Lariam

Protect yourself with Lariam (Mefloquine) antimalarial tablets

Lariam is no longer available from Dr Felix. Lariam has more severe side effects compared to other antimalarials. Please consider other malaria tablets as an alternative.

Lariam works well to prevent malaria in South America, most of Asia and sub-Saharan Africa. It is often taken in combination with Proguanil to provide greater protection.

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Strength Quantity Price Stock
250mg8 tablets£26.99Out of Stock
250mg9 tablets£28.99Out of Stock
250mg10 tablets£30.99Out of Stock
250mg11 tablets£32.99Out of Stock
250mg12 tablets£34.99Out of Stock
250mg13 tablets£37.99Out of Stock
250mg15 tablets£42.99Out of Stock
250mg19 tablets£51.99Out of Stock
250mg26 tablets£71.00Out of Stock
Prices exclude a prescription fee. This treatment requires a quick online consultation,
which a doctor will review to determine if a prescription is appropriate.

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Information

Virginia Chachati

Reviewed by Virginia Chachati MPharm
(2013, University College London)
GPhC Registration number: 2087654

Information last reviewed 31/01/21

About

What is Lariam?

Lariam (generic name Mefloquine) is a type of antimalarial used to prevent and treat certain types of malaria.

How does Lariam work?

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.

How effective is Lariam?

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.

Does Lariam protect against malaria?

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.

Ingredients

Active ingredients

The active ingredient in Lariam is mefloquine.

Inactive ingredients

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.

Dosage

How to take Lariam

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 dosage for children

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.

Is Lariam dosage different for adults and children?

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.

Side Effects

Lariam side effects

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:

  • Signs of a severe allergic reaction, including difficulty breathing, swollen tongue, itching and severe rash
  • Severe skin changes, including blistering and peeling, particularly around the mouth, eyes and genitals
  • Seizures or convulsions
  • Inflammation of the lungs
  • Severe changes in heartbeat including pounding, racing or palpitations
  • Severe liver problems, characterised by yellowing of the skin or whites of the eyes (jaundice), dark urine, light-coloured stools and general itchiness
  • Depression or anxiety
  • Suicidal thoughts
  • Self-endangering behaviour
  • Psychosis
  • Paranoia
  • Panic attacks
  • Unusual behaviour
  • Feeling of confusion
  • Hallucinations
  • Aggression or agitation
  • Restlessness
  • Unusual mood swings
  • Disturbance of attention

Less serious side effects may affect up to 1 in 10 people and include:

  • Sleeping problems
  • Dizziness
  • Headache
  • Problems with vision
  • Vertigo
  • Nausea or vomiting
  • Diarrhoea
  • Abdominal pain
  • Itching

The following side effects have also been reported, although their frequency cannot be estimated:

  • Abnormal blood tests demonstrating an increase or decrease in white blood cells, or a decrease in red blood cells or platelets. Symptoms may include mouth or throat ulcers, fever, chills, unexplained bruising, nosebleeds, bleeding in the stomach or vaginal bleeding
  • Kidney problems, including kidney failure, impairment, infection, cessation or blood in the urine. Symptoms may include dehydration, fatigue, swelling, shortness of breath, nausea or vomiting, loss of appetite, headache.
  • Decreased appetite
  • Headache
  • Fainting
  • Neuropathy with signs of pins and needles, weakness, new or worsening clumsiness, unsteadiness
  • Forgetfulness
  • Difficulty talking
  • Difficulties with sense of smell and taste, eye movement, facial sensation and expression, hearing, balance, taste, tongue movement, head-turning and shoulder raising.
  • Difficulties with vision
  • Difficulties with hearing
  • Symptoms of pancreatic problems, including stomach pain, nausea, vomiting, changes in blood pressure or heart rate and breathlessness
  • Indigestion
  • Rash
  • Hair loss
  • Sweating
  • Muscle weakness
  • Muscle cramps
  • Joint or muscle pain
  • Oedema
  • Tiredness
  • Fever or chills

If you experience any of the above side effects, consult your doctor for advice.

Contraindications

Do NOT take Lariam if you have or have ever had:

  • An allergy to any of the ingredients in this medication, or to similar medicines such as quinine or quinidine
  • Depression, thoughts about suicide or self-endangering behaviour
  • Any mental problems, including anxiety disorder, schizophrenia and psychosis
  • Seizures or convulsions
  • Severe liver problems
  • Blackwater fever

Before taking Lariam, tell your doctor or pharmacist if you have any of the following:

  • Epilepsy
  • Seizures or convulsions
  • Heart problems
  • Liver or kidney problems
  • Eye problems
  • Blood or lymphatic disorder
  • Neuropathy
  • Pneumonitis (inflammation of the lungs)
  • A history of malaria contraction despite taking Lariam as a preventative
  • Low blood glucose due to congenital hyperinsulinemic hypoglycemia

Drug interactions

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:

  • Halofantrine
  • Quinine, quinidine or chloroquine
  • Medicines for heart problems, including beta-blockers and calcium channel blockers
  • Antihistamines
  • Antidepressants, selective serotonin reuptake inhibitors (SSRIs), bupropion or antipsychotics
  • Epilepsy medications including sodium valproate, carbamazepine, phenobarbital, and phenytoin
  • Ketoconazole
  • Antibiotics such as rifampicin, penicillins and cephalosporins
  • Efavirenz
  • Tramadol
  • Medicines for diabetes or blood-clotting disorders

How to cope with Lariam side effects

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 side effects to watch out for

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.

Lariam and pregnancy

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.

Lariam and alcohol

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.

Treatment Options

Alternatives to Lariam

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.

Other ways to avoid malaria

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.

For which countries is Lariam suitable?

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.

Q&A

Is Lariam available on the NHS?

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.

Should I buy Lariam before I travel?

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.

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