Children are more at risk from serious complications of malaria infection than adults and they need to take the same types of anti-malaria tablets as adults. Fortunately there are a whole range of malaria tablets for children.
There is one major exception: children under the age of 12 years should not take doxycycline, as it can cause permanent yellow staining of the teeth in younger children. There is always an alternative to doxycyline, usually mefloquine (Lariam) or atovaquone/proguanil (Malarone).
Many people obtain malaria tablets online. People in the UK should use only websites which are registered with the Care Quality Commission. Malaria tablets from regulated online doctors are supplied through e-prescriptions issued after online consultations and sent automatically to pharmacies. Tablets are then posted from General Pharmaceutical Council registered pharmacies. Medicines from online clinic websites in the UK are supplied only to named individual patients/customers who are over 18. See Dr Fox online malaria consultation.
Regulated clinic website are not permitted to prescribe medicine for children. Prescription medicine for children can be posted from online pharmacies only if a child has been prescribed the medicine already, usually by their GP, and the prescription is posted to the online pharmacy. There are many regulated online pharmacies in the UK.
Buy treatment (adults)
From Chemist Shops
Malaria tablets for children are usually supplied on doctor’s prescriptions. Chloroquine (Avloclor) and proguanil (Paludrine) are exceptions, as they can supplied on prescription and they can also be bought from UK pharmacies without prescriptions.
Some specialist pharmacists are able to supply all types of malaria tablets for adults and children without prescriptions, even those tablets which are normally prescription only medicines (doxycycline, Malarone, Lariam). You may wish to check with your pharmacy before making an appointment with your doctor.
If a doctor has already issued a prescription for malaria tablets for a child or adult, the prescription can either be taken to a high-street pharmacy (dispensing chemist) for dispensing or can be posted to a regulated online pharmacy for dispensing and posting.
Malaria tablets, like other travel medicines, are not normally funded by the NHS. NHS doctors can prescribe malaria tablets, but usually do so on private prescriptions, often charging a fee to write the prescription. The cost of tablets dispensed on private prescriptions is set by individual pharmacies. It can be worth shopping around, particularly for atovaquone/proguanil (Malarone), which is an expensive medicine.
Malaria tablets bought through online doctors tend to be lower cost, as online services usually include a consultation and e-prescription (only over 18s eligible).
Private doctors and specialist travel clinics tend to have higher charges. Specialist pharmacies, able to supply malaria tablets without prescriptions, set their own prices, which will vary.
Recommendations about which tablets are advised for different parts of the world can be found at the NHS Scotland Fitfortravel website. Also see ‘bite prevention’ page.
NOTE: All the doses below are taken from manufacturer’s patient information leaflets supplied with tablets and are based on the standard strength of tablets (June 2013). Tablets should always be taken in accordance with prescription instructions or the instructions supplied with the tablets.
Malarone – Atovaquone/Proguanil
Atovaquone/proguanil is a proper medical drug name. Malarone is the best known UK brand, although not the only UK brand of atovaquone/proguanil. There is a child’s strength tablet, atovaquone 62.5mg/25mg proguanil. There are different brands of child’s strength tablets the best known of which is Malarone Paediatric.
See link to the full manufacturer’s patient information leaflet supplied with Malarone Paediatric (Malarone for children).
Child strength atovaquone 62.5mg/25mg proguanil can be taken by children right down to 11kg. Tablets can be crushed and mixed with food.
Atovaquone/proguanil tablets are taken daily, starting 2-3 days before a trip and continued for 7 days after leaving malarial areas.
The usual dose to prevent malaria depends on a child’s weight.
- 11-20 kg: 1 paediatric tablet once a day
- 21-30 kg: 2 paediatric tablets once a day (as a single dose)
- 31-40 kg: 3 paediatric tablets once a day (as a single dose)
Lariam – Mefloquine
Mefloquine is the medical name of Lariam. Lariam is the brand name of the medicine.
There is no children’s strength Lariam tablet. Adult tablets are divided to make up children’s doses. See the table below for doses. See the manufacturer’s patient information leaflet for Lariam tablets.
Lariam is taken once weekly on the same day each week, started 10 days before travel (first dose 10 days before, second 3 days before) and continued for 4 weeks after leaving malarial areas.
|5 – 19 kg (11 – 42 lbs)||3 months – 5 years||¼ tablet|
|20 – 30 kg (44 – 66 lbs)||6 – 8 years||½ tablet|
|31 – 45 kg (68 – 99 lbs)||9 – 14 years||¾ tablet|
Doxycycline is an antibiotic which can be used for malaria prevention. Doxcycline is the medical name. It is available in a variety of different brand names, of which the best known in the UK is Vibramycin. The adult’s and children’s dose of doyxcycline for malaria prevention is the same, except that children under 12 should not be given doxyccyline.
Note: Doxycycline is NOT advised for children under 12 years. In younger children it can cause permanent yellow staining of the teeth.
Different brands of doxycycline are supplied with very similar manufacturer’s advice leaflets. See the manufacturer’s patient information leaflet supplied with one of the brands of doxycycline.
The dose of doxycycline in adults and children over 12 years for malaria prevention is one 100mg capsule taken daily, started 1-2 days before travel and continued for 4 weeks after leaving malarial areas.
Chloroquine, Proguanil and Chloroquine plus proguanil
Chloroquine 250mg plus proguanil 100mg (Paludrine™/Avloclor™ anti-malarial travel pack)
The combination of chloroquine 250mg tablets (Avloclor) taken weekly and proguanil 100mg tablets (Paludrine) taken daily is known as chloroquine plus proguanil. This combination treatment is usually supplied in one week packs containing containing 16 tablets. A one week pack contains enough chloroquine tablets for a week (adult dose two tablets once weekly) and enough proguanil tablets for a week (adult dose – two tablets once daily).
For children over 1 year of age, the dose depends on the child’s age.
- Ages 1 to 4 years: Take half an Avloclor tablet once a week (on the same day each week) and take half a Paludrine tablet daily (at the same time each day).
- Ages 5 to 8 years: Take one Avloclor tablet once a week (on the same day each week) and take one Paludrine tablet daily (at the same time each day).
- Ages 9 to 14 years: Take one and a half Avloclor tablets once a week (on the same day each week) and take one and a half Paludrine tablets daily (at the same time each day).
Do not use this Anti-malarial Travel Pack in children under 1 year of age.
Manufacture’s patient information leaflets for chloroquine plus proguanil (Avloclor/Paludrine)
Chloroquine phosphate 250mg (Avloclor)
Chloroquine tablets are taken weekly, started one week before travel and continued for 4 weeks after leaving a malaria area.
Chloroquine on its own is not suitable for areas of the world where there is chloroquine resistant malaria.
Do not give chloroquine (Avloclor) to children under 1 year of age.
For children over 1 year of age, the dose depends on the child’s age.
- Ages 1 to 4 years: Take half an Avloclor tablet once a week (on the same day each week).
- Ages 5 to 8 years: Take one Avloclor tablet once a week (on the same day each week).
- Ages 9 to 14 years: Take one and a half Avloclor tablets once a week (on the same day each week).
Manufacture’s patient information leaflets for chloroquine (Avloclor)
Proguanil hydrochloride 100mg tablets (Paludrine)
Proguanil is the medical name for a medicine which is often known by the brand name, Paludrine.
Proguanil (Paludrine) tablets are taken once daily, started one week before travel and continued for 4 weeks after leaving malarial areas.
|Child age||Paludrine 100mg Dosage|
|Under 1 year:||1/4 tablet (25 mg) daily|
|1 to 4 year:||1/2 tablet (50 mg) daily|
|5 to 8 years:||1 tablet (100 mg) daily|
|9 to 14 years:||1 1/2 tablets (150 mg) daily|
|Over 14 years:||Adult dose daily|
Manufacture’s patient information leaflets for proguanil (Paludrine)
It is not possible to avoid mosquito bites completely but the less you are bitten, the less likely you are to get malaria.
To avoid being bitten:
- Stay somewhere with screening on doors and windows or make sure that doors and windows close properly.
- Sleep under an intact mosquito net that has been treated with insecticide.
- Use insect repellent re-applied frequently. The most effective repellents contain diethyltoluamide (DEET), available in sprays, roll-ons, sticks and creams.
- Wear light, loose-fitting trousers, rather than shorts, and shirts with long sleeves. This is particularly important at dusk and at night when mosquitoes prefer to feed.
- Garlic, vitamin B and ultrasound devices do not prevent mosquito bites.