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Table 3 Position of expert guidelines regarding the use of mefloquine in pregnancy

From: The position of mefloquine as a 21st century malaria chemoprophylaxis

Expert Group Recommendation
Manufacturer's label. International standard prescribing information Mefloquine should be used during the first trimester only if the expected benefit justifies the potential risk to the fetus. Women of childbearing potential should be advised to practise contraception during malaria chemoprophylaxis with mefloquine and for up to 3 months thereafter. However in the case of unplanned pregnancy, malaria chemoprophylaxis with Lariam® is not considered an indication for pregnancy termination.
UK Health Protection Agency Advisory Committee on Malaria Prevention for UK Travellers Mefloquine should only be used in pregnancy if the need for it is great*. Women capable of childbearing should take contraceptive precautions while taking mefloquine and for three months after the last dose. Having taken mefloquine inadvertently during pregnancy is usually not viewed as an indication to terminate a pregnancy.
World Health Organisation Mefloquine can be used in the second and third trimester. Pregnancy should be avoided for three months after use of the drug.
Centers Disease Control (CDC) (US expert group) Use is permissible in all trimesters by pregnant women traveling to areas with known CQ-resistant P. falciparum when travel cannot be deferred. There is no clause suggesting that pregnancy should be avoided for three months following mefloquine use.
Committee to advise on tropical medicine and travel (CATMAT) (Canadian expert group) Use is permissible in all trimesters by pregnant women traveling to areas with known CQ-resistant P. falciparum when travel cannot be deferred. There is no clause suggesting that pregnancy should be avoided for three months following mefloquine use.
SWISS working group Mefloquine should be used during the first trimester only if the expected benefit justifies the potential risk to the foetus. Women of childbearing potential should be advised to practise contraception during malaria chemoprophylaxis with mefloquine and for up to 3 months thereafter.
  1. (* An electronic update of the UK guidelines states the following: " After expert advice, mefloquine may be considered for use in the first trimester of pregnancy "
  2. http://www.hpa.org.uk/infections/topics_az/malaria/menu.htm)