With many different options available when it comes to antimalarial medication, it can be confusing working out which one is best for you. The safest option would be to come for a consultation in one of our clinics to discuss your trip and medical history. But if you’re looking to safely buy medication online from the Nomad pharmacy, we’ve put together a guide to help you decide which malaria prevention medication might be right for you and your trip.
What are the Different Antimalarial Options?
In the UK the main options for malaria tablets are:
- Atovaquone/Proguanil (brand name Malarone)
- Mefloquine (brand name Lariam)
- Chloroquine (brand name Avloclor)
All of these options are available at Nomad but choosing which is the right one for you depends on a number of factors. There are other antimalarial options sold in other countries, but always be aware of the risk of counterfeit medications.
The Right Malaria tablets for your destination
Depending on the country you are travelling to, some antimalarials may not be suitable because the malaria parasite has become resistant to the medication. It’s important to make sure you choose one that’s going to work most effectively for where you are going. Chloroquine (Avloclor) is only effective in a small number of countries, mainly in Central America, and should never be taken to prevent malaria in Africa, South East Asia or South America where the malaria parasite has developed resistance to Chloroquine (Avloclor). Lariam has some patches of resistance in parts of South-East Asia, so is not an ideal option there. However, Atovaquone/Proguanil (brand name Malarone) and Doxycycline should work in all malaria risk areas.
Pre-Exisiting Medical Conditions & Malaria Tablets
Some malaria medications may not be suitable for you if you have pre-existing medical conditions including pregnancy. To find out if you can take antimalarials with your medical conditions, and which ones are advised, you will need come in for a travel health consultation with one of our expert Nurses or see your GP for advice.
How frequently do you want to take malaria tablets
Atovaquone/Proguanil, Malarone and Doxycycline all need to be taken every day, at roughly the same time each day. If you already take daily medicines or supplements, you may prefer a daily dose so it’s easily added to your routine.
If you’re not great at remembering to take medication every day, you might prefer a weekly dose medication. Lariam only needs to be taken once a week, which some people find easier to stick to. You have a little more wiggle room with these ones, you can take them a day late if you forget and still get high levels of protection against malaria. Chloroquine (Avloclor) is also a weekly option but is less effective in most parts of the world.
How Long should you continue taking malaria tablets
You need to start taking antimalarials in advance of arriving in the malaria area. How long before depends on which one you choose. If you’re taking a last minute trip to a malaria zone, it’s worth bearing in mind that you might have to take a specific medication to give you adequate protection in the time available. The various antimalarials also have different lengths of time that they must be continued after you have left the malaria zone. It’s very important that you complete your course of treatment as the medicines continue to fight against malaria parasites, so pick an antimalarial with a schedule you can stick to.
Malarone, Atovaquone/Proguanil and Malarone Paediatric only need to be started one day before you arrive in the malaria zone, every day while in the affected area, and are taken for 7 days after leaving. This shorter schedule is preferred by many, especially for short trips.
Doxycycline only needs to be started 1-2 days before entering a malaria zone, taken every day while in the risk area, then must be continued for 28 days after leaving. It is often easy to be mindful of taking this while you are away and surrounded by mosquitoes, but harder to remember for a whole month once you are back at home, so it is worth setting a reminder on your phone or something to ensure you remember to take it every day.
Lariam needs to be taken for 3 weeks before travel if it is your first time, to ensure that you do not experience any side-effects. If you have taken it before and were fine on it, then you can start 1.5 weeks before travel. This one must be continued weekly during your trip and for 4 weeks after. This is a good one for children as parents only have to get them to take it once a week. Children take a smaller dose according to their weight.
Chloroquine (Avloclor) needs to be started one week before you get to the malaria zone, weekly while there and must be taken for 4 weeks after leaving.
Atovaquone/ Proguanil (Malarone)
Effective Malaria Zones
|Worldwide||Worldwide||Worldwide but caution in SE Asia||Central America & Caribbean|
Days/Weeks Before Malaria Zone
|1 day||2 days||2-3 weeks||1 week|
Days/Weeks After Malaria Zone
|1 week||4 weeks||4 weeks||1 week|
Schedule in Malaria Zone
|Once per Day||Once per Day||Once per week||Once per Week|
Suitable for Children
|Yes - Paediatric version||No - until over 12 years||Yes – smaller dose according to weight||Yes – smaller dose according to weight|
Antimalarials to treat Covid-19 coronavirus
Scientists are testing the use of antimalarials, namely a form of Chloroquine, to treat coronavirus covid-19. Results from a small test group suggested chloroquine, taken along with the antibiotic azithromycin, might drastically reduce the severity of covid-19 symptoms. There are currently tests being done by researchers worldwide on these and other antiviral medications, and definitive results will take time. If you are taking chloroquine for travel in a malaria zone, you are not protected against covid-19 and must follow guidance on travel during the pandemic.
Safely buy malaria tablets online
Now you’ve worked out which antimalarial is best for your trip, head over to the Nomad Pharmacy to simply & quickly buy your malaria tablets online. If you need some help, we’ve made a super easy step-by-step guide to help you – here. Our pharmacists will check your details, prescribe your medication and ship them out to your home or work. Remember, no antimalarial is 100% effective against malaria! Stock up DEET insect repellents and permethrin mosquito nets with your malaria medication to minimise bites.