[e-drug] Mefloquine as malaria chemoprophylaxis

["kae" <kaecherie@yahoo.co.uk>]

E-DRUG: Mefloquine as malaria chemoprophylaxis (feedback)
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Greetings E-Druggers,

First of all my deepest thanks for your prompt responses to my earlier
request for info on Maloprim, especially from Mrs Lee Baker, Dr Richard
Laing and Mr Andy Gray. You have greatly influenced our abandon of Maloprim
as suitable malaria chemoprophylaxis in our protocol with the detailed
information you sent. Thank you once again :-)!

Now to my new question: is there any contraindication to using mefloquine in delicate job situations, here I am thinking of piloting a ship or working in the ship engine rooms where psychotic side effects may endanger hundreds of volunteers? 

Most sources of information suggest that psychotic side effects
of mefloquine should appear within three weeks of starting, but it can
appear later according to ADR reports. If so, does it justify avoiding
mefloquine as malaria chemoprophylaxis in such job situations (a
clarification, we have no hesitation with its use in malaria treatment).

Were there similar problems with its use in the army, for example? I imagine
handling weaponry would be a sensitive job situation. Since mefloquine is
available as generics at low cost and is one of the first chemoprophylaxis
(if not the only) recommended for malaria in west Africa, I would welcome
any comments on this. 

Thank you and best regards,

Kae

Kae Ting Trouilloud
Pharmacist/Editor, Mercy Ships formulary
kaecherie@yahoo.co.uk

[moderator: mefloquine was developed for the Vietnam war by the Walter Reed institute, but the war was lost before the drug was ready...
Iraq has no malaria as far as I know. Maybe Afghanistan?

More serious: I know that Lufthansa pilots are not allowed to use mefloquine for malaria prophylaxis.

Difficult to recommend what to do for a ship captain. WB]