PropranololAdverse Effect: an increased risk of ECG abnormalities and cardiac arrestClinical Management: Caution should be used if mefloquine is to be administered to patients receiving concurrent propranolol, especially in patients with known cardiac disease. Carefully monitor ECG when this combination is given.
QuinineAdverse Effect: an increased risk of convulsions, electrocardiographic abnormalities, cardiac arrest, and decreased mefloquine efficacyClinical Management: If mefloquine and quinine are both used during the initial treatment of severe malaria, mefloquine should be administered at least 12 hours after the last dose of quinine.
Sodium Valproate Adverse Effect: loss of seizure controlClinical Management: If mefloquine and valproic acid must be administered concurrently, monitor the levels of valproic acid. Adjustments of the valproic acid dose may be required. Also monitor the patient for seizure control. |