BMJ: ‘Adding a sulfonylurea to metformin looks safer than switching to one’

BMJ: ‘Adding a sulfonylurea to metformin looks safer than switching to one’

July 25 2018 Switching to sulfonylureas in type 2 diabetes has been linked with an increased risk...

Effect of omega-3 or other fatty acids on heart disease is negligible finds Cochrane review

Effect of omega-3 or other fatty acids on heart disease is negligible finds Cochrane review

July 19 2018 Cochrane researchers have published research indicating that omega 3 supplements...

DOACs associated with reduced risk of major bleeding compared to warfarin

DOACs associated with reduced risk of major bleeding compared to warfarin

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Recorded penicillin allergy associated with increased risk of MRSA and C difficile

Recorded penicillin allergy associated with increased risk of MRSA and C difficile

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MPS advises of need for better awareness of cauda equina red flag symptoms

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May 9 2018 The Medical Protection Society is advising doctors of a revision to the NICE Clinical...

  • BMJ: ‘Adding a sulfonylurea to metformin looks safer than switching to one’

    BMJ: ‘Adding a sulfonylurea to metformin looks safer than switching to one’

    Wednesday, 25 July 2018 14:07
  • Effect of omega-3 or other fatty acids on heart disease is negligible finds Cochrane review

    Effect of omega-3 or other fatty acids on heart disease is negligible finds Cochrane review

    Thursday, 19 July 2018 10:36
  • DOACs associated with reduced risk of major bleeding compared to warfarin

    DOACs associated with reduced risk of major bleeding compared to warfarin

    Wednesday, 11 July 2018 13:22
  • Recorded penicillin allergy associated with increased risk of MRSA and C difficile

    Recorded penicillin allergy associated with increased risk of MRSA and C difficile

    Tuesday, 03 July 2018 16:51
  • MPS advises of need for better awareness of cauda equina red flag symptoms

    MPS advises of need for better awareness of cauda equina red flag symptoms

    Wednesday, 09 May 2018 16:01

a pregnant woman pharmacyMarch 29 2018

Mefloquine is safe to use for malaria prevention during pregnancy, a Cochrane Review has concluded.

After reviewing five studies relating to the drug’s use in sub-Saharan Africa and one in Thailand between 1987 and 2013, the Cochrane authors said that “mefloquine is efficacious and safe for prevention of malaria in pregnant women living in stable transmission areas.

“The drug has been found to be safe in terms of adverse pregnancy outcomes, such as low birth weight, prematurity, stillbirths and abortions, and congenital malformations. However, it is worse tolerated than other antimalarial drugs.”

Data included in the review covered women living with and without having HIV infection. It also found relative efficacy relating to other malarial chemophrophylaxis. “Mefloquine was more efficacious than sulfadoxine-pyrimethamine in HIV-uninfected women or daily cotrimoxazole prophylaxis in HIV-infected pregnant women for prevention of malaria infection.”

However, in all circumstances, mefloquine “increases risks of drug-related adverse events including vomiting, fatigue/weakness, and dizziness,” said the reviewers. “Overall, the high proportion of mefloquine-related adverse events constitutes an important barrier to its effectiveness for malaria preventive treatment in pregnant women.”

The Summary of Product Characteristics for Larium notes that mefloquine is teratogenic in mice and rats, and embryo-toxic in rabbits, “however, large clinical experience with Lariam as prophylactic treatment has not revealed an embryotoxic or teratogenic effect.”

Links:
Cochrane Library announcement          http://www.cochrane.org/CD011444/INFECTN_mefloquine-preventing-malaria-pregnant-women
http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD011444.pub2/full
Larium SPC      

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