Update: New Recommendations for Mefloquine Use in Pregnancy

Update: New Recommendations for Mefloquine Use in Pregnancy

The Centers for Disease Control and Prevention (CDC) now recommends the antimalarial drug mefloquine for pregnant women both as a malaria treatment option and as an option to prevent malaria infection for all trimesters. Previously mefloquine was not recommended for the treatment of malaria in pregnant women. The change in recommendations is based on the recent Food and Drug Administration (FDA) re-categorization of mefloquine from a pregnancy category C drug to category B, based on their review of the published data on mefloquine use during pregnancy. These data showed that pregnant women who took mefloquine at various doses for both prevention and treatment of malaria did not have an increased risk of teratogenic effects (birth defects) or adverse pregnancy outcomes compared to the background rate in the general population. Based on studies, the FDA assigns risk categorizes for drugs used in pregnancy which include categories A, B, C, D, and X with categories A and B demonstrating the least risk to the pregnancy.

Malaria is a serious, sometimes fatal, mosquito-borne disease. Malaria infection in pregnant women can be more severe than in nonpregnant women and may also be transmitted from a mother to her unborn infant before or during delivery (“congenital” malaria). Malaria can increase the risk for adverse pregnancy outcomes, including prematurity, spontaneous abortion, and stillbirth. Pregnant women should avoid travel to malaria-endemic areas if possible. If travel cannot be avoided, malaria infection is largely preventable with the appropriate antimalarial drugs along with other measures to prevent mosquito bites.

See drugs for the prevention of malaria to learn more about mefloquine and other antimalarial drugs.

See the table Guidelines for the Treatment of Malariapdf icon for information about malaria treatment.

For general information about malaria see, www.cdc.gov/malaria

Page last reviewed: December 11, 2019