Malaria Region MDM

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Malaria Region MDM - For this region there is a choice of 

malarone tablets

Generic Malarone - Atovaquone/Proguanil 250mg/100mg

OR 

doxycycline capsules

OR

mefloquine tablets

to prevent malaria in adults. The choice of medicine will depend on your medical history, current medication and length of visit.

These 3 medicines are only available with a prescription.

Malaria medication4

 

malaria prevention4

 

Important information:

It is highly recommended that you use a DEET containing mosquito repellent in addition to your anti-malaria medication.  

General Information:

  • Always use the correct medication for the areas you are travelling to.
  • If you are travelling between areas that require different medications then discuss the itinerary with your doctor.
  • Always discuss child medication with your doctor.
  • Always complete the course of medication unless advised by a doctor.
  • ALWAYS TAKE EXACTLY AS PRESCRIBED. STOPPING MEDICATION OR CHANGING THE DOSAGE IS NOT ADVISABLE.
  • Seek medical advice if you experience side effects to any antimalarial medication.

Things you might need for your trip:

Oral rehydration, antidiarrhoea capsules, sun cream, aftersun, travel sickness, anti deep vein thrombosis measures (low dose aspirin, travel socks), Insect bite treatments, travel first aid kit, your regular medication, sun hats.

If you still are not sure which medication you need for your trip then please use our malaria enquiry form and we will advise you which is the current recommendation.

Adult Dosages:

mefloquine tablets

1 x tablet weekly (1 x 250mg Lariam tablet)
Take 2-3 weeks before travel, throughout stay and for four weeks after return.

OR

doxycycline capsules

1 x daily (1 x 100mg capsule) Take 1-2 days before travel, throughout stay and for four weeks after return.

OR

malarone tablets

Generic Malarone - Atovaquone/Proguanil 250mg/100mg

1 x tablet daily. Take 1-2 days before travel, throughout stay and for seven days after return.

Long-term Travel

Mefloquine (Lariam) is currently licensed to be used for a period of 12 months, but can be taken safely for up to three years.
Doxycycline can be taken for up to two years.
Malarone is currently licensed for periods of stay not exceeding 28 days, but there is now experience of it being taken safely for up to one year.

PRECAUTIONS

Doxycycline can alter the metabolism of oral contraceptives. Patients using an oral contraceptive should take extra contraceptive precautions for the first three weeks after starting long-term antibiotics. After three weeks, gut flora develops antibiotic resistance and additional precautions become unnecessary. Rarely Doxycycline can cause photosensitivity (sensitivity to sunlight) in patients taking it at doses for malaria prophylaxis, it is normally mild and can be minimised by using high factor sunscreens.
Mefloquine should be avoided in patients with hypersensitivity to quinine and in patients with a history of any type of seizures or psychiatric disturbances, including depression.

EPILEPSY

Mefloquine is contra-indicated in patients with epilepsy. Some antiepileptics may after the metabolism of doxycycline and reduce its plasma levels, but there is no evidence to suggest increasing the dose.

PSORIASIS

Mefloquine, doxycycline and Malarone do not cause any problems in patients with psoriasis.

HEPATIC OR RENAL IMPAIRMENT

All patients with hepatic or renal impairment should be referred to their specialist, as we will not know the degree of your condition.

PREGNANCY

Travel to malarious zones during pregnancy should be avoided. However, if travel is unavoidable, effective prophylaxis should be used as malaria is more severe during pregnancy and the risk of malaria to mother and foetus is greater than the risk from any antimalarial drugs at the recommended doses.  All pregnant travellers should see their doctor.
Mefloquine is not licensed for use in pregnancy and should normally be avoided. 
Doxycycline is contra-indicated during pregnancy.
Malarone should be avoided because its safety in pregnancy has not been established.

BREASTFEEDING AND BREASTFED INFANTS

Prophylaxis is still required in breast-fed infants; although anti-malarials are excreted in breast milk, the amounts are too variable to give reliable protection. Doxycycline and Malarone are contra-indicated in lactation. Mefloquine may be suitable in some circumstances.

This page was last updated: Monday 25 September, 2017