Surgeon General releases report regarding use of mefloquine

The medication prescribed to treat malaria, mefloquine, will now only be recommended if a Canadian Armed Forces (CAF) member requests it or if they cannot use any other malaria medication as a result of a new Surgeon General’s report.

According to the Surgeon General’s Review on the Operational Use of mefloquine, the short-term side effects associated with mefloquine can impact a CAF members performance while deployed and could be mistaken as a normal response to operational situations, “which would in turn complicate the management of adverse effects.”

Caution is advised when using the drug because a large number of CAF members sent on deployments within such a short period of time can pose challenges for adequately screening individuals for potential harmful side effects.

The report also notes that the dispersed deployment of personnel and limited access to physicians while on missions, make it difficult to monitor any negative side effects and provide alternative medication, if necessary.

“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,” said BGen. Colin MacKay, Surgeon General.

The report does note, however, that taking into consideration the body of evidence, 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.

Additionally, it found that no evidence was found that would suggest potential long-term harmful effects of mefloquine.

The report reviewed available literature pertaining to the medication and how it is used in an operational setting.

“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,” said Gen. Jonathan Vance, Chief of the Defence Staff.