This list is not comprehensive and does not include every variety of combinations available. Some countries and regions have developed varying degrees of resistance to some, so not all prophylaxis will be recommended for all areas. It is essential you speak to your GP or nurse practitioner who will be able to use your medical history and clinical judgement to determine which drug is right for you as an individual.
Taking Antimalarial Tablets.
- It is important you visit a travel clinictravel clinic at least a couple of months before you travel to discuss all your options with a qualified professional.
- Start your course of antimalarials as advised by your travel health professional, this is usually for a period of up to 3 weeks before you leave.
- Take the tablets regularly and as directed.
- The incubation period of the disease can vary and can last even after you have gotten home from your trip so it is extremely important to continue taking tablets as directed after you have returned.
Types of antimalarial tablets.
Atovaquone plus Proguanil (also known as Malarone and a variety of brand names).
This is a common and popular anti malarial due to the fact that it has relatively few and mild side effects compared to others.
Possible side effects include headaches, mouth ulcers, rash and sometimes intestinal upset. It is not recommended for pregnant women during the first trimester or those with kidney problems.
The adult dose is one tablet taken once a day every day you are travelling, and the child dose is also once a day but at a lesser strength. It should be started two days before you travel and taken for a week after you return, and is recommended for periods of 28 days but can be used for up to a year. It is also relatively expensive compared to other anti malarial tablets so may be useful on shorter trips.
Mefloquine (also known as Lariam and a variety of brand names).
This is a tablet that is taken as a 250 mg tablet once a week. It should be started three weeks before you travel if you have never taken it before (1 week is sufficient if you have), taken throughout travel through an endemic area and four weeks after you get back.
Serious side effects are rare, but do include depression, anxiety, psychosis and seizures, insomnia, panic attacks and hallucinations amongst others. Mefloquine has gained quite a bad reputation because of these side effects, but the benefits of taking the anti malarial outweigh the risks. Many people take this medication quite safely, but the side effects if you are susceptible to them are sever, so it is strongly recommended that you do a three week trial at least a month before you travel to test if you develop any side effects.
Doxycycline (also known as Vibramycin D and a variety of brand names).
This is a 100mg capsule taken daily. You should start the course two days before you travel, every day you are travelling and for a month after you return.
This is popular because it is relatively cheap compared to other anti malarial tablets and the side effects – for those that get them – are not as severe.
It can cause increased susceptibility to sunburn in some people, as well as heartburn, stomach upset and thrush, and is not recommended for pregnant women or children under 12 at all.
It can also reduce the effectiveness of combined hormone contraceptives such as the pill.
Chloraquine (also known as Avloclor and and a variety of brand names).
This is one of the most common anti malarials and the normal dose is 2 tablets once a week, started one week before you leave, throughout your trip and for 4 weeks afterwards.
There are a wide variety of potential side effects which may include nausea, diarrhoea, headache, rashes, skin itch, blurred vision, hair loss, dizziness, mood change, sun sensitivity or seizures. Those with kidney or liver disease should be assessed carefully before taking this medication and it is normally not recommended for long term use.
Proguanil (also known as Zeneca, chlorguanide, chloroguanide and and a variety of brand names).
The normal dose is a 200mg tablet daily and is generally safe for long term, extended use of up to 5 years. One or two doses should be taken before departure, continued throughout your trip and for 4 weeks afterwards. It is very important to complete the course.
Side effects may include: anorexia, nausea, diarrhoea, constipation, skin itch and mouth ulcers.