Mepacrine

Indications
 Oral
Giardiasis
Adult: As hydrochloride: 100 mg tid for 5-7 days.
Child: As hydrochloride: 2 mg/kg tid for 5-7 days. Max dose: 300 mg daily.
Oral
Lupus erythematosus
Adult: As hydrochloride: 100 mg once a day for the first 1-2 mth. Maintenance dose: Reduce to 25-50 mg once a day several times a wk, although occasional management with 100-200 mg once daily may be required.
Child: As hydrochloride: 1-2 mg/kg, up to 100 mg/day. Max dose: 100 mg daily.
Intrapleural
Prophylaxis of pneumothorax
Adult: As hydrochloride: 100 mg instilled once a day for 3-4 consecutive days.
Contraindications
 Hypersensitivity; psoriasis.
Warnings / Precautions
 Elderly, history of psychosis, hepatic disease, porphyria. Pregnancy and lactation.
Adverse Reactions
 Dizziness, headache; nausea, vomiting; reversible yellow discolouration of the skin, conjunctiva, urine (on prolonged use); blue-black discolouration of the palate and nails; psychosis, CNS stimulation, convulsions; ocular toxicity chronic dermatoses; rarely, liver toxicity and aplastic anaemia.
Overdose Reactions
 Symptoms: Seizures, hypotension,cardiac arrhythmia, cardiovascular collapse. Management: Gastric lavage or induction of emesis. Symptomatic and supportive.
Drug Interactions
 May produce disulfiram-type reaction with alcohol. May increase plasma concentrations and toxicity of primaquine.
See Below for More mepacrine Drug Interactions
Mechanism of Actions
 Mepacrine is a 9-aminoacridine antiprotozoal agent. It is used in the treatment of giardiasis (as an alternative to the nitroimidazoles), treatment of discoid and SC lupus erythematosus, and prophylaxis of pneumothorax (as an sclerosing agent). Its use for nonsurgical sterilisation in some countries is controversial and it was formerly used as an antimalarial agent. One suggested mechanism for its antiparasitic action is binding to DNA thereby inhibiting RNA transcription and translation.
Absorption: Absorbed rapidly from GI tract (oral); absorbed rapidly after intrapleural and intrauterine admin. Peak plasma levels after 8-12 hr.
Distribution: Widely distributed in body tissues. Crosses the placenta and distributes in breast milk. Protein-binding: 80-90%.
Excretion: Via urine (<11%); via faeces; small amounts excreted in bile, sweat and saliva.
Storage Conditions
 Oral: Store at 15-30°C (59-86°F).
ATC Classification
 P01AX05 - mepacrine ; Belongs to the class of other agents used in the treatment amoebiasis and other protozoal diseases.
Storage
 Oral: Store at 15-30°C (59-86°F).
Available As
  • Mepacrine 100 mg
  • Mepacrine 300 mg

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