The first dose should be taken 1 week before travel. It should be continued weekly during the entire period of travel in malarious areas and for 4 weeks after departure from such areas.
All studies confirm that mefloquine is well tolerated when used for prophylaxis.
However, serious adverse reactions have been reported, especially when mefloquine was used for treatment of patients with malaria. Because mefloquine has been used in the United States for only 18 months, monitoring of adverse reactions remains important. Travelers to areas of risk where chloroquine-resistant P. falciparum is endemic and for whom mefloquine is contraindicated may elect to use daily doxycycline alone or chloroquine alone. Periodic shortages of mefloquine have occurred in the United States. Travelers who cannot obtain mefloquine before departure may be able to purchase it in Europe while in transit to countries with endemic malaria.