Fatty food does not alter blood mefloquine concentrations in the treatment of falciparum malaria

Food has been reported to increase the bioavailability of mefloquine in healthy volunteers, but its role in increasing blood mefloquine concentrations in malaria patients treated with mefloquine is unclear. In this study, we compared blood mefloquine concentrations after the administration of artesunate (8 mg/kg) and mefloquine (15 mg/kg) over 12 h with either a low-fat (∼3 g of fat) or high-fat (∼30 g of fat) meal for the treatment of Plasmodium falciparum malaria in 12 Vietnamese patients. No statistical differences were detected in the following kinetic parameters between the low-fat (n = 6) and high-fat (n = 6) groups, respectively: maximum blood mefloquine concentrations (2838 ± 531 ng/ml and 2556 ± 657 ng/ml, 95% CI −486 to 1050 ng/ml, P = 0.43) and the area under the blood mefloquine concentration versus time curves (246.8 ± 58.3 μg.h/ml and 238.3 ± 28.4 μg.h/ml, 95% CI −50.5 to 67.5 μg.h/ml, P = 0.75). A fatty meal does not appear to increase the bioavailability of mefloquine in malaria patients and should not affect the response of malaria infections to treatment.