Mefloquine tolerability during chemoprophylaxis: focus on adverse event assessments, stereochemistry and compliance

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Abstract:

This longitudinal study of travellers to Africa taking mefloquine (MQ) chemoprophylaxis aimed to quantify and assess non-serious adverse events (AE) occurring during short-term prophylaxis and relate these to concentrations of racemic MQ, its enantiomers and metabolite. A total of 420 volunteers (52% F) participated. AEs with some impact on activities were reported by 11.2% of participants including 7.9% of neurological/psychiatric symptoms. Women were more likely to report AEs (P=0.02). The standardized questionnaires used showed more pathological indicators in travellers who reported subjective AE with significantly more dizziness, distress, sleep disturbances and a high total mood disturbance (TMD) in the AE group. There was, however, no significant performance deficit in computerized psychomotor tests in those experiencing AE. Furthermore, no significant differences were observed in enantiomer ratios, metabolite concentrations, or racemic MQ levels in participants with or without AEs suggesting that these factors are not the main predictors of mefloquine intolerability.

Keywords: adverse event; mefloquine

Document Type: Research Article

Affiliations: 1: Institute for Social and Preventive Medicine, University of Zurich 2: Centers for Disease Control and Prevention, National Center for Infectious Diseases, Atlanta 3: US Army Research Institute of Environmental Medicine, Natick, Maryland 4: Department of Bahavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta 5: Department of Chemistry, Falun Hospital 6: Pharmacy, Huddinge Hospital, Stockholm 7: Department of Infectious Diseases, Huddinge Hospital, Karolinska Institute, Stockholm 8: Medical School, University `G. dD'Annunzio', Chieti 9: Tropical Medicine Unit, F-Hoffmann La Roche, Basel

Publication date: August 1, 1996

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