariam is only effective in parts of the world where Plasmodium falciparum is not present. You must speak with a doctor about which type of antimalarial medication is suitable for your trip. Furthermore, no antimalarial medication is 100% effective, so it is essential to avoid being bitten by mosquitoes while travelling within a malarial area.
Lariam can protect against malaria in areas of the world where Plasmodium falciparum (the most prevalent and dangerous strain of malaria) is not present, such as South America, parts of Asia and sub-Saharan Africa. It is often taken in combination with Proguanil to provide a higher level of protection.
The active ingredient in Lariam is mefloquine.
The inactive ingredients in Lariam are poloxamer, microcrystalline cellulose, lactose monohydrate, maise starch, crospovidone, ammonium calcium alginate, talc, and magnesium stearate.
Please note: Different brands of Mefloquine (generic Lariam) can contain different inactive ingredients. Please read the Patient Information Leaflet provided for further details.
Severe allergic reactions to Lariam are rare, unless you have a known allergy to any of the ingredients in the medication. If you have previously had an allergic reaction (any severity) to this medication, do let your doctor know as you should not take it again. Symptoms of a severe allergic reaction are: a rash, trouble breathing, facial swelling and dizziness. This is a medical emergency and should visit your nearest emergency department right away.
Always take Lariam as instructed by a doctor. As an adult, you should take your first dose of Lariam 10 days in advance of your arrival in a malarial area, and your second dose three days in advance of arrival. After this, take one tablet a week, always on the same day each week, for the duration of your trip and an additional four weeks after you leave the malarial area. You should take Lariam for at least six weeks, depending on the duration of your trip. Make sure to avoid mosquito bites during your travels, as no antimalarial is 100% effective.
Lariam is not recommended for use in children under three months of age. For children aged three months to 5 years and weighing between 5kg and 19kg, the dosage is ¼ tablet taken once a week. Children aged 6 to 8 years and weighing between 20kg and 30kg should take ½ tablet once a week. Children aged 9 to 14 years and weighing between 31kg and 45kg should take ¾ tablet once a week. The recommended dose for adults is one tablet taken once a week.
Unlike some other antimalarials, Lariam is suitable for use in children over the age of 3 months. Children will need to take a lower dose than adults, and you should speak to your doctor for advice before beginning a course of Lariam.
Like all medications, Lariam can cause side effects in some people. If you experience any of the following serious side effects, stop taking this medication and consult a doctor immediately:
Less serious side effects may affect up to 1 in 10 people and include:
The following side effects have also been reported, although their frequency cannot be estimated:
If you experience any of the above side effects, consult your doctor for advice.
Do NOT take Lariam if you have or have ever had:
Before taking Lariam, tell your doctor or pharmacist if you have any of the following:
Before taking Lariam, tell your doctor if you are taking any other medications, including those bought over the counter at a pharmacy without a prescription. In particular, tell your doctor if you are taking:
The most common side effect of Lariam is sleeping problems (affects around 1 in 10 people), including sleepiness, insomnia or bad dreams. Speak to your doctor for advice if these symptoms persist. It may be that a different type of antimalarial is better suited to you.
Lariam is known to cause mental problems in a small number of people. If you experience feelings of depression or anxiety while taking Lariam, stop taking it immediately and consult your doctor.
Pregnant women should avoid travel to malarial areas. Speak to your doctor before you take Lariam if you are pregnant or breastfeeding as it may not be suitable.
You can drink alcohol whilst taking Lariam, although you are advised to take caution and drink only in moderation. In combination with Lariam, alcohol can cause dizziness or drowsiness.
There are different types of antimalarials available in the UK. The type of antimalarial you need depends on your destination and the type of malaria prevalent there. Click here to find out which type of antimalarial you need for your travels.
Chloroquine is an alternative to Lariam that is also only taken once a week. Similarly, both need to be started well in advance of travelling to a malarial area, to be continued during your stay there and taken for four weeks after leaving. Therefore, you will need to plan well ahead of time to accommodate these antimalarials.
Malarone is a popular antimalarial. It is suitable for most areas where malaria is known to be prevalent and protects against Plasmodium falciparum. It is a more expensive option, but tends to have fewer side effects. Malarone only needs to be started two days before travelling to a malarial area and is ideal for short trips or last minute plans abroad.
Doxycycline is a cheaper alternative antimalarial, although it has more known side effects such as sensitivity to sunlight, which can be problematic for some travellers. It is an antibiotic that acts as a malaria preventative in some parts of the world.
While antimalarials provide a good level of protection against malaria, it is vital to avoid being bitten by mosquitoes in the first place. Make sure to wear insect repellent (preferably containing 50% DEET or higher) on exposed skin, particularly in the evenings and at night. You can buy mosquito repellent sprays, plug-ins and coils for your accommodation, as well as nets impregnated with insect repellent to hang over your bed at night. Where possible, avoid staying in accommodation that is close to stagnant water sources, such as lakes or ponds, as this is where mosquitoes breed. Keep your skin covered up in the evenings to prevent bites. For more tips on mosquito avoidance, click here.
Because Lariam does not protect against Plasmodium falciparum, it is not often used to prevent malaria on its own. It can be used to provide some protection in South America, sub-Saharan Africa and parts of Asia.
Antimalarial medication is only available on the NHS in exceptional circumstances. Lariam cannot be accessed through the NHS for travel purposes, and instead should be purchased from a doctor on a private prescription.
You will need to start taking Lariam 10 days before you arrive in a malarial area, so it is important to buy it well in advance of your trip.