Mefloquine Shortage Update: What Patients Need to Know in 2026

If you're trying to fill a mefloquine prescription and running into roadblocks, the current drug shortage is likely the cause. Mefloquine — the generic antimalarial formerly branded as Lariam — has been listed as a supply shortage since October 2024, when the American Society of Health-System Pharmacists (ASHP) published a drug shortage bulletin that was still being updated as recently as September 2025.

This shortage directly affects travelers who rely on mefloquine for malaria prevention — one of its primary uses. Here's a complete picture of where things stand and what you should do.

What Is the Current Status of the Mefloquine Shortage?

The shortage is linked to Teva Pharmaceuticals USA, the primary U.S. generic manufacturer of mefloquine hydrochloride 250 mg tablets. The FDA first flagged the drug as "limited supply" in May 2024. The ASHP shortage bulletin was created in October 2024 and continued to be updated through at least September 2025, indicating the supply situation had not fully resolved.

The shortage has had international reach as well. The UK's NaTHNaC (National Travel Health Network and Centre) also separately flagged mefloquine as out of stock in the UK market during overlapping time periods, suggesting the supply disruption affects the global manufacturing chain rather than just U.S. distribution.

Who Is Most Affected by the Mefloquine Shortage?

While many travelers can switch to an alternative antimalarial, certain patient populations are particularly reliant on mefloquine:

Pregnant travelers — Mefloquine is one of the few antimalarials considered safe during pregnancy. The alternatives (doxycycline is contraindicated; atovaquone-proguanil has limited safety data) make mefloquine a critical medication for this group.

Long-term travelers and expatriates — The once-weekly dosing of mefloquine is highly practical for individuals spending months in endemic regions. Daily alternatives are harder to maintain consistently over long periods.

Patients who cannot tolerate alternatives — Some patients have had adverse reactions to doxycycline (GI intolerance, sun sensitivity) or atovaquone-proguanil (GI side effects) and rely specifically on mefloquine.

Patients with G6PD deficiency — Tafenoquine (an alternative) is contraindicated in G6PD deficiency, making mefloquine a needed option.

What Does This Shortage Mean for Your Travel Plans?

The impact depends on your destination and timeline:

If you're traveling to sub-Saharan Africa or South America: Atovaquone-proguanil and doxycycline are effective alternatives and widely available at standard pharmacies.

If you're traveling to Southeast Asia: Mefloquine is not recommended in many parts of Southeast Asia anyway due to drug resistance. Atovaquone-proguanil or doxycycline are the preferred options there.

If you're pregnant and traveling to a high-risk area: Contact a travel medicine specialist immediately. They may have access to mefloquine through specialty suppliers or can advise on the safest alternative given your specific situation.

What Steps Should You Take Right Now?

Contact your prescriber immediately — Don't wait to hear from the pharmacy. Your doctor should know the shortage is affecting your prescription.

Ask about travel health clinics — These specialized facilities often maintain mefloquine inventory specifically for travelers when retail pharmacies are out.

Use medfinder to search pharmacies near you — Instead of calling pharmacies one by one, medfinder will contact pharmacies in your area to find which ones have mefloquine in stock and text you the results.

Discuss alternatives proactively — Even while searching for mefloquine, have a conversation with your provider about the best backup medication so you don't lose time if mefloquine remains unavailable.

Has Mefloquine Historically Had Shortage Problems?

Yes. Mefloquine has experienced intermittent supply issues before. The core problem is structural: mefloquine is a low-volume specialty drug. When Roche stopped marketing Lariam in the U.S. in 2009 and the market shifted entirely to generics, the number of manufacturers dwindled. With Teva being the dominant (and in many cases only) supplier in the U.S., any production disruption immediately creates a market shortage.

This is compounded by declining overall demand — mefloquine's serious neuropsychiatric side effects profile has led many travel medicine providers to favor alternatives like Malarone and doxycycline, further reducing commercial incentive for multiple manufacturers to enter the market.

Is Mefloquine Still Safe to Take?

Yes, mefloquine is still FDA-approved and considered effective when prescribed appropriately. The shortage is not related to safety concerns. The drug carries a serious black box warning — added in July 2013 — about neuropsychiatric and vestibular side effects that can persist long after stopping the medication. This existing safety profile is a separate matter from the supply shortage.

For a step-by-step guide on finding mefloquine near you, see How to Find Mefloquine in Stock Near You. Or use medfinder to have pharmacies called on your behalf.