Lariam

Lariam is used for:

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Treating or preventing malaria.

Lariam is an antimalarial agent. How it works to kill sensitive malaria parasites is not known.

Do NOT use Lariam if:

• you are allergic to any ingredient in Lariam or similar medicines (eg, quinine, quinidine)
• you do not already have malaria and you currently have depression, a recent history of mental illness (eg, anxiety disorder, depression, psychosis, schizophrenia) or a history of seizures
• you are taking halofantrine

Contact your doctor or health care provider right away if any of these apply to you.

Before using Lariam :

Some medical conditions may interact with Lariam . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines (especially quinine or quinidine), foods, or other substances
• if you have a history of seizures, heart disease, liver problems, or mental or emotional disorders (eg, depression)
• if you are taking medicine for diabetes (eg, glyburide) or an anticoagulant (eg, warfarin)

Some MEDICINES MAY INTERACT with Lariam . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Beta-blockers (eg, propranolol), chloroquine, dofetilide, halofantrine, hydroxychloroquine, paliperidone, quinidine, quinine, or ziprasidone because the risk of heart problems (eg, irregular heartbeat) and seizures may be increased
• Anticoagulants (eg, warfarin) because the risk of bleeding may be increased
• Oral live vaccines because the effectiveness of the vaccine may be decreased. Oral live vaccines should be completed at least 3 days before the first dose of Lariam .
• Anticonvulsants (eg, valproic acid, carbamazapine, phenobarbital, phenytoin) because their effectiveness may be decreased by Lariam

This may not be a complete list of all interactions that may occur. Ask your health care provider if Lariam may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine

How to use Lariam :

Use Lariam as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Lariam comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Lariam refilled.
• Lariam should not be taken on an empty stomach. It should be taken with food and at least a full glass of water (8 oz/240 mL).
• If the tablets cannot be swallowed whole, they may be crushed and suspended in a small amount of water, sugar water, milk, or other beverage. Be sure to drink all the liquid so that you receive the entire dose.
• Patients taking Lariam to prevent malaria should begin taking it 1 week prior to traveling and continue taking it for 4 weeks after leaving the area where malaria can be contracted. If you are unable to complete the course of treatment, contact your doctor.
• Weekly doses of Lariam should be taken regularly, on the same day of each week, preferably after the main meal.
• Continue to use Lariam for the full course of treatment. Do not miss any doses.
• If you miss a dose of Lariam and you are taking it to prevent infection, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Lariam .

Important safety information:

• Lariam may cause drowsiness, dizziness, lightheadedness, or a loss of balance. These effects may be worse if you take it with alcohol or certain medicines. Effects of Lariam may continue for a period of time (eg, several weeks) even after you stop taking it. Use Lariam with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Carry an ID card at all times that says you take Lariam .
• Malaria can be life-threatening. Lariam helps to prevent or treat the infection.
• No medicine is completely effective against malaria. While you are in a hazardous area, use bed nets and insect repellents and wear protective clothing (long sleeves and long pants) to decrease your risk. If you are out in the bush, you may want to pre-wash your clothes with permethrin, a mosquito repellent that may be effective for weeks after use. Ask your doctor for other ways to protect yourself.
• Contact your health care provider at once if you develop a fever or flu-like symptoms (eg, chills, headache, muscle pains) after returning from an area where malaria exists.
• Lariam may cause early vomiting in children. If a significant amount of Lariam is lost because of vomiting, give a second full dose to patients who vomit less than 30 minutes after receiving it. If vomiting occurs 30 minutes to 1 hour after a dose, give an additional half-dose. Monitor the patient closely if vomiting occurs again.
• Stop using Lariam and contact your health care provider if anxiety, depression, restlessness, or confusion occur. Lariam should not be used for re-treatment if a full course of Lariam does not lead to improvement within 48 to 72 hours. Your doctor may need to prescribe an alternative medicine. If you do not have access to a health care provider or to another medicine and you have to stop taking Lariam , leave the malaria area. Leaving the area may not protect you from contracting malaria and you may still need to take another medicine to prevent the disease.
• Tell your doctor or dentist that you take Lariam before you receive any medical or dental care, emergency care, or surgery.
• Women who may become pregnant should use effective birth control while taking Lariam and for up to 3 months after stopping treatment. Check with your doctor if you have questions about using birth control.
• If you are taking other medicines, it may be necessary to start treatment with Lariam 2 to 3 weeks before traveling in order to make sure the other medicines and Lariam are well tolerated.
• Certain vaccines may not work if taken while using Lariam . Vaccinations with live bacteria should be completed at least 3 days before taking the first dose of Lariam .
• Lab tests, including liver function tests, blood counts, and eye exams, may be performed while you use Lariam . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Lariam with caution in the ELDERLY; they may be more sensitive to its effects, especially heart problems.
• Lariam should not be used in CHILDREN younger than 6 months of age; safety and effectiveness in these children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: Do not become pregnant while you are taking Lariam . If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Lariam while you are pregnant. Lariam is found in breast milk. Do not breast-feed while taking Lariam .

Possible side effects of Lariam :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; drowsiness; fever; headache; insomnia; lightheadedness; loss of appetite; muscle aches; nausea; stomach pain or upset; strange dreams; tiredness or weakness; vomiting.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior; chest pain; fainting; fast, slow, or irregular heartbeat; flu-like symptoms (eg, chills, fever, muscle pain, headache); loss of balance and coordination; muscle pain; numbness and tingling of hands or feet; paranoia; red, swollen or blistered skin; ringing in the ears; seizures; severe or persistent cough; shortness of breath; suicidal thoughts or behaviors; tremor; unexplained anxiety, mood changes, depression, hallucinations, restlessness, or confusion; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately. Symptoms may include diarrhea; fast, slow, or irregular heartbeat; mental or mood changes; vomiting.

Store Lariam at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep out of the reach of children and away from pets.

General information:

• If you have any questions about Lariam , please talk with your doctor, pharmacist, or other health care provider.
• Lariam is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Lariam . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

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