Mefloquine (a.k.a Lariam) anti-malarial in CF use (merged)

[McG]

You are not forced to take mefloquine.  There are two other drug choices.  Soldiers are given qualified medical advice and then are permitted to choose which anti-malarial drug they will take.

 

[Armymedic]

Forced.... no.
You are required to take some sort of anti malarial medications. Current approved medications for Ops in Afghanistan are:

Melfloquine (Lariam)-1 tablet a week starting 3 weeks prior until 4 weeks post exposure period
Malarone- Daily starting 1 week prior until 5 days after.
Doxycycline-1 per week.

There is also a post prophylaxis medication called Primiquimine which is taken for 4 weeks after you are complete the above meds.

I personally took Lariam on my tour earlier this yr.

I'm asking because I've read numerous reports that say that this drug has been scientifically linked with an endless list of terrible side effects.  It can cause horrible depression and quite a few suicides have been suspected from its use.  Also I recently read an article in which a group of American soldiers returning from Iraq were diagnosed with permanent brain damage caused by mefloquine.

Every drug has some sort of effect on your body. Some drugs have more them others.  In the case of Melfoquine, there are several mild to severe symptoms which vary in intensity on a individual basis. The question that must be asked "is the reason the drug is being used out weight the "side effects"? In this case does the prophylaxis effect of Larium in preventing soldiers in acquiring deadly strains of malaria out weight potential negative effects of the drug? In this specific case, the CF medical specialists say yes.

Also, if you further investigate the articles you mention, you will note addition mental and physical circumstance which are not quite so obvious or headline catching as the use of the antimalarial Larium. Melfoquine has been in use since the early 90's by literally hundreds of thousands of soldiers. Certainly a few murders in one distinct area by a specific group of people would have something more in common other then a medication they were using.

 

[a_himself]

Yeah I'm looking to put in for the next task force when they start taking names in January so I'm all nervous and spending a lot of time researching all these little details.  But you answered my question perfectly, thanks a lot guys.

 

[Scoobie Newbie]

that is being issued for those going overseas.  Thank you.

 

[ModlrMike]

The three most commonly used meds are:

Mefloquine;
Malarone; and
Doxycycline.

What you get depends on where you're going and whether you have any medical limitations vis-a-vis (allergy etc) these meds.

 

[Scoobie Newbie]

Thanks

 

[PMedMoe]

Malaria season is May-Nov inclusive.  If you stay in KAF there is no requirement for meds.

Normally, you will discuss with your MO and/or Pharm O which medication is best for you.

 

[Piper1911]

Malarone is the good stuff, as long as you remember to take it daily. Worked in Africa!

 

[Sparkplugs]

Malarone is the good stuff, as long as you remember to take it daily. Worked in Africa!

It's great until you discover an unknown anaphylactic allergic reaction to it somewhere in the mountains of Afghanistan, lol!

People give me a funny look now at the MIR when I say "Malarone" as one of my allergies.  ;D

 

[Fishbone Jones]

I don't know if they're still using Mefloquine, but that shit can have some pretty adverse side effects in some individuals. I switched off it and took Doxycycline on a daily basis instead.

 

[PMedMoe]

I don't know if they're still using Mefloquine, but that shit can have some pretty adverse side effects in some individuals. I switched off it and took Doxycycline on a daily basis instead.

I agree.  IMHO, some health care personnel are not screening people properly.  Doxy isn't really the greatest either, as one of the side effects is sun sensitivity.  Of course, one should be using sunscreen in A'stan anyway.....   

 

[dapaterson]

I guess I'm just a traditionalist - what's wrong with Gin and Tonic?

>

 

[PMedMoe]

I guess I'm just a traditionalist - what's wrong with Gin and Tonic?

Just make sure you get the tonic that has quinine in it. 

 

[PuckChaser]

I was on Mefloquine. Dreams were super vivid for the whole time I was on it, and for 2-3 days after taking the pill each week I had an upset stomach. Definitely was not a good feeling, but I heard worse about the other ones so I stuck with it, was only for 3 months.

 

[aesop081]

I took Malarone with no issues.

 

[Occam]

I don't know if they're still using Mefloquine, but that crap can have some pretty adverse side effects in some individuals.

Yes, I remember a certain fella who decided that he was going to try to take over the bridge of a ship and bring it back to Halifax...from the Indian Ocean. 

'Tis strange stuff, that mefloquine!

 

[Alea]

I remember having to take 1 Nivaquine a day, 365/365...

For those who have access to Nivaquine, it is one of the good medication against malaria (except if you have liver problems).
That said, most people I know who've been under any malaria medication ended up by catching the disease one day or another. I personally had Malaria (Paludisme) at least 10 times in my life if not more. When you live in Africa, you get this like you'd get the flue here.

Alea

 

[medicineman]

Took Mefloquine in Afghanistan - only had one cool dream that someone interrupted, otherwise no probs.  Took Malarone in Haiti - no biggy.  Some people there were on Chloroquine, which causes gut rot in some (as does Malarone), others were on Doxy.  Of course, it's all location dependant. 

MM

 

[captloadie]

When I was in Trenton, they did a blood test, which they explained to me was to determine which medication would be best for me. Then they put it in my med files and my vaccination booklet. I was however aircrew at the time.

 

[PMedMoe]

When I was in Trenton, they did a blood test, which they explained to me was to determine which medication would be best for me. Then they put it in my med files and my vaccination booklet. I was however aircrew at the time.

The blood test is for the presence or absence of G6PD (a blood enzyme) to determine if you can take Primaquine (terminal prophylaxis).  It doesn't determine which other medication you can take.  If your G6PD is "normal", you're good to go.  If the G6PD is "deficient", you cannot take Primaquine.  There are some experts who believe that a G6PD deficient person may have a natural immunity to malaria as it does not survive well in a G6PD deficient environment.

For those who have access to Nivaquine, it is one of the good medication against malaria (except if you have liver problems).

AFAIK, this medication is not available in the CF.

I personally had Malaria (Paludisme) at least 10 times in my life if not more. When you live in Africa, you get this like you'd get the flue here.

No, you probably have the type of malaria that remains dormant in the liver and periodically releases mature parasites into the bloodstream, causing recurring attacks of symptoms.  Either Plasmodium vivax or Plasmodium ovale.

Also, even when taking medication, insect discipline is important.  Medications (like vaccines) are not always 100% effective.