Key Takeaways: Using Lariam Correctly

Start early: First dose 10 days before travel, second dose 3 days before.
Weekly schedule: Take on the same day each week with food and water.
Continue after return: Keep taking for 4 weeks after leaving malaria area.
Children's dosing: Based on weight; see table below.
Stop if side effects: Seek help immediately if you experience mood changes, anxiety, or unusual thoughts.

Lariam (mefloquine) is a prescription-only antimalarial tablet. Using it correctly is essential for effective protection. Follow this step-by-step guide based on the official Patient Information Leaflet and UK medical guidelines.

Important Medical Advice

If you experience suicidal thoughts, severe anxiety, hallucinations, or unusual behaviour while taking Lariam, stop the medication and seek immediate medical help. These side effects require urgent attention.

How to Take Lariam: Step-by-Step Usage Guide

Correct timing and administration are vital for Lariam to work effectively.

Before travel: Take your first tablet 10 days before you leave. This checks that you tolerate the medicine. Take the second tablet 3 days before departure.
During travel: Take one tablet on the same day each week. Choose a day you will remember (e.g., every Monday). Swallow the tablet whole with plenty of water, preferably after a meal.
After return: Continue taking the weekly tablet for 4 weeks after leaving the malaria area. This covers the incubation period of the parasite.
If you vomit within 1 hour: Take another dose. If vomiting persists, contact a doctor.
Missed dose: Take it as soon as you remember. If it's nearly time for your next dose (within 2-3 days), skip the missed dose and continue as usual. Do not double dose.

The full course is at least 6 weeks, depending on your length of stay. Never stop early.

Dosage Guide for Lariam (Mefloquine)

Dosage depends on body weight and age. Use the table below for prevention. For treatment of malaria, your doctor will give specific instructions (usually a total of up to 6 tablets, split into 2-3 doses).

Prevention Dosage Table

Weight	Approx. Age	Weekly Dose
5 – 19 kg	3 months – 5 years	¼ tablet
20 – 30 kg	6 – 8 years	½ tablet
31 – 45 kg	9 – 14 years	¾ tablet
Over 45 kg	Adults & children ≥15y	1 tablet (250 mg)

Note: Lariam is not recommended for infants under 3 months or weighing less than 5 kg. Do not use for more than 12 months continuously.

Tablets have a cross-score line and can be broken to obtain the correct dose.

Who Should Use Lariam and Who Should Not

Lariam is suitable for travellers to areas with chloroquine-resistant malaria, but not everyone can take it.

You should NOT take Lariam if you:

Are allergic to mefloquine, quinine, quinidine, or any tablet ingredients.
Have or have had depression, suicidal thoughts, self-endangering behaviour, or any mental illness (e.g., anxiety, schizophrenia, psychosis).
Have a history of seizures (fits) or epilepsy.
Have severe liver problems.
Have blackwater fever (a complication of malaria).
Are taking halofantrine (another malaria drug) or have taken it in the last 15 weeks.

Consult your doctor before use if you have:

Heart problems (especially rhythm disturbances).
Liver or kidney disease.
Eye problems (e.g., vision changes).
Blood disorders (low white cells, platelets).
Neuropathy (pins and needles, weakness).
Previous allergic reaction to Lariam.

Should Lariam Be Taken With Food or Without Food?

Always take Lariam with food and plenty of water. Taking it after a meal helps reduce nausea and other stomach side effects, and it may improve absorption. Swallow the tablet whole – do not chew or crush it.

If you have a sensitive stomach, taking it with a light meal or snack is recommended. Avoid taking it on an empty stomach.

Special Conditions: Pregnancy, Breastfeeding and Other Considerations

Pregnancy

Malaria during pregnancy is dangerous for both mother and baby. However, Lariam should normally be avoided in pregnancy unless the benefit outweighs the risk. If you are pregnant, planning pregnancy, or think you might be, discuss with your doctor before travel. It is generally recommended not to travel to malaria areas while pregnant.

Breastfeeding

Mefloquine passes into breast milk in small amounts. Lariam is not usually recommended for breastfeeding mothers. Your doctor can advise on suitable alternatives.

Elderly

No specific dose adjustment, but monitor for side effects, especially dizziness and neuropsychiatric symptoms.

Liver or kidney impairment

Avoid in severe liver disease. In mild-to-moderate impairment, use with caution. For kidney problems, no dose adjustment is usually needed but monitoring is advised.

Drug interactions

Lariam interacts with many medicines. Tell your doctor if you take:

Halofantrine (dangerous heart rhythm changes) – must not be used together or within 15 weeks after Lariam.
Quinine, quinidine, chloroquine.
Heart medications (beta-blockers, calcium channel blockers).
Antihistamines, antidepressants (SSRIs, tricyclics), antipsychotics.
Anti-epileptics (carbamazepine, phenytoin, valproate).
Ketoconazole (avoid within 15 weeks after Lariam).
Rifampicin, some antibiotics, efavirenz, tramadol.
Oral typhoid vaccine – take at least 3 days before starting Lariam.

Always provide a full list of your medications to your doctor.

Lariam Usage FAQs

When should I start taking Lariam before travel?

Take the first dose 10 days before departure, and the second dose 3 days before. This checks tolerability and builds protective levels before you enter a malaria area.

What if I vomit after taking Lariam?

If you vomit within 1 hour of taking the tablet, take another dose. If vomiting continues, seek medical advice as you may need a different antimalarial.

Can I take Lariam with other medications?

Lariam interacts with many drugs, including some heart medicines, antidepressants, and epilepsy treatments. Always tell your doctor about all medicines you take, including herbal products.

What should I do if I miss a weekly dose?

Take the missed dose as soon as you remember. If it's nearly time for your next dose (within 2-3 days), skip the missed one and continue on your usual day. Do not double dose.

Can I take Lariam if I am breastfeeding?

Lariam is usually not recommended during breastfeeding because it passes into breast milk. Discuss alternative malaria prevention with your doctor.

Need Lariam for Your Trip?

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