Published: 12 December 2013

Mefloquine and Visual Disturbances

Prescriber Update 34(4): 48
December 2013

Key Messages

  • Lariam (mefloquine) may be associated with an increased risk of eye disorders.
  • Adverse events may occur or persist up to several weeks after finishing treatment.
  • Treatment may need to be stopped in those who experience adverse events.

The Lariam (mefloquine) data sheet has recently been updated to include new safety information about the potential for visual disorders1. This has arisen following the sponsor’s review of non-clinical studies, the global drug safety database, the UK General Practice Research Database and the published literature.

The review found that treatment with Lariam, an anti-malarial drug, may be associated with an increased risk of eye disorders, including (but not limited to) cataracts, retinal disorders and optic neuropathy. Common presenting symptoms include visual impairment and blurred vision.

Due to the long half-life of Lariam, visual disturbances may occur during treatment or for several weeks afterwards. There were also some reports of permanent after-effects.

Lariam treatment may need to be stopped in patients who experience visual disorders.

The following has been added to the Warnings and Precautions section of the data sheet.

Eye disorders, including but not limited to optic neuropathy and retinal disorders, have been reported during treatment with mefloquine. Any patient presenting with a visual disorder should be referred to the treating physician, as certain conditions may require stopping treatment with Lariam.

'Eye disorders' has also been added to the list of adverse events.

In New Zealand, the Centre for Adverse Reactions Monitoring (CARM) has received three reports of visual disturbances while using mefloquine. None were classed by CARM as serious.

As always, please report any adverse events to CARM. This can be done via either the Medsafe website (download form at: or by reporting directly to CARM (

  1. Roche Products (New Zealand) Limited. 2013. Lariam Data Sheet. 9 July 2013. URL: (accessed 18 November 2013).