Selecting your Malaria Tablets

Choosing Your Malaria Tablets

To select which type of antimalarial tablet you should take, first make a note of which antimalarial tablets are recommended for your area of travel. After your medical consultation a doctor will recommend the antimalarials which are safe for you take. If all three prescription-only medicines are recommended your choice comes down to personal preference such as cost and the number of tablets you need to take for your trip. We have provided a detailed summary to aid your decision below:

1. Find out which antimalarials are recommended for your area of travel

Please visit the NHS Fit for Travel website which lists the recommended antimalarials for every country in the World. Click on the countries you intend on visiting and make a note of the recommended antimalarial tablets.

2. Submit your medical consultation for antimalarial medicine

Register for free and submit a medical consultation questionnaire for malaria tablets. It is very important that you accurately complete your questionnaire in full. A doctor will then assess your medical questionnaire and may approve you to order.

3. Choosing between the three types of antimalarial drugs for next day delivery?

If a doctor approves you more for more than one type of prescription-only antimalarial drug they will have made their decision by assessing the suitability of each antimalarial drug depending on how you would tolerate the drug and whether you have any contraindications to it.

To help you choose which antimalarial drug you would like to order please use the table below. You are strongly encouraged to read through the reported side-effects of each drug in addition to considering other factors such as cost and the number of tablets you would need to take.

	Doxycycline (also known as Vibramycin-D)	Atovaquone plus proguanil (also known as Malarone)	Mefloquine (also known as Lariam)
When to start taking your tablets	2 days before entering a malaria area	2 days before entering a malaria area	3 weeks before entering a malaria area
When to stop taking your tablets	4 weeks after leaving malaria area	1 week after leaving malaria area	4 weeks after leaving malaria area
Number of tablets you need to take	1 week trip: 37 2 week trip: 44 3 week trip: 51 4 week trip: 58 8 week trip: 86 12 week trip: 114	1 week trip: 16 2 week trip: 23 3 week trip: 30 4 week trip: 37 8 week trip: 65 12 week trip: 93	1 week trip: 8 2 week trip: 9 3 week trip: 10 4 week trip: 11 8 week trip: 15 12 week trip: 19
Reported side effects	Sunburn due to light sensitivity, stomach upset, heartburn and thrush. Reduces the effectiveness of some oral contraceptives.	Intestinal upset, headaches, skin rash and mouth ulcers.	Dizziness, headache, sleep disturbances (insomnia and vivid dreams) and psychiatric reactions (anxiety, depression, panic attacks and hallucinations).
Advantages	Cheap. Effective in most areas of the world. Generally well tolerated.	Effective in most areas of the world. Generally well tolerated. Tablets continued for only one week after leaving a malarial region.	Effective in most areas of the world. Convenient one tablet taken per week.
Disadvantages	May cause photosensitivity and predispose to vaginal candidal infections in women.	Expensive.	Not suitable if you suffer from epilepsy, seizures, psychiatric disorders or depression. Needs to be started 2 to 3 weeks before departure.
Patient information leaflet (PIL)	Doxycycline - (0.47MB)	Malarone - (2.42MB)	Lariam - (0.56MB)

There are other antimalarial medicines such as Chloroquine (also known as Avloclor tablets or Nivaquine syrup) and Proguanil (also known as Paludrine). The major disadvantage of these two medicines is that many strains of malaria are now resistant, so the drugs are no longer effective. Chloroquine and Proguanil are not provided through Anytime Pharmacy's antimalarial service.

Concerns about mefloquine?

Many people raise concerns that mefloquine has a bad reputation for side effects. All effective medicines can cause side effects. This means that the reported side effects listed above can occur.

A medicine is only made available to the public if the clinical trials have shown that the benefits of taking the medicine outweigh the risks. Some side-effects may be serious while others may only be a mild inconvenience. Everyone's reaction to a medicine is different. It is difficult to predict which side-effects you will have from taking a particular medicine, or whether you will have any side-effects at all. It is important that you accurately complete your medical consultation so that a doctor can judge which antimalarial tablet is safe for you to take.

The adverse effects of mefloquine will usually present before travel as the drug is started three weeks before you travel. Adverse effects that require you to stop taking mefloquine include dizziness, depression, anxiety, and insomnia. If you develop any side effects your doctor will advise you as to switching over to doxycycline or malarone.

The Yellow card Scheme - (opens in new window) is the MHRA website used to report suspected side effects to any medication including vaccines. You are encouraged to report any medicine side effects to the MHRA.

Taking antimalarials during pregnancy

If you are pregnant, avoid travelling to areas where there is a risk of malaria. Pregnant women have an increased risk of developing severe malaria and it is more dangerous for them and their baby.

If you feel you must travel to malaria risk areas while pregnant, it is important to take the right antimalarial medicine. Some of the drugs used to prevent and treat malaria are unsuitable as they may cause side effects for you and your baby.

• Chloroquine and proguanil are safe to use at any stage of your pregnancy without harm to you or your baby. It is recommended that you take a 5mg folic acid supplement while you are taking proguanil. Chloroquine alone or the combination with proguanil does not offer enough protection in many regions, including Africa.
• Mefloquine (Lariam) is not usually prescribed in pregnancy. However, if travel is unavoidable, it can be considered for countries with a high risk of malaria.
• Doxycycline is never recommended for pregnant or breastfeeding women in the UK as it could harm the baby.
• Atovaquone and proguanil (Malarone) is generally not recommended as there is only limited research on use of this drug in pregnancy. If the risk of malaria is high, it can be taken if mefloquine is not suitable.

Long-term travel

If you are planning to go away for more than six months, you are considered a long-term traveller. When travelling to areas where there is a risk of malaria, always consider taking antimalarial medicine. If you are travelling to different places, you may only need to take antimalarials for part of your trip.

Long-term travellers' should discuss their options at a specialist travel health clinic or with their GP.