Malaria tablets side effects

Side effects of malaria tablets & reasons to use particular drugs

No anti malaria tablet is 100% effective. Different malaria tablets are recommended for different parts of the world. No one recommended tablet is more effective in preventing malaria than another. The drugs recommended by the UK NHS can be found by links from the Dr Fox malaria page, where you can also buy malaria tablets.

Lists of side effects for each medicine are given in the manufacturer’s patient information leaflets – links below.

Information about malaria tablets for children can be found here.

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Malarone side effects (Atovaquone/Proguanil)

  • Malarone is taken daily.
  • Very well tolerated medicine
  • Malarone side effects are uncommon
  • Paediatric tablets are available
  • Cannot be used by women who are pregnant or breastfeeding or children less than 5 kg
  • Cannot be taken by people with severe renal impairment
  • Tends to be more expensive than some of the other options (especially for trips of long duration)
  • Some people (including children) would rather not take a medicine every day
  • Good for last-minute travellers because the drug is started 1-2 days before travelling to an area where malaria transmission occurs
  • Some people prefer to take a weekly malaria tablet (Lariam)
  • Good choice for shorter trips because you only have to take the medicine for 7 days after travelling rather than 4 weeks
  • Since February 2013 a non-branded (generic) version of Malarone has become licensed in the UK. The cost is similar to branded Malarone (May 2013).

Read the manufacturer’s (GlaxoSmithKline) patient information leaflet for Malarone.

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Chloroquine side effects

  • Chloroquine is taken once weekly.
  • In some parts of the world daily proguanil tablets are required in addition to chloroquine.
  • Some people already take hydroxychloroquine for rheumatologic conditions
  • Can be taken in all trimesters of pregnancy
  • Not effective in areas of chloroquine or mefloquine resistance
  • May exacerbate psoriasis
  • For trips of short duration, some people would rather not take medication for 4 weeks after travel
  • Not a good choice for last-minute travellers because drug needs to be started 1-2 weeks prior to travel

Read the manufacturer’s (AstraZeneca) patient information leaflet for Chloroquine (Avloclor).

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Doxycycline side effects

  • Doxycycline is taken daily.
  • Good for last-minute travellers because the drug is started 1-2 days before travelling to an area where malaria transmission occurs
  • Tends to be the least expensive antimalarial for areas of chloroquine resistant malaria
  • Some people take doxycycline chronically for prevention of acne. In those instances, they do not have to take an additional medicine
  • Doxycycline also can prevent some additional infections (e.g., Rickettsiae and leptospirosis) and so it may be preferred by people planning to undertake hiking, camping, and wading and swimming in fresh water
  • Cannot be used by pregnant women and children <12 years old
  • For trips of short duration, some people would rather not take medication for 4 weeks after travel
  • Women prone to getting vaginal yeast infections when taking antibiotics may prefer taking a different medicine
  • Persons planning on considerable sun exposure may want to avoid the increased risk of sun sensitivity
  • Some people experience acid indigestion type symptoms from doxycycline

Read the manufacturer’s (Actavis) patient information leaflet for Doxycycline.

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Lariam side effects (Mefloquine)

  • Lariam is taken weekly
  • Good choice for long trips because it is taken only weekly
  • Can be used in second and third trimester of pregnancy, and in first trimester, if there is no other option (i.e. if postponing travel is not possible)
  • Cannot be used in areas with mefloquine resistance
  • Cannot be taken by patients who have a history of significant psychiatric disorder(s)
  • Cannot be used in patients with a seizure disorder e.g. epilepsy or fits
  • Not recommended for persons with cardiac conduction abnormalities
  • Not a good choice for last-minute travellers because drug needs to be started 10 days prior to travel
  • For trips of short duration, some people would rather not take medication for 4 weeks after travel

Read the manufacturer’s (Roche) patient information leaflet for Lariam (Mefloquine).

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The above information is adapted from the advice of the Centre for Disease Control.

Travellers should always take anti malaria tablets in areas of malaria risk. It is also important to reduce exposure to malaria by reducing mosquito bites.

Dr Tony Steele