Ric PriceJulie A. SimpsonPaktiya Teja-IsavatharmMyint Myint ThanChristine LuxemburgerD. Gray HeppnerTan ChongsuphajaisiddhiFrançois NostenNicholas J. WhiteShoklo Malaria Research UnitSt George's University of LondonJohn Radcliffe HospitalMahidol UniversityArmed Forces Research Institute of Medical Sciences, ThailandWalter Reed Army Institute of Research2018-09-072018-09-071999-02-01Antimicrobial Agents and Chemotherapy. Vol.43, No.2 (1999), 341-346006648042-s2.0-0032993695https://repository.li.mahidol.ac.th/handle/20.500.14594/25689Combining artemisinin or a derivative with mefloquine increases cure rates in falciparum malaria patients, reduces transmission, and may slow the development of resistance. The combination of artesunate, given for 3 days, and mefloquine is now the treatment of choice for uncomplicated multidrug- resistant falciparum malaria acquired on the western or eastern borders of Thailand. To optimize mefloquine administration in this combination, a prospective study of mefloquine pharmacokinetics was conducted with 120 children (4 to 15 years old) with acute uncomplicated falciparum malaria, who were divided into four age- and sex-matched groups. The patients all received artesunate (4 mg/kg of body weight/day orally for 3 days and mefloquine as either (i) a single dose (25 mg/kg) on day 2 with food, (ii) a split dose (15 mg/kg on day 2 and 10 mg/kg on day 3) with food, (iii) a single dose (25 mg/kg) on day 0 without food, or (iv) a single dose (25 mg/kg) on day 2 without food. Delaying administration of mefloquine until day 2 was associated with a mean (95% confidence interval) increase in estimated oral bioavailability of 72% (36 to 109%). On day 2 coadministration with food did not increase mefloquine absorption significantly, and there were no significant differences between patients receiving split- and single-dose administration. In combination with artesunate, mefloquine administration should be delayed until the second or third day after presentation.Mahidol UniversityMedicinePharmacology, Toxicology and PharmaceuticsArticleSCOPUS