GtoPdb Ligand ID: 4252

Synonyms: GNF-Pf-5544 | Lariam® | Ro-21-5998-001 | WR-142490
mefloquine is an approved drug (FDA (1989), UK (1989))
Compound class: Synthetic organic
Comment: Mefloquine belongs to the aryl amino alcohols, a chemical class of antimalarial drugs that includes quinine, lumefantrine and halofantrine.
The approved drug is a racemic mixture of (R,S)- and (S,R)-enantiomers. We show the chemical structure without stereochemistry to represent the mixture and the non-isomeric structure is also represented in the PubChem and ChEMBL entries listed in the links table below, while the two enantiomers forming the racemate are represented by PubChem CID 40692 and PubChem CID 456309. PubChem lists 9 stereoisotopes.
The administerd form contains the mefloquine hydrochloride salt.

The Malaria tab on this ligand page provides additional curator comments of relevance to the Guide to MALARIA PHARMACOLOGY.

Activity at non-malarial protein targets:
Racemic mefloquine has been identified as an antagonist of the human adenosine A2A and A1 receptors, with nanomolar binding affinities [8]. The (11R,2'S) isomer of mefloquine (PubChem CID 456309) has been determined as the most potent A2A binder, with a Ki of 61 nM (Ki vs. A1 receptor is 255 nM) [4]. It has been suggested that off-target activity at human adenosine receptors may contribute towards the adverse neuropsychiatric side-effects that are associated with mefloquine use.
2D Structure
Click here for structure editor
Physico-chemical Properties
Hydrogen bond acceptors 3
Hydrogen bond donors 2
Rotatable bonds 4
Topological polar surface area 45.15
Molecular weight 378.12
XLogP 3.87
No. Lipinski's rules broken 0
Canonical SMILES OC(c1cc(nc2c1cccc2C(F)(F)F)C(F)(F)F)C1CCCCN1
Isomeric SMILES OC(c1cc(nc2c1cccc2C(F)(F)F)C(F)(F)F)C1CCCCN1
InChI InChI=1S/C17H16F6N2O/c18-16(19,20)11-5-3-4-9-10(15(26)12-6-1-2-7-24-12)8-13(17(21,22)23)25-14(9)11/h3-5,8,12,15,24,26H,1-2,6-7H2
No information available.
Summary of Clinical Use
Mefloquine should not be prescribed to prevent malaria in patients with major psychiatric disorders or with a history of seizures. In 2013, the FDA added a 'Boxed Warning' to highlight the risks of neurological side effects that may persist or become permanent.
Mechanism Of Action and Pharmacodynamic Effects
The exact mechanism of action of mefloquine is unknown but it has been shown to bind directly to the P. falciparum ribosome (Pf80S) and may mediate killing of the malaria parasite by inhibition of protein synthesis [9]. Translation inhibitors are a promising avenue for development of a novel target class: doxycycline and azithromycin are examples of ligands that target ribosomes within the malaria parasite's mitochondria and apicoplast, leading to loss of function of these organelles [6].
The estimated terminal half-life for elimination is 13.8 to 40.9 days (median 20 days) [5].
External links