Anti-Malarial Medication - Prevention
The choice of anti-malarial medication will depend on where you are going, the type of trip you have planned, any medical conditions and allergies. NO ANTI-MALARIAL MEDICATION IS 100% EFFECTIVE.
It is essential to take precautions against mosquito bites
SIDE EFFECTS | ADVANTAGES | DISADVANTAGES / PRECAUTIONS | INSTRUCTIONS |
DOXYCYCLINE Nausea or indigestion Vaginal or oral thrush Sunburn and sun sensitivity Rash or itching | 90% effective in malarial areas Provides protection against skin infections and some intestinal infections | Carry anti-thrush cream if you have a history of thrush Causes photosensitivity- use sunscreen Contraindicated in children and pregnant women | Take one tablet daily with food Start one day before you enter malarial area and continue for 28 days after leaving the area. Stay upright (sitting or standing) for 2 hours after taking tablet |
LARIAM (MEFLOQUINE) Headache and dizziness Nausea and loss of appetite Rash, aching muscles or weakness Vivid dreams Depression and anxiety Fits and psychosis (rare) | 90% effective in majority of malarial areas Weekly tablet easier for long term travel Can be used in second and third trimesters of pregnancy, and is safe in children | Trial period recommended Not recommended for pilots, SCUBA divers or people operating dangerous machinery Contraindicated for people with cardiac conduction disturbance, seizure disorders, and history of depression or other mental illness | Take one tablet weekly after your main meal. Start taking _______ week/s before arriving in malarial and take one per week on the same day whilst there. Continue to take for 4 weeks after leaving the area. Avoid drinking alcohol on the day and the day after the tablet |
PLAQUENIL (HYDROXYCHLOROQUINE) Headache, dizziness and nausea Blurred vision Itchy skin Hair loss | Cheap Few side effects Safe for use by pregnant women and children | Less effective in Africa and South-East Asia May make psoriasis worse Contraindicated for people with seizure disorders | Take 2 tablets weekly with food on the same day every week starting 2 weeks before arriving in malarial area, weekly while there and continue for 4 weeks after leaving malarial area |
MALARONE (ATOVAQUONE AND PALUDRINE) Nausea and abdominal discomfort Headache | Over 90% effective in all malarial areas Few side effects Safe for use in children | Higher cost Not for use in pregnant or breastfeeding women Cannot be used if patient has severe renal impairment | Take one tablet daily with food Start one day before entering malarial area, continue taking one tablet daily whilst there and continue for seven days after leaving malarial area |
TREATING MALARIA
If not on preventative tablets, self treatment should be considered if travelling to remote areas where medical attention is not readily available. If symptoms develop and there is no medical access for 24 hours you should start to treat yourself immediately.
Long term travellers to remote areas should also consider taking malaria testing kits.
RIAMET (CO-ARTEM) : Take 4 tablets when diagnosed, then 4 tablets at 8, 24, 36, 48 and 60 hours thereafter.
Take with meals to maximize absorption.
MALARONE : Take 4 tablets daily for 3 days. Malarone should be taken with food to maximize absorption.
CHLOROQUINE: Still an effective and cheap treatment for malaria in some areas but chloroquine resistance is now widespread in many parts of the world. If you have been treated with chloroquine and symptoms do not improve, seek further medical care. It is often used as a first line treatment in Africa as it is cheap and available.
LARIAM (MEFLOQUINE): 2 tablets to start then another 2 tablets 6 hours later but there is a high risk of side effects, especially nausea.
QUININE : An effective treatment, but should be used in hospitalised patients only.
Avoid FANSIDAR as most malaria is resistant to this. Avoid HALFAN (HALOFANTRINE) due to dangerous side effects