Topic: Mefloquine (a.k.a Lariam) anti-malarial in CF use (merged)

[Brihard]

I remember being given three options for antimalarials, and no information on them beyond how frequent the doses were to be taken. I remember a lawful order to pick one and take it. With nothing else to go on, I picked the weekly option, Mefloquine. There was no 'informed consent'. That's utter hogwash.

[PMedMoe]

I remember being given three options for antimalarials, and no information on them beyond how frequent the doses were to be taken. I remember a lawful order to pick one and take it. With nothing else to go on, I picked the weekly option, Mefloquine. There was no 'informed consent'. That's utter hogwash.

Depends on when you deployed (and maybe with who).  I remember having to give briefings on all three meds as early as 2005 and everyone had to see a pharmacist with their choice.  YMMV.

[Occam]

On HMCS Preserver in 92/93 for Op Deliverance (supporting the Canadian Airborne Regiment in Somalia), we were given mefloquine and the directions that everyone will take it - except personnel from the HelAirDets in flying positions.  They took doxycycline.

[Jarnhamar]

Defence Minister Harjit Sajjan is defending his department’s continued prescription of an anti-malarial drug that Health Canada now agrees can cause permanent brain damage, saying troops make their own informed decisions about whether to take it.

Awesome.

I remember being given three options for antimalarials, and no information on them beyond how frequent the doses were to be taken. I remember a lawful order to pick one and take it. With nothing else to go on, I picked the weekly option, Mefloquine. There was no 'informed consent'. That's utter hogwash.

Same here.
First time we were told we will take it or be charged with disobeying a lawful order. That included the usual threats that we wouldn't be covered under VA if we got sick.
Next time we were given 3 options and ordered to pick one with no information beyond dosage.

[AirDet]

Awesome.

Same here.
First time we were told we will take it or be charged with disobeying a lawful order. That included the usual threats that we wouldn't be covered under VA if we got sick.
Next time we were given 3 options and ordered to pick one with no information beyond dosage.

We were given the same line in East Timor but no choice. Mefloquine or a charge and sent home.

We named our days by the drug:
-Mefloquine Mondays
-Terror Tuesdays
-Nightmare Wednesdays... etc.

Some of us even reported "daymares" after the Monday dosage.

[milnews.ca]

The latest from the Surgeon General - highlights mine ...

The Government of Canada is committed to protecting and enhancing the health and well-being of Canadian Armed Forces (CAF) members. Today, the Department of National Defence and the CAF announced the release of the findings from the Surgeon General’s Review on the Operational Use of Mefloquine. The review looked at available literature on mefloquine use and how it is used in an operational setting.

Mefloquine will now only be recommended for use if a CAF member requests it, or if there are contraindications to the member being prescribed other anti-malarials.

Quotes

    “The health and well-being of our people is directly linked to the operational effectiveness of the Canadian Armed Forces. Because of this, I have a duty to ensure everyone under my command has access to the best options for medical care currently available. I am confident the Surgeon General’s recommendations, which are supported by third-party evidence, are consistent with ensuring the overall health of our women and men.”

    General Jonathan Vance, Chief of the Defence Staff

    “We are recommending mefloquine as a second line drug only, because of the unique operational environment that we work in. This direction should not be applied to a non-military environment. We will continue to monitor and review all relevant scientific literature on mefloquine.”

    Brigadier-General Colin MacKay, Surgeon General

Quick Facts

    Canadian Clinical Practice Guidelines for malaria prevention are consistent with other national and international guidelines in that mefloquine is considered a first-line option.

    Compared to currently recommended alternatives, the body of evidence suggests mefloquine is not consistently associated with an excess overall risk of adverse effects, nor is it associated with an excess risk of not being able to perform occupational duties.

    No evidence was found (that met the inclusion criteria) that would suggest potential long-term adverse effects of mefloquine on human health.

    The report also recommended caution for the CAF, because the deployment of large numbers of personnel within a short period of time can pose challenges for adequately screening individuals for potential contraindications. Additionally, the dispersed deployment of personnel, limiting access to physicians on operations, may reduce opportunities to assess for adverse effects and if necessary to provide alternative medications to CAF personnel taking mefloquine. Also, the nature of the short term side effects associated with mefloquine could impact an individual’s performance and could be confused with usual responses to operational situations, which would in turn complicate the management of adverse effects ...

Full report attached.