Chloroquine malaria from "Plasmodium vivax", "P. ovale", and "P. malariae", excluding the malaria parasite "Plasmodium falciparum", for it started to develop widespread resistance to it. Chloroquine has been extensively used in mass drug administrations, which may have contributed to the emergence and spread of resistance. It is recommended to check if chloroquine is still effective in the region prior to using it. In areas where resistance is present, other antimalarials, such as mefloquine or atovaquone, may be used instead. The Centers for Disease Control and Prevention recommend against treatment of malaria with chloroquine alone due to more effective combinations. In treatment
Mefloquine with an increased risk of birth defects or miscarriages. The drug may be used during breastfeeding, though it appears in breast milk in low concentrations. The World Health Organization gives approval for the use of mefloquine in the second and third trimesters of pregnancy and use in the first trimester does not mandate termination of pregnancy. Mefloquine is metabolized primarily through the liver. Its elimination in persons with impaired liver function may be prolonged, resulting in higher plasma levels and an increased risk of adverse reactions. The mean elimination plasma half-life of mefloquine is between two and four weeks. Total