Mefloquine safety and tolerability in pregnancy: a systematic literature review

Mar 4, 2014Malaria journal

Mefloquine’s safety and side effects during pregnancy: a review of existing studies

AI simplified

Longevity & Aging on OpenScience ↗PubMed ↗DOI ↗

Abstract

Eighteen articles were reviewed regarding the use of mefloquine (MQ) in pregnant women for malaria prevention.

No differences were found in the risk of adverse pregnancy outcomes for women exposed to MQ compared to those on other anti-malarials or the general population.
Mefloquine combined with artesunate appears to be better tolerated than standard quinine therapy for treating non-severe falciparum malaria.
A loading dose of MQ (10 mg/kg) is associated with more dizziness compared to placebo.
When used for intermittent preventive treatment in pregnancy, MQ (15 mg/kg) may have more side effects than sulphadoxine-pyrimethamine.
There are no indications from the literature that MQ use during pregnancy increases risk for the fetus.

AI simplified

BACKGROUND: Control of malaria in pregnant women is still a major challenge as it constitutes an important cause of maternal and neonatal mortality. Mefloquine (MQ) has been used for malaria chemoprophylaxis in non-immune travellers for several decades and it constitutes a potential candidate for intermittent preventive treatment in pregnant women (IPTp).

METHODS: The safety of MQ, including its safety in pregnancy, is controversial and a continuing subject of debate. Published studies which evaluated the use of MQ for malaria prevention or treatment in pregnant women and which reported data on drug tolerability and/or pregnancy outcomes have been reviewed systematically.

RESULTS: Eighteen articles fitted the inclusion criteria, only one study was double-blind and placebo controlled. No differences were found in the risk of adverse pregnancy outcomes in women exposed to MQ compared to those exposed to other anti-malarials or to the general population. MQ combined with artesunate seems to be better tolerated than standard quinine therapy for treatment of non-severe falciparum malaria, but a MQ loading dose (10 mg/kg) is associated with more dizziness compared with placebo. When used for IPTp, MQ (15 mg/kg) may have more side effects than sulphadoxine- pyrimethamine.

CONCLUSIONS: In the published literature there are no indications that MQ use during pregnancy carries an increased risk for the foetus. Ideally, the use of MQ to prevent malaria should be based on a risk-benefit analysis of adverse effects against the risk of acquiring the infection. For this purpose double-blinded randomized controlled trials in African pregnant women are much needed.

Full Text

We can’t show the full text here under this license. Use the link below to read it at the source.

View full text (PDF) ↗

Mefloquine safety and tolerability in pregnancy: a systematic literature review

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the longevity & aging brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the longevity & aging brief