Larium or Mefloquine and Babesia Treatment
Larium is the brand name of Mefloquine, and two other brand names are Mephaquin or Mefliam) It was developed in the 1970s at the USA department of Defense, Walter Reed. It is a synthetic drug related to quinine. The brand name drug, Larium, is now gone and in the USA it is made by generic manufacturers.
I am not going to discuss its use to prevent and treat malaria. My investigation shows virtually nothing is published on the effectiveness of Larium against Babesia. Does it slow Babesia growth? Does it inhibit reproduction? Does it kill Babesia? And if it does any of these things, what dose is required?
Simply, we do not know. Based on my experience of inherited treatment failures, I believe Larium does not kill Babesia on typical doses. I am not sure how much Babesia inhibition exists, so I do not suggest it as a major option.
It may be of use to note that Larium is supposed to be taken much longer then Malarone (atovaquone/proguinil) before entering an area with malaria.
Mefloquine is useful for the prevention of malaria in all areas except for those where parasites may have resistance to multiple drugs. It is typically taken for one to two weeks before entering an area with malaria. Doxycycline and atovaquone/proguanil or Malarone provide protection within one to two days and may be better tolerated.
If a person becomes ill with malaria despite prevention with mefloquine, the use of halofantrine and quinine for treatment may be ineffective.
Larium should never be used in those with a seizure disorder in the past or who have a past psychiatric history. My impression is psychiatric effects are profoundly under-reported, and when I ask the right questions, psychiatric disorders are increased found with Larium. However, it is important to remember psychiatric symptoms can be caused by Bartonella, Babesia and Lyme disease. So some psychiatric troubles can be both this medication and these other infections-Bartonella, Babesia and Lyme disease.
The out of date FDA product guide states it can cause "mental health problems," including anxiety, hallucinations, depression, unusual behavior, and suicidal ideations, etc. At least about 15% of users report side effects that limit functioning. Such as dizziness, headaches, insomnia Mefloquine may cause abnormalities with heart rhythms which are detectable on EKGs.
The QTc interval should be watched, especially if this drug is added to others that can impact heart rhythms.
Mefloquine is metabolized primarily through the liver with a ½ life is typically two to four weeks. However, like other Babesia medications, stopping the drug may drop effect and side effects quickly, despite this long half-life.
Liver function tests should be performed during long-term administration of Mefloquine. Alcohol use should be avoided during treatment with Mefloquine. Mefloquine is two drugs in one — the (–)-enantiomer and the (+)-enantiomer… Some research suggests the (+) — is more effective in treating malaria, and the (–)-causes neurology and psychiatry troubles.
Mefloquine was invented at Walter Reed Army Institute of Research (WRAIR) in the 1970s shortly after the end of the Vietnam War. Mefloquine was one of literally ¼ million antimalarial compounds screened during the study. Walter Reed transferred all clinical trial data to Hoffman LaRoche and Smith Kline, and FDA approval was swift.
So fast that phase III safety and tolerability trials were skipped.
The Centers for Disease Control also weighed in and originally recommended a mefloquine dosage of 250 mg every two weeks; however, this caused an unacceptably high malaria rate in the Peace Corps volunteers who participated in the approval study, so the drug regimen was switched to once a week.
In 2001 a randomized, controlled trial was finally done, and about 65% had at least one serious adverse event. In 2002 there were murder/suicides at Ft. Bragg. There, four soldiers were accused of murdering their wives; two of these soldiers committed suicide. Their actions, as well as other military suicides, have been linked to Larium use.
Studies in the 1990s and early 2000s demonstrated mefloquine's neurotoxicity and significant ability to cause psychiatry and neurology adverse events.
The 2012 CDC travel yellow book removed mefloquine as its first line prevention medication.
In conclusion, I do not see any reason to use this medication for Babesia since we have more and more options for treatment.