Malarone or chloroquine and proguanil

Taking the right anti-malaria tablet

According to an article in The Telegraph (Danger of buying malaria pills at the chemist) some people are being given the wrong advice about which malaria tablet to take. Some high street chemists are advising people to take proguanil and chloroquine for countries where only Malarone or doxycycline or mefloquine (Larium) are effective.

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Chloroquine and chloroquine and proguanil tablets are available without prescription from high street chemists. It appears some people are being told that proguanil and chloroquine can be taken to prevent malaria in some parts of the world where the malaria parasite is resistant to this combination of drugs.

For many parts of sub-Saharan Africa the only effective malaria tablets are Malarone (Atovaquone/proguanil) or doxycycline. These two anti-malaria tablets are prescription only items. They cannot be bought without a prescription. These prescriptions are issued by doctors or in some cases by nurses and pharmacists with specialist training.

Recommended Anti-Malaria tablets

The malaria tablets required for a country depends on the malaria parasite drug resistance of that country. Drug resistance changes from region to region and from time to time. Doctors in the UK usually get advice from the NHS for Scotland travel health website Fitfortravel. This website, which can be difficult to navigate, has maps for each country showing where there is a substantial risk of malaria. There are pages of advice associated for each country detailing the recommended malaria tablets.

It is unwise to take a malaria tablet without first checking the current advice for the country being visited. For large areas of the world chloroquine and chloroquine and proguanil in combination are no longer effective.

Malarone cost

The main problem most people find with Malarone is the cost. Malarone is under patent (update: the patent was invalidated by a court in January 2013). It is produced only by GlaxoSmithKline. The wholesale cost of Malarone is close to £2.10 per tablet. The cost of the private prescription required before Malarone can be supplied is usually another £10.00 to £25.00; sometimes more.

People are put off by having to spend so much for malaria prevention. They have often not budgeted for a cost which can be as much as the cost of a flight or hotels. Unfortunately the NHS policy is not to pay for malaria prevention in most areas of the UK. Malaria prevention, for better or worse, is regarded as something individuals must fund for themselves – being a travel medicine it is classed as a lifestyle choice.

Problem with Doxycycline

Doxycycline and Malarone must both be taken daily. Doxycyline needs to be taken for four weeks after exposure to malaria whereas Malarone needs to be taken for only one week afterwards. Doxycycline tends to cause slightly more side effects than Malarone. The most common side effects being nausea, indigestion and tummy upset. Some people taking doxycycline also experience increased sensitivity to sunlight, with a need to avoid direct sun whilst taking it.

Doctor Fox anti-malaria tablets

People wishing to check up-to-date advice on recommended tablets can follow links at the Dr Fox malaria tablets page. When malaria tablets are needed there is an online consultation process to check which tablets are suitable for each individual. People who qualify for treatment can go all the way through to register and pay for tablets in one visit. The tablets are posted by recorded delivery. The overall price paid is less than the cost of any other online clinic or travel clinic price.

Dr Tony Steele