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Details

Stereochemistry RACEMIC
Molecular Formula C17H16F6N2O.CH4O3S
Molecular Weight 474.418
Optical Activity ( + / - )
Defined Stereocenters 2 / 2
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of MEFLOQUINE MESYLATE

SMILES

CS(O)(=O)=O.[H][C@@]1(CCCCN1)[C@@H](O)C2=C3C=CC=C(C3=NC(=C2)C(F)(F)F)C(F)(F)F

InChI

InChIKey=GFKKBAFIZVIFAZ-YLCXCWDSSA-N
InChI=1S/C17H16F6N2O.CH4O3S/c18-16(19,20)11-5-3-4-9-10(15(26)12-6-1-2-7-24-12)8-13(17(21,22)23)25-14(9)11;1-5(2,3)4/h3-5,8,12,15,24,26H,1-2,6-7H2;1H3,(H,2,3,4)/t12-,15+;/m1./s1

HIDE SMILES / InChI

Molecular Formula CH4O3S
Molecular Weight 96.106
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Molecular Formula C17H16F6N2O
Molecular Weight 378.3122
Charge 0
Count
Stereochemistry RACEMIC
Additional Stereochemistry No
Defined Stereocenters 2 / 2
E/Z Centers 0
Optical Activity UNSPECIFIED

Mefloquine, sold under the brand names Lariam among others, is a medication used to for the treatment of mild to moderate acute malaria caused by Mefloquineuine-susceptible strains of Plasmodium falciparum (both chloroquine-susceptible and resistant strains) or by Plasmodium vivax. Also for the prophylaxis of Plasmodium falciparum and Plasmodium vivax malaria infections, including prophylaxis of chloroquine-resistant strains of Plasmodium falciparum. Mefloquine acts as a blood schizonticide. Mefloquine is active against the erythrocytic stages of Plasmodium species. However, the drug has no effect against the exoerythrocytic (hepatic) stages of the parasite. Mefloquine is effective against malaria parasites resistant to chloroquine. Mefloquine is a chiral molecule. According to some research, the (+) enantiomer is more effective in treating malaria, and the (-) enantiomer specifically binds to adenosine receptors in the central nervous system, which may explain some of its psychotropic effects.

CNS Activity

Curator's Comment: Male Wistar rats orally administered Mefloquine daily for 22 days at the equivalent human therapeutic plasma concentration showed CNS penetration of Mefloquine, with a 30 to 50 fold greater brain/plasma drug ratio up to 10 days after the final dose administered. The clinical use of mefloquine (MQ) has declined due to dose-related neurological events.

Originator

Curator's Comment: Mefloquine was developed by the United States Army in the 1970s. It is an antimalaria drug discovered by the US Army shortly after the Vietnam War, and subsequently marketed worldwide by F. Hoffmann-La Roche.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
46.0 nM [EC50]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Curative
MEFLOQUINE HYDROCHLORIDE

Approved Use

Treatment of Acute Malaria Infections: Mefloquine hydrochloride tablets are indicated for the treatment of mild to moderate acute malaria caused by mefloquine-susceptible strains of P. falciparum (both chloroquine-susceptible and resistant strains) or by Plasmodium vivax. There are insufficient clinical data to document the effect of mefloquine in malaria caused by P. ovale or P. malariae. Note: Patients with acute P. vivax malaria, treated with mefloquine, are at high risk of relapse because mefloquine does not eliminate exoerythrocytic (hepatic phase) parasites. To avoid relapse, after initial treatment of the acute infection with mefloquine, patients should subsequently be treated with an 8-aminoquinoline derivative (e.g., primaquine). Prevention of Malaria: Mefloquine hydrochloride tablets are indicated for the prophylaxis of P. falciparum and P. vivax malaria infections, including prophylaxis of chloroquine-resistant strains of P. falciparum.

Launch Date

1989
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
1018 ng/mL
750 mg single, oral
dose: 750 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEFLOQUINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
432 μg × h/mL
750 mg single, oral
dose: 750 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEFLOQUINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
396 h
750 mg single, oral
dose: 750 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
MEFLOQUINE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
2%
MEFLOQUINE plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
25 mg/kg single, oral
Highest studied dose
Dose: 25 mg/kg
Route: oral
Route: single
Dose: 25 mg/kg
Sources: Page: p.836
unhealthy, 0.4-88
n = 873
Health Status: unhealthy
Condition: Acute falciparum malaria
Age Group: 0.4-88
Sex: M+F
Population Size: 873
Sources: Page: p.836
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Co-administed with::
Halofantrine
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Other AEs: Electrocardiogram QTc interval prolonged...
Other AEs:
Electrocardiogram QTc interval prolonged
Sources: Page: p.12
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Co-administed with::
Ketoconazole
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Other AEs: Electrocardiogram QTc interval prolonged...
Other AEs:
Electrocardiogram QTc interval prolonged
Sources: Page: p.12
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Co-administed with::
chloroquine
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Disc. AE: Electrocardiogram abnormal...
AEs leading to
discontinuation/dose reduction:
Electrocardiogram abnormal
Sources: Page: p.12
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Co-administed with::
quinine
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Disc. AE: Electrocardiogram abnormal...
AEs leading to
discontinuation/dose reduction:
Electrocardiogram abnormal
Sources: Page: p.12
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Disc. AE: Anxiety, Paranoia...
AEs leading to
discontinuation/dose reduction:
Anxiety
Paranoia
Depression
Hallucinations
Psychotic behavior
Sources: Page: p.12
AEs

AEs

AESignificanceDosePopulation
Electrocardiogram QTc interval prolonged
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Co-administed with::
Halofantrine
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Electrocardiogram QTc interval prolonged
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Co-administed with::
Ketoconazole
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Electrocardiogram abnormal Disc. AE
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Co-administed with::
chloroquine
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Electrocardiogram abnormal Disc. AE
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Co-administed with::
quinine
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Anxiety Disc. AE
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Depression Disc. AE
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Hallucinations Disc. AE
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Paranoia Disc. AE
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Psychotic behavior Disc. AE
1250 mg single, oral
Recommended
Dose: 1250 mg
Route: oral
Route: single
Dose: 1250 mg
Sources: Page: p.12
unhealthy
Health Status: unhealthy
Condition: Malaria
Sources: Page: p.12
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG


OverviewOther

Drug as perpetrator​Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
yes
yes
yes (co-administration study)
Comment: Co-administration of a single 500 mg oral dose of Lariam with 400 mg of ketoconazole once daily for 10 days in 8 healthy volunteers resulted in an increase in the mean Cmax and AUC of mefloquine by 64% and 79%, respectively, and an increase in the mean elimination half-life of mefloquine from 322 hours to 448 hours.
Page: 2.0
PubMed

PubMed

TitleDatePubMed
The effect of artemisinine, its derivatives and mefloquine against chloroquine-resistant strains of Plasmodium falciparum in vitro.
1992 Jul-Aug
Design, synthesis, and pharmacological evaluation of mefloquine-based ligands as novel antituberculosis agents.
2007 Nov
Mefloquine neurotoxicity: a literature review.
2009 Jan
Idiosyncratic quinoline central nervous system toxicity: Historical insights into the chronic neurological sequelae of mefloquine.
2014 Aug
Patents

Sample Use Guides

Treatment of mild to moderate malaria in adults caused by mefloquine-susceptible strains of P. falciparum or by P. vivax: Dosage: Five tablets (1250 mg) mefloquine hydrochloride to be given as a single oral dose. The drug should not be taken on an empty stomach and should be administered with at least 8 oz (240 mL) of water. The recommended prophylactic dose of mefloquine is approximately 5 mg/kg body weight once weekly. One 250 mg mefloquine hydrochloride tablet should be taken once weekly in pediatric patients weighing over 45 kg.
Route of Administration: Oral
In Vitro Use Guide
Mefloquine inhibited chloroquine-resistant strains of Plasmodium falciparum in vitro. The EC50 values for mefloquine were 46-185 nM. At higher concentrations, strains K1 and LS21 were fully inhibited, while with strain T996 mefloquine did not fully inhibit even at the highest concentration, 1.28 x 10(-6) M.
Substance Class Chemical
Created
by admin
on Fri Dec 15 15:18:27 GMT 2023
Edited
by admin
on Fri Dec 15 15:18:27 GMT 2023
Record UNII
642Y4F6L0K
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
MEFLOQUINE MESYLATE
Common Name English
4-QUINOLINEMETHANOL, .ALPHA.-(2R)-2-PIPERIDINYL-2,8-BIS(TRIFLUOROMETHYL)-, (.ALPHA.S)-REL-, METHANESULFONATE (1:1)
Common Name English
MEFLOQUINE METHANESULFONATE
Common Name English
4-QUINOLINEMETHANOL, .ALPHA.-2-PIPERIDINYL-2,8-BIS(TRIFLUOROMETHYL)-, (R*,S*)-(±)-, MONOMETHANESULFONATE (SALT)
Common Name English
Code System Code Type Description
EPA CompTox
DTXSID70213988
Created by admin on Fri Dec 15 15:18:27 GMT 2023 , Edited by admin on Fri Dec 15 15:18:27 GMT 2023
PRIMARY
PUBCHEM
71587223
Created by admin on Fri Dec 15 15:18:27 GMT 2023 , Edited by admin on Fri Dec 15 15:18:27 GMT 2023
PRIMARY
CAS
64003-26-5
Created by admin on Fri Dec 15 15:18:27 GMT 2023 , Edited by admin on Fri Dec 15 15:18:27 GMT 2023
PRIMARY
FDA UNII
642Y4F6L0K
Created by admin on Fri Dec 15 15:18:27 GMT 2023 , Edited by admin on Fri Dec 15 15:18:27 GMT 2023
PRIMARY
Related Record Type Details
PARENT -> SALT/SOLVATE
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ACTIVE MOIETY