Mefloquine

Summary of Use during Lactation

Very small amounts of mefloquine are excreted in breastmilk; the amount of drug is not sufficient to harm the infant nor is the quantity sufficient to protect the child from malaria. Breastfeeding infants should receive the recommended dosages of mefloquine.[1]

Drug Levels

Maternal Levels. Two women who were 2 to 3 days postpartum were given mefloquine 250 mg orally. In one woman who provided milk samples periodically for 56 days, the milk mefloquine level declined from 53 to 32 mcg/L over this period. The average half-life in breastmilk for the 2 women was 16.6 days. The authors estimated that an exclusively breastfed infant would receive an average of 3.8% of the maternal weight-adjusted dosage of mefloquine after a single dose. However, this value could be higher with weekly doses because of accumulation.[2]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Atovaquone and Proguanil, Doxycycline, Chloroquine

References

1.

Centers for Disease Control and Prevention. CDC Yellow Book 2020: Health Information for International Travel. New York: Oxford University Press 2019. https://wwwnc​.cdc.gov​/travel/yellowbook/2020​/travel-related-infectious-diseases​/malaria.

2.

Edstein MD, Veenendaal JR, Hyslop R. Excretion of mefloquine in human breast milk. Chemotherapy. 1988;34:165–9. [PubMed: 3262044]

Substance Name

Mefloquine

CAS Registry Number

53230-10-7

Drug Class

Breast Feeding

Lactation

Anti-infective Agents

Antimalarials

Antiparasitic Agents

Antiprotozoal Agents