Mefloquine in "Pfmdr1" copy number. Mefloquine is contraindicated in those with a previous history of seizures or a recent history of psychiatric disorders. Severe side effects requiring hospitalization are rare. Compared to other malaria prophylaxis regimens, mefloqinone may produce more side effects in non-pregnant travelers. In pregnant travelers, it appears to pose minimal risk to the fetus. In 2013 the United States Food and Drug Administration added a boxed warning to the U.S. label of mefloquine regarding the potential for neuropsychiatric side effects that may persist even after discontinuing administration of the drug. Psychiatric effects include nightmares, visual and auditory hallucinations,
Mefloquine clearance is through the liver, and the primary means of excretion is through the bile and feces, as opposed to only 4% to 9% excreted through the urine. During long-term use, the plasma half-life remains unchanged. Liver function tests should be performed during long-term administration of mefloquine. Alcohol use should be avoided during treatment with mefloquine. Mefloquine is a chiral molecule with two asymmetric carbon centres, which means it has four different stereoisomers. The drug is currently manufactured and sold as a racemate of the ("R","S")- and ("S","R")-enantiomers by Hoffman-LaRoche, a Swiss pharmaceutical company. Essentially, it is two drugs in