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 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