Plasmodium vivax the first-line treatment for "P. falciparum" malaria, it may also be used for P. vivax malaria in combination with primaquine for radical cure. An exception is artesunate plus sulfadoxine-pyrimethamine (AS+SP), which is not effective against P. vivax in many places. Mefloquine is a good alternative and in some countries is more readily available. Atovaquone-proguanil is an effective alternative in patients unable to tolerate chloroquine. Quinine may be used to treat "vivax" malaria but is associated with inferior outcomes. 32–100% of patients will relapse following successful treatment of "P. vivax" infection if a radical cure (eradication of liver stages) is not
Mefloquine of the users reported severe events requiring medical attention, vs 1.2% in the atovaquone-proguanil arm. The brand name drug, Lariam, is manufactured by the Swiss company Hoffmann–La Roche. In August 2009, Roche stopped marketing Lariam in the United States. In June 2010, the first case report appeared of a progressive multifocal leukoencephalopathy being successfully treated with mefloquine. Mefloquine can also act against the JC virus. Administration of mefloquine seemed to eliminate the virus from the patient's body and prevented further neurological deterioration. WRAIR has published several papers outlining ongoing efforts at that institution to make mefloquine safer by producing a