What is malaria
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Antimalarial medication is used to prevent and treat malaria.
You should always consider taking antimalarial medicine when travelling to areas where there is a risk of malaria.
It is very important that you take the correct dose and that you finish the course of antimalarial treatment. If you are unsure, check with your GP or pharmacist how long you should take your medication for.
It is usually recommended you take antimalarial tablets if you are visiting an area where there is a malaria risk because they can reduce your risk of malaria by about 90%.
The type of antimalarial tablets prescribed will be based on the following information you give:
where you are going
any relevant family medical history
your medical history, including any allergies to medication that you have
any medication that you are currently taking
any problems that you have had with antimalarial medicines in the past
whether you are pregnant
You may need to take a short trial course of antimalarial tablets before travelling. This is to check that you don't have an adverse reaction or side effects. If you do, alternative antimalarials can be prescribed before you leave.
Information on spread of Malaria - WHO information video.
Types of antimalarial medication
Atovaquone plus proguanil (Malarone)
Dosage – the adult dose is one adult-strength tablet a day.
Child dosage is also once a day, but the amount depends on the child’s weight.
It should be started one or two days before your trip, taken every day that you are in a risk area and for seven days after you return.
Recommendations – a lack of clear evidence means that this antimalarial should not be taken by pregnant or breastfeeding women. It is also not recommended for people with severe kidney problems.
Possible side effects – stomach upset, headaches, skin rash andmouth ulcers.
Other factors – it can be more expensive than other antimalarials so may be more suitable for short trips.
Dosage – the dose is 100mg daily as a tablet or capsule. You should start the capsules two days before you travel, take them each day you are in a risk area and for four weeks after you return.
Recommendations – not suitable for pregnant or breastfeeding women, children under the age of 12 (due to the risk of permanent tooth discolouration), people who are sensitive to tetracyclineantibiotics or people with liver problems.
Possible side effects – sunburn due to light sensitivity, stomach upset, heartburn and thrush. It should always be taken with food, preferably when standing or sitting. Doxycycline reduces the effectiveness of combined hormone contraceptives, such as thecontraceptive pill or contraceptive patches.
Other factors – if you take doxycycline for acne, it will also provide protection against malaria as long as you are taking an adequate dose (ask your GP). Doxycycline is relatively cheap.
Dosage – the adult dose is one tablet weekly.
Child dosage is also once a week but the amount will depend on the child’s weight.
It should be started three weeks before you travel, taken all the time you are in a risk area and for four weeks after you get back.
Recommendations – it is not recommended if you have epilepsy, seizures, depression or other mental health problems, or if a close relative has any of these conditions. It is not usually recommended for people with severe heart or liver problems.
Possible side effects – dizziness, headache, sleep disturbances (insomnia and vivid dreams) and psychiatric reactions (anxiety, depression, panic attacks and hallucinations). It is very important to tell your doctor about any previous mental health problems, including mild depression. Do not take this medication if you have a seizure disorder.
Other factors – if you have not taken mefloquine before, it is recommended that you do a three-week trial before you travel to see whether you develop any side effects.
Chloroquine and proguanil (Paludrine/Avlocor)
A combination of antimalarial medications called chloroquine and proguanil is also available, although these medications are rarely recommended nowadays because they are largely ineffective against the most common (particularly in Africa) and dangerous type of malaria parasite called Plasmodium falciparum.
However, chloroquine and proguanil may occasionally be recommended for certain destinations where the Plasmodium falciparum parasite is less common than other types, such as India and Sri Lanka.