Mepacrine

Intrapleural
Prophylaxis of pneumothorax

Oral
Giardiasis

Oral
Lupus erythematosus

Hypersensitivity; psoriasis.

Elderly, history of psychosis, hepatic disease, porphyria. Pregnancy and lactation.

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.

Symptoms: Seizures, hypotension,cardiac arrhythmia, cardiovascular collapse. Management: Gastric lavage or induction of emesis. Symptomatic and supportive.

May produce disulfiram-type reaction with alcohol. May increase plasma concentrations and toxicity of primaquine.

Description:
Mechanism of Action: 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.
Pharmacokinetics:
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.

Oral:
Store at 15-30°C (59-86°F).

Anthelmintics / Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)