ArticlePloS one2017
Adverse effects of mefloquine for the treatment of uncomplicated malaria in Thailand: A pooled analysis of 19, 850 individual patients.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The effect of mefloquine dose on outcome of uncomplicated falciparum malaria treated with artesunate-mefloquine: a WWARN systematic review and individual patient data meta-analysis.Malaria journal · 2026Pooled it
- Mefloquine for preventing malaria in pregnant women.The Cochrane database of systematic reviews · 2018Pooled it
- Mefloquine for preventing malaria in pregnant women.The Cochrane database of systematic reviews · 2018Pooled it
- Antimalarial chemoprophylaxis for forest goers in southeast Asia: an open-label, individually randomised controlled trial.The Lancet. Infectious diseases · 2023Trial
- Sequential Open-Label Study of the Safety, Tolerability, and Pharmacokinetic Interactions between Dihydroartemisinin-Piperaquine and Mefloquine in Healthy Thai Adults.Antimicrobial agents and chemotherapy · 2019Trial
- Artemether-Lumefantrine Versus Chloroquine for the Treatment of Uncomplicated Plasmodium knowlesi Malaria: An Open-Label Randomized Controlled Trial CAN KNOW.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Trial
- Pharmacokinetics and Pharmacodynamics of Antimalarial Agents: Optimizing Combination Therapies to Overcome Resistance Mechanisms.Journal of clinical pharmacology · 2026Review
- Long-Acting Antimalarial Drug Delivery Systems for Chemoprophylaxis: Formulation Strategies and Routes of Administration.Pharmaceutical research · 2026Review
- Innovative application of mefloquine and Methacycline in combating Tet(X3/X4)-positive Escherichia coli infections.BMC microbiology · 2025Article
- Synthesis of New Enantiopure Aminoalcohol Fluorenes as Promising Antimalarial Compounds.ChemMedChem · 2025Article
- Recent Advances in the Treatment of Malaria.Pharmaceutics · 2024Review
- Gut microbial β-glucuronidases influence endobiotic homeostasis and are modulated by diverse therapeutics.Cell host & microbe · 2024Article
- An In Silico and In Vitro Assessment of the Neurotoxicity of Mefloquine.Biomedicines · 2024Article
- Recent Updates on Interaction Studies and Drug Delivery of Antimalarials with Serum Albumin Proteins.Current medicinal chemistry · 2024Review
- Methylene Blue-Based Combination Therapy with Amodiaquine Prevents Severe Malaria in an Experimental Rodent Model.Pharmaceutics · 2022Article
- In Silico Drug Repurposing Approach: Investigation ofMolecules (Basel, Switzerland) · 2022Article
- Repurposing of FDA Approved Drugs Against SARS-CoV-2 Papain-Like Protease: Computational, Biochemical, andFrontiers in microbiology · 2022Article
- Mefloquine as a prophylaxis for malaria needs to be revisited.International journal for parasitology. Drugs and drug resistance · 2021Review
- Fever in the Returned Pediatric Traveler.Global pediatric health · 2021Review
- The Ototoxicity of Antimalarial Drugs-A State of the Art Review.Frontiers in neurology · 2021Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Mefloquine (MQ) has been used for the treatment of malaria since the mid-1980s, first as monotherapy or as fixed combination with sulfadoxine-pyrimethamine (MSP) and since the mid-1990s in combination with artesunate. There is a renewed interested in MQ as part of a triple therapy for the treatment of multi-drug resistance P. falciparum malaria. The widespread use of MQ beyond south-East Asia has been constrained by reports of poor tolerability. Here we present the side effect profile of MQ for the treatment of uncomplicated malaria on the Thai-Myanmar/Cambodia borders. In total 19,850 patients received seven different regimens containing either 15 or 24-25 mg/kg of MQ, the latter given either as a single dose, or split over two or three days. The analysis focused on (predominantly) gastrointestinal and neuropsychiatric events as compared to the new fixed dose combination of MQ plus artesunate given as equal doses of 8 mg/kg MQ per day over three days. Gastrointestinal side effects were dose-dependent and associated with the severity of malaria symptoms. Serious neuropsychiatric side effects associated with MQ use were rare: for a single 25 mg/kg dose it was 11.9 per 10,000 treatments (95% confidence interval, CI, 4-285) vs. 7.8 (3-15) for the 15 mg/kg dose. The risk with 25 mg/kg was much higher when it was given as repeat dosing in patients who had failed treatment with 15 mg/kg MQ in the preceding month; (RR 6.57 (95% CI 1.33 to 32.4), p = 0.0077). MQ was best tolerated as 15 mg/kg or as 24 mg/kg when given over three days in combination with artesunate. We conclude that the tolerance of a single dose of MQ in the treatment of uncomplicated malaria is moderate, but can be improved by administering it as a split dose over three days.
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