Antimalarials

Medical information

Written and reviewed by a team of doctors. Dr Fox is regulated by the CQC & GPhC.

Antimalarial Treatments

Every year more than 1,500 travellers from the UK catch malaria and several of them die. The onset of serious illness can be rapid. The right antimalarial provides good protection. The risks are higher for children and pregnant women, and for people with ongoing medical conditions.

Do NOT forget you may also need vaccines and other health advice from a GP or travel clinic.

How does antimalarial treatment work

Antimalarial medicines help prevent malaria infection by stopping the malaria parasite (Plasmodium) from developing in your body after a mosquito bite.

Different medicines work in slightly different ways, but all aim to prevent infection becoming established.

No antimalarial is 100% effective, so it is important to also avoid mosquito bites.

Who can benefit from antimalarial treatment

Antimalarial treatment is recommended for anyone travelling to areas where malaria is moderate or high risk.

The type of antimalarial you need depends on where you are travelling. This is because malaria parasites in different regions may be resistant to certain medicines.

People who previously built up immunity by living in malaria areas can lose that immunity over time. The recommended tablets for an area can change from time-to-time.

Where are you travelling?

Selecting your destination above opens a country information page on the Travel Health Pro website. This page contains health information including vaccines and malaria precautions for that country (if applicable). The Malaria section (again if applicable to the country) includes more information, vaccine recommendations, details on other risks, and also a downloadable PDF.

Antimalarial recommendations are based on malaria parasite drug resistance. It is important to take the medicine which is recommended for the area being visited. Drug resistance is becoming an increasing problem with the malaria parasite. If antimalarials are not advised for your country of destination it is not recommended to take them and we will not prescribe.

How to use antimalarial treatment

• Take the antimalarial recommended for the area you are visiting.
• Start your treatment before entering a malaria zone. This may be a few days or up to 10 days before.
• Take your treatment regularly, preferably with or after food.
• Continue to take it for 4 weeks after leaving the malaria area. This period is reduced to 7 days for Malarone (atovaquone/proguanil).
• No antimalarial is 100% effective. Malaria risk can also be reduced by avoiding mosquito bites (details below).

Instructions on how to take your chosen antimalarial will be supplied on the box and in the patient information leaflet included.

Who should NOT take antimalarial treatment

This depends on your medical history, current medications, and the specific drug.

Larium (mefloquine) in particular should be avoided if there is a history of mental health issues. Most people can take Lariam with no problems. However in a few people it can cause significant and serious side effects, which may last for several months after stopping. There is also a patient alert card within the medicine pack which should be carried whilst taking Lariam.

Suitability is checked through the online medical questionnaire. If you are not eligible, you should speak to your GP or a travel clinic.

For a full list of interacting medicines see the patient information leaflets for doxycycline, Malarone, and Lariam.

Antimalarial treatment possible side effects

As with all medicines, side effects are possible. See the table below for possible side effects of the different antimalarial options.

Doxycycline causes the skin to become more sensitive to the sun so it is not advised if sun exposure is prolonged.

Compare different antimalarials

Antimalarial treatments and pregnancy or breastfeeding

Pregnant women are at much higher risk of severe malaria and complications. You are strongly advised not to travel to malaria-risk areas during pregnancy. If travel is unavoidable you should take appropriate antimalarial medication and take extra care to avoid mosquito bites. The risk from malaria is much greater than the risk from antimalarial medicines.

If you are pregnant or breastfeeding, please discuss what antimalarial would be most suitable for you with your usual GP or travel health clinic as Dr Fox is unable to prescribe.

Alternative treatment for malaria prevention

Malaria is transmitted by mosquitoes which are themselves infected with the plasmodium parasite. Avoiding mosquito bites is an essential part of protecting yourself from malaria and some other tropical diseases, e.g. dengue fever, yellow fever, zika.

Mosquitoes can bite at any time of day. Most bites by malaria mosquitos occur in the evening and overnight between dusk and dawn. In contrast, dengue fever mosquitoes tend to bite during the day.

Avoiding mosquito bites

Malaria is transmitted by mosquitoes which are themselves infected with the plasmodium parasite. Avoiding mosquito bites is an essential part of protecting yourself from malaria and some other tropical diseases, e.g. dengue fever, yellow fever, zika.

Mosquitoes can bite at any time of day. Most bites by malaria mosquitos occur in the evening and overnight between dusk and dawn. In contrast, dengue fever mosquitoes tend to bite during the day.

• Wear long-sleeved clothing and long trousers if you are out at dusk, dawn, and at night. Several companies sell insect resistant travel clothing pre-treated with insecticide (permethrin).
• Use insect repellent containing DEET on exposed skin and under thin clothing, particularly around the ankles. The best strength DEET is 50% - there is no added benefit to using higher concentrations. Other repellents containing picaridin, IR3535, or lemon eucalyptus are less effective than DEET and must be reapplied very frequently.
• Insect repellent room sprays, mosquito coils, and heating insecticide impregnated tablets all reduce the risk of bites, and should be used to kill mosquitoes in bedrooms before going to bed.
• Where possible sleep in screened rooms and use a mosquito net, preferably one impregnated with insecticide (permethrin). Mosquitoes are deterred by air conditioning but not fans.

Ultrasound devices, mobile phone apps, garlic, vitamin B, marmite, homeopathic products, tonic water, alcohol, tea tree oil, and citronella DO NOT prevent bites.

For further information see Travel Health Pro - Insect and tick bite avoidance.

What are the symptoms of malaria?

Malaria symptoms start out similar to flu. Symptoms include fever, shivers, sweating, backache, joint pains, headache, vomiting, diarrhoea, cough, and sometimes delirium.

These symptoms may take a week or more to develop after you have been bitten by an infected mosquito.

• Seek medical advice if you get malaria symptoms for up to a year after exposure, even after taking antimalarials. Malaria is diagnosed with a simple blood test.
• If you are travelling in remote areas for prolonged periods it may be helpful to also carry a malaria treatment and/or a malaria testing kit with you. Discuss this with your regular doctor or a specialist travel clinic. (not available from Dr Fox)

Antimalarial tablets/capsules are supplied on prescription - our doctors will issue the prescription online direct to our pharmacy. Dr Fox Pharmacy supplies medicines only for adults (over 18 years). Further information about malaria tablets for children.

Comparing antimalarials

Authored 09 January 2010 by Dr Tony Steele
MB ChB Sheffield University 1983. Former hospital doctor and GP. GMC no. 2825328

Reviewed by Dr J. Tweedie, DrC. Pugh, DrB. Babor
Last reviewed 16 April 2026
Last updated 18 September 2026
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  Please read the important medical information about malaria tablets before you start.