Microsoft word - malaria_all_meds
history of epilepsy. Pregnant women should seek
MALARIAL PREVENTION
medical advice regarding malarial prevention.
Malaria can be fatal. It is essential to take medical
Prolonged administration of Chloroquine may
advice on which antimalarial drugs are
rarely lead to eye damage. If any problems occur
appropriate. No medication can be guaranteed to
with the eyes you should seek medical advice.
protect against malaria in every case. Any
traveller becoming ill when visiting a malarious
Side effects of Chloroquine
region or up to one year after returning home
Headache, stomach upsets, hair loss and visual
should seek medical advice.
disturbances may occur. May also provoke
psoriasis. Seek medical advice should these
GENERAL MEASURES
In addition to taking antimalarial drugs, it is
essential to take other measures to reduce your
3. MALARONE (Atovaquone
exposure to the mosquito:
250mg/Proguanil100mg per tablet)
Prescription from doctor required
Protect against mosquito bites by wearing
This medication has been developed relatively
long-sleeved clothing.
recently and is generally considered a great
Use insect repellent creams containing DEET
advance. It is known to be very effective for
prevention and treatment of Malaria, particularly
Spray your room or tent before going to bed
the resistant forms of chloroquine-resistant
with a knockdown spray (fly-spray).
malaria eg P. Falciparum.
Sleep in a properly screened room or under a
Malarone has a low risk of side effects with the great advantage that it can be started at short
Use a plug-in electric insecticide vaporiser and if available use air conditioning as this
notice, only 24 hours prior to travel. Also It need
helps eliminate mosquitoes in sleeping areas.
only be taken for 7 days after a travellers return
unlike other prophylactics which must be
MEDICATIONS IN USE
continued for 28 days
. It is therefore
Various different Antimalarials are in use and are
particularly useful for the short term business
described below. Different ones are
traveller.
recommended for different areas and it is
Malarones main disadvantage presently is that it
essential you get clear advice about this. Some
is very expensive.
useful information can be found on the internet at
Dosage for prophylaxis against malaria: Take
one Malarone tablet daily starting 24 hours before
travel and continuing for 7 days after leaving the
1. PROGUANIL HYDROCHLORIDE 100mg
Malaria risk area. Ideally it should be taken with a
(Paludrine)
fat rich meal (or at least a glass of milk or a
Available from pharmacist without prescription
yoghourt) as this improves absorption from the
Dosage for prophylaxis against malaria:
Take 2 tablets of Proguanil daily. Starting one
week prior to departure and continuing for four
Side effects of Malarone
weeks after return.
This medicine is most
When Malarone is used for malaria prevention in
commonly taken in conjunction with Chloroquine.
general side effects are uncommon and minor.
When higher doses of the drug are used for
Precautions
treatment of malaria, headache, nausea, vomiting,
Proguanil should be used with caution in patients
mouth ulcers, abdominal pain, diarrhoea, and
with kidney problems.
coughing can occur though are still quite
Pregnant women should seek medical advice
uncommon. Convulsions and rash have rarely
regarding malaria prevention.
Side effects of Proguanil
Precautions
Mild gastric upset and diarrhoea. Mouth ulceration has been reported.
Not suitable for women during pregnancy.
Travellers with a known allergy to Atovaquone or Proguanil should use an alternative.
2. CHLOROQUINE 250mg (Avoclor)
Available from pharmacist without prescription
Malarone should not be taken at the same
Dosage for prophylaxis against malaria:
time as preparations containing either
Take 2 tablets of Chloroquine once a week on the
Tetracycline, Rifampicin or Metoclopramide,
same day. Starting one week prior to departure
since such combinations can significantly
and continuing for four weeks after return.
reduce the effectiveness of Malarone.
It may not be suitable for persons with Kidney
Precautions
Chloroquine should be used with precaution if you suffer from liver or kidney problems or if there is a
4. DOXYCYCLINE 100mg daily
5. MEFLOQUINE HYDROCHLORIDE 250mg
Prescription from doctor required
(Lariam) Prescription from doctor required
Dosage for prophylaxis against malaria: Take
Dosage for prophylaxis against malaria: Take
one doxycycline capsule daily with food. Start 2 to
one Mefloquine tablet once a week on the same
3 days prior to departure and continuing for four
day, starting
two to three weeks prior to
weeks after return.
departure and continuing for four weeks after
Precautions
• Drink sufficient fluid to ensure capsule is
Precautions
washed into the stomach.
Lariam should not be taken if
• Do not lie down for 30 minutes after
You have kidney or severe liver problems
swallowing the capsule.
Heart conduction abnormalities
• Doxycycline interferes with absorption of the
If you are allergic to quinine
contraceptive pill with initial use.
Hence you
If you are taking other anti-malarial
must not rely on your pill alone for the first
3 weeks of doxycycline use. ie use condoms
If you have had fits, a strong family history of
epilepsy or severe psychiatric complaints
• Not suitable for children under 12 years, or
Reliable contraceptive precautions should be
during pregnancy.
used to prevent pregnancy whilst taking
• Travellers with a known allergy to Doxycycline.
Lariam and for three months afterwards.
Side effects of Doxycycline
Side effects of Mefloquine
Possible side effects can rarely include skin
Dizziness, visual disturbance, nausea, vomiting,
photosensitivity that may result in an exaggerated
diarrhoea, abdominal pain, changes in mood,
sunburn reaction. This risk can be minimised by
sleep disturbance. Very rarely Lariam can cause
wearing a hat and using good quality sunscreens.
blood disorders and skin rashes. You should
Fortunately this only affects approximately 5% of
avoid carrying out tasks requiring a high degree of
people who use doxycycline.
co-ordination while taking Lariam as it can cause
Women who take doxycycline for long periods
dizziness and a disturbed sense of balance.
may develop vaginal thrush and may wish to
Ensure you are not affected in this way before
discuss this with their doctor before using
doxycycline.
Psychiatric effects of Mefloquine
Travelers are always very concerned about the
risk of psychiatric disturbance that they have
heard can occur with Lariam. Although
undoubtedly this does occur the risk is small and
Very Approximate Costs of Medications.
fortunately effects do reverse quickly when the
Different Pharmacies will vary in price.
drug is stopped. About 1 in 140 people taking
mefloquine will experience
temporary mild
psychiatric side effects. More serious side effects
Medication
can be expected in only 1 in 10,000 people taking this drug. Most people who get side effects will
Proguanil &
develop them after the first 2 to 3 doses. Doctors
Chloroquine
therefore now advise you to start taking mefloquine 2 or 3 weeks before you travel. Then
Malarone
if you do develop early side effects an alternative can be found.
Doxycycline
For most countries (but not all) where mefloquine is advised a suitable alternative is Malarone.
Mefloquine
There is no doubt that the risks from developing
resistant malaria vastly outweigh the very small risk of psychiatric disturbance from Mefloquine.
Source: http://www.lanternsurgery.co.uk/website/H81672/files/Malaria_All_Meds.pdf
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