Publication: Mefloquine pharmacokinetics in pregnant women with acute falciparum malaria
Issued Date
1994-01-01
Resource Type
ISSN
00359203
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2-s2.0-0028229619
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Mahidol University
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SCOPUS
Bibliographic Citation
Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.88, No.3 (1994), 321-323
Suggested Citation
K. Na Bangchang, T. M.E. Davis, S. Looareesuwan, N. J. White, D. Bunnag, J. Karbwang Mefloquine pharmacokinetics in pregnant women with acute falciparum malaria. Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.88, No.3 (1994), 321-323. doi:10.1016/0035-9203(94)90101-5 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/9603
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Title
Mefloquine pharmacokinetics in pregnant women with acute falciparum malaria
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Abstract
Mefloquine has an established place in the treatment of chloroquine-resistant falciparum malaria. To investigate mefloquine pharmocokinetics in pregnancy, 9 untreated pregnant women aged 16-33 years and 8 non-pregnant females aged 16-38 years received an average of 15 (range 13-19) mg mefloquine/kg body-weight as single-dose treatment for uncomplicated falciparum malaria. Regular blood samples were taken during the subsequent 48 h and then intermittently for 3-26 d after treatment. Whole blood mefloquine concentrations were analysed by high-performance liquid chromatography and a one-compartment open pharmacokinetic model was fitted to the data. Peak mefloquine concentrations were significantly lower in the pregnant patients (median [range]; 1257 [650-1584] vs. 1617 [1051-3111] ng/mL) and the total apparent volume of distribution ( V d f) was larger (10·8 [8·3-26·1] vs. 10·0 [4·8-13·9] L/kg; P < 0·05 in each case), consistent with an expanded circulating blood volume and increased tissue binding in pregnancy. There was no significant difference between the 2 groups in half-times of absorption or elimination (P > 0·1), and systemic clearance rates were also similar. These results suggest that pregnant patients need larger doses of mefloquine than non-pregnant women to achieve comparable blood levels, an important consideration in areas where multi-drug resistant falciparum malaria is emerging. © 1994.