Comprehensive medication guide to Mefloquine including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$50 copay depending on formulary tier; some Medicare Part D plans cover mefloquine at approximately $28 per fill; Tier 2–3 on most plans, prior authorization may be required.
Estimated Cash Pricing
$90–$120 retail for 8 tablets (8-week prophylaxis course); as low as $32.83 with GoodRx or $22 per 4 tablets with SingleCare coupons.
Medfinder Findability Score
42/100
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Mefloquine hydrochloride is an oral prescription antimalarial medication used to prevent and treat malaria caused by Plasmodium falciparum and Plasmodium vivax. Originally developed by the U.S. military at the Walter Reed Army Institute of Research in the 1970s, it was first approved by the FDA in May 1989 and was previously marketed under the brand name Lariam by Roche.
The brand name Lariam was withdrawn from the U.S. market in August 2009, and today only generic mefloquine is available domestically. Teva Pharmaceuticals USA is the primary U.S. manufacturer of generic mefloquine 250 mg tablets.
Mefloquine belongs to the antimalarial quinoline class — the same broad chemical family as quinine, the original malaria treatment. It is a blood-stage schizonticide, meaning it kills malaria parasites during the erythrocytic (red blood cell) stage of their life cycle. Its unusually long half-life of approximately 3 weeks enables once-weekly dosing, making it convenient for long-term travelers.
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Mefloquine works as a blood-stage antimalarial — it targets Plasmodium parasites during the erythrocytic (red blood cell) stage of their life cycle. It is believed to interfere with the parasite's hemoglobin digestion process: when parasites break down hemoglobin, they produce toxic free heme as a byproduct. Normally, the parasite converts this into a harmless crystalline form called hemozoin. Mefloquine disrupts this detoxification process, causing toxic heme to accumulate inside the parasite and ultimately killing it.
Mefloquine does NOT eliminate parasites in the liver stage of the disease. This is why it must be continued for 4 weeks after leaving a malaria-endemic area — allowing time for any liver-stage parasites to emerge into the bloodstream, where mefloquine can destroy them. It must also be started 1-3 weeks before entering an endemic area to establish protective blood levels.
Mefloquine's remarkable pharmacokinetic profile — a half-life of approximately 3 weeks, extensive tissue distribution, and high protein binding (~98%) — allows a single weekly dose to maintain protective blood concentrations. The drug is metabolized primarily by the CYP3A4 liver enzyme, which is why drugs that inhibit this enzyme (like ketoconazole) can dangerously increase mefloquine blood levels.
250 mg — tablet
Standard adult dose. 1 tablet weekly for prophylaxis (starting 1-3 weeks before travel, continuing during travel, and for 4 weeks after return). 5 tablets as single dose for malaria treatment.
Mefloquine has been in documented short supply since May 2024, when Teva Pharmaceuticals USA — the primary U.S. generic manufacturer — reported limited inventory. The American Society of Health-System Pharmacists (ASHP) published a drug shortage bulletin for mefloquine in October 2024 that remained active through at least September 2025. The UK's NaTHNaC travel health network separately flagged mefloquine as out of stock in the UK market during overlapping periods.
Mefloquine's findability score is 42 out of 100 — indicating frequent localized shortages and significant difficulty filling prescriptions at standard retail pharmacies. Travel health clinics and hospital outpatient pharmacies tend to maintain better availability. Not all chain pharmacies stock mefloquine routinely, and during the shortage, even those that do stock it may run out quickly.
Rather than calling pharmacies one by one, use medfinder to find which pharmacies near you currently have mefloquine in stock. medfinder calls pharmacies on your behalf and texts you the results — saving you significant time during an active shortage.
Mefloquine is a prescription medication but is not a controlled substance. There are no DEA scheduling restrictions on who can prescribe it. Any licensed prescriber with full prescriptive authority can write a mefloquine prescription, including physicians, nurse practitioners, and physician assistants. However, prescribers should have familiarity with antimalarial prophylaxis guidelines and mefloquine's contraindications — particularly its psychiatric and neurological screening requirements — to prescribe it appropriately.
Travel medicine specialists — The most knowledgeable about resistance patterns, destination risks, and mefloquine contraindications. Recommended for complex cases.
Infectious disease physicians — Excellent pharmacology expertise; ideal for patients with comorbidities.
Primary care physicians (PCPs) and family medicine physicians — Routinely prescribe malaria prophylaxis for established travel patients.
Nurse practitioners (NPs) and physician assistants (PAs) — Can prescribe mefloquine in most states with full prescriptive authority; commonly see patients in travel clinics and urgent care.
Telehealth options are available through dedicated travel medicine telemedicine platforms and general telehealth services. A same-day telemedicine consultation can result in a prescription sent to your pharmacy within hours. Patients should confirm the telehealth provider is familiar with antimalarial prescribing guidelines and mefloquine's contraindications before proceeding.
No. Mefloquine is not a controlled substance and has no DEA scheduling designation. Any licensed prescriber — including physicians, nurse practitioners, and physician assistants with full prescriptive authority — can prescribe mefloquine without any special DEA registration or controlled substance requirements. Prescriptions can be phoned in, faxed, or sent electronically to any pharmacy.
However, mefloquine does carry an FDA boxed warning — the most serious type — for neurological and psychiatric side effects that can persist or become permanent after stopping the drug. Because of this, prescribers must conduct a thorough psychiatric history screening before prescribing it for malaria prevention. The drug is absolutely contraindicated for prophylaxis in patients with active depression, anxiety disorder, psychosis, schizophrenia, or history of seizures.
Most people who take mefloquine do not experience serious side effects. Common, generally manageable side effects include:
Nausea and vomiting
Diarrhea and stomach pain
Headache
Dizziness (mild)
Difficulty sleeping and vivid dreams or nightmares
Skin rash
Mefloquine carries an FDA boxed (black box) warning — its strongest level — for neurological and psychiatric side effects that can persist months to years after stopping the drug or become permanent:
Severe dizziness, vertigo, or loss of balance (vestibular damage — may be permanent)
Tinnitus (ringing in the ears)
Anxiety, paranoia, depression
Hallucinations and psychotic behavior
Suicidal thoughts or actions (call 988 immediately)
Seizures
Liver damage (hepatotoxicity)
QTc interval prolongation (cardiac arrhythmia risk — especially with other QT-prolonging drugs)
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Atovaquone-Proguanil (Malarone)
Daily oral antimalarial; equally effective; generally better tolerated; only 7 days post-travel dosing (vs. 4 weeks for mefloquine); preferred for short trips and Southeast Asia travel.
Doxycycline
Daily antibiotic with antimalarial activity; most cost-effective option; effective worldwide including Southeast Asia; not safe in pregnancy or children under 8 years.
Chloroquine (Aralen)
Weekly oral antimalarial; only effective in chloroquine-sensitive areas (the Caribbean, parts of Central America); widespread resistance limits use in most of Africa, Asia, South America.
Tafenoquine (Arakoda)
Weekly antimalarial for adults only; requires G6PD testing before use; shorter post-travel dosing; not available for children or pregnant women.
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Halofantrine
majorABSOLUTELY CONTRAINDICATED. Fatal QTc prolongation risk. Do not use halofantrine with mefloquine or within 15 weeks of the last mefloquine dose.
Ketoconazole
majorABSOLUTELY CONTRAINDICATED. Ketoconazole increases mefloquine AUC by 79% via CYP3A4 inhibition, creating potentially fatal cardiac arrhythmia risk. Avoid within 15 weeks of last mefloquine dose.
Quinine / Quinidine
majorContraindicated. Concurrent use causes dangerous QTc prolongation and increased seizure risk. If quinine is needed for severe malaria, delay mefloquine at least 12 hours after last quinine dose.
Chloroquine
majorConcurrent use increases risk of seizures. Should not be used simultaneously with mefloquine.
CYP3A4 Inhibitors (itraconazole, fluconazole, erythromycin)
moderateModerate CYP3A4 inhibitors may increase mefloquine blood levels. Use with caution; monitor for increased mefloquine side effects.
CYP3A4 Inducers (carbamazepine, phenytoin, rifampin, St. John's Wort)
moderateMay significantly reduce mefloquine blood levels, potentially compromising efficacy. Avoid St. John's Wort; discuss other inducers with prescriber before starting mefloquine.
Other QT-Prolonging Medications
moderateAntipsychotics, antidepressants, fluoroquinolone antibiotics, azithromycin, and antiarrhythmics may have additive QT-prolonging effects with mefloquine. Review all medications with prescriber.
Mefloquine remains a valuable antimalarial for specific patient populations — particularly pregnant travelers to high-risk areas, long-term travelers who prefer weekly dosing, and those who cannot tolerate atovaquone-proguanil or doxycycline. Its once-weekly convenience and broad geographic efficacy (outside Southeast Asia) make it a practical choice when tolerated.
However, mefloquine's FDA black box warning for neuropsychiatric and vestibular side effects that can become permanent demands careful patient screening. The ongoing supply shortage — documented since May 2024 — adds an additional layer of complexity. Patients must start their pharmacy search weeks ahead of travel to allow time for sourcing or switching to an alternative antimalarial.
If you're struggling to find mefloquine in stock at pharmacies near you, medfinder can help. Provide your medication name, dosage, and location, and medfinder will call pharmacies near you to find which ones currently have mefloquine available, then text you the results.
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