Mefloquine (Lariam) for anti-malaria prevention
 

There are a couple earlier posts on this subject. This is just a reminder.. Ref: lariam

From another QP:

Here we go again:rolleyes:

It is bad stuff
 

Hunters in Africa are now mostly not taking any prophylactic malaria drugs. Larium is dangerous and the others almost useless. I, and most of my pals would rather wait until we feel unwell, then take a course of Coartem, which cures malaria pretty effectively, and with no side effects. I have just returned yesterday from the Limpopo River , a malaria area and will see if I get cold or flu like symptoms in a week. If so, Coartem at about $10 a dose should do the trick. No problem if you dont actually have Malaria, apart from wasting the $10.

Though you are from the area, your opinionated "information" regarding the efficacy and safety of current medication profiles is both inaccurate and irresponsible.

I would not be surprised if you, and a number of your colleagues, have a rather significant parasite load and are, in fact, asymptomatic carriers with a symbiotic relationship between yourselves and one plasmodium species or another.

Mefloquin has been used safely for decades. If you give enough people ANYTHING there is going to be a population of recipients who experience side effects. Mefloquin is no different.

All someone needs to do is watch late night TV and you can get a number for a lawyer who will listen to you complain about a drug, surgery, birth defect, allergic reaction, loss of hair, or the fact that the sunset was pink instead of purple on the 3rd weekend of Jun.

If you have a moment, read this from a British newspaper. It is also opinionated and the writer possibly another carrier, but all the same, worth reading. http://www.guardian.co.uk/society/20....lifeandhealth

Opinion.

Opinion regarding someone with KNOWN mental illness - and people looking to blame (and benefit from) someone OTHER THAN the individual who bears the true responsibility. :rolleyes:

There are any number of individuals who claim the exact same thing. And I will not argue the point that there are indeed probably a number of folks who have had negative side effects taking Lariam / Mefloquin...as well as there are those with negative effects from any number of other drugs that are out there.

If you read the first sentence of the article it says exactly what I am saying...
THOUSANDS take the drug every year, many WITHOUT any side effects...some C L A I M it causes serious side effects. And indeed for some it may. Doesn't make it a bad drug IF that can be proven to be the case. It means some people can't take it.

This issue is completely secondary to your post stating that most other drugs are useless and your preference to not prophylax against malaria and "wait until you feel bad" is not an option for soldiers; Special Operations or otherwise.

And I will also add that my CSM just got back from a 10day hunting trip in the Limpopo region - and the guide that he went with ENSURED he brought malaria prophylaxis with him (I wrote the prescription) and that he recommends the same to ALL visitors to his game reserve.

When you add your opinion to the medical forum, it should be stated as such so others do not take your information as any sort of factual information.

Are you familiar with Coartem? And do you know that most , malaria prophylactics (other than Lariam) are ineffective in Africa due to drug resistance of the parasite? There are even reports that Coartem is becoming less effective in the Far East because patients are taking just enough to make them feel better, but not enough to kill off the parasite infestation completely.

I am not going to get in a pissing contest with you, and I can assure you that as a requirement I research malaria prophylaxis for various regions of the world on a regular basis. Tolerance is rampant across the globe - that doesn't mean that anti-malarials are ineffective.

As far as Riamet / Coartem: yes, it is an "anti-malarial" that is ineffective for preventing malaria...but is used to treat malaria once diagnosed (including Falcip). It was routinely used when I was in Southeast Asia by civilian agencies but is not on the military formulary.

But that (again) has nothing to do with your previous post.

Is that the post where you diagnosed me and my buddies as being malaria carriers from many thousands of miles away?
Lariam has been discontinued by many large and knowledgeable organisations because of its inherent dangers. Coartem is a highly effective cure for malaria, although your military doesnt seem to think so. Many of the remainder of malaria treatments have become ineffective over time. We seem to agree on most of this, so where is the pissing contest? Over my state of health?

I provided no such diagnosis, but did say that I would not be surprised if in fact you were asymptomatic carriers as many people who live in endemic areas and do not utilize prophylaxis (it's not really practical) carry a parasite load as a normal function of their system. When we go into areas and eradicate their parasite load, they do in fact then become ill because their bodies are not used to functioning without parasites in their system.

You continue to assert your OPINION as medical fact, which it is not.

If Lariam was so dangerous, it wouldn't have recently been approved for use during pregnancy for malaria prophylaxis.

Now, this is THE LAST word on this subject from you unless you can produce your entomology degree, infectious disease research certificate, or some other document demonstrating your status as a health care provider with the ability to prescribe medications.
Further, I did not say that "out military doesn't think that Coartem is an effective cure for malaria". Being that Novartis still carries the patent on that medication, it is not cost effective to be placed on our formulary when there are other medications that work as well, for cheaper. After the patent runs out and the generics for Coartem flood the market, then it too will cost pennies per dose instead of dollars and the US Military may then look at adding to our formulary.

There may be a time in the future when Mefloquin is also advertised on late night TV for a class action lawsuit. Until then, the US Military will continue to use it and our people will continue to take it as directed.

Dissent and differing opinions are always welcome if they are coming from a known source and handled in a respectful manner between colleagues. Reckless recommendations without the appropriate disclaimer about the inherent Assumptions you make in your decision are potentially dangerous.

This thread really went off track when YOU stated
"I, and most of my pals would rather wait until we feel unwell, then take a course of Coartem, which cures malaria pretty effectively, and with no side effects. I have just returned yesterday from the Limpopo River , a malaria area and will see if I get cold or flu like symptoms in a week. If so, Coartem at about $10 a dose should do the trick. No problem if you dont actually have Malaria, apart from wasting the $10."

Statements like the above are exactly the type of posts that are unwanted on this site. Either there is ignorance to the multiple presentations (specifically the ASYMPTOMATIC presentation) of the disease processes being discussed, or you are uneducated and cavalier about your own health. That is your choice, and you are free to make it for you and your friends. Our membership expects the admins and moderators to vette information posted in this medical section. A significant number of the readers do not have a substantial medical education, so posts like yours could possibly be taken as an acceptable alternative or recommended treatment protocol. What may have worked for you and your friends does not equate to what is recommended for our entire membership.

Eagle5US's posts are well written and explain in detail why your post was challenged. If you will reread them, without being defensive, you will see his point. If you can't, then you probably shouldn't be posting recommendations in this forum anyway. Have a good one....

recent SOMA presentation on mefloquine
 

Dr. Remington Nevin, the army's expert on mefloquine toxicity was invited to present his latest DoD funded research to the Special Operations Medical Association's annual conference in Tampa this past December. Here is a link to the video:

http://www.youtube.com/watch?v=zTUgF3aYGqk

He was invited to the conference by the USASOC command surgeon, Col Peter Benson.

CDR Bill Manofsky USN(ret)

VA WRISSC lists mefloquine exposurr with Agent Orange and others
 

The VA War Realted Illness and Injury Study Center has formally recognized mefloquine toxicity by listing it on its exposure web page at the top with Agent Orange and Burn pits.

http://www.warrelatedillness.va.gov/.../exposures.asp

CDR Bill Manofsky USN(ret)

Thank you for your measured posts in this thread. A friend is experiencing some of the delayed symptoms that have been observed in, as you point out, the small population over the zillions of doses. He's not the kind to sit up at night & wait for the late-night lawyer ads. He'll proceed to the VA and get it checked out in an orderly & objective fashion and see if there's a correlation.

Thanks.