If you are travelling to a country where mosquitoes are known to carry malaria – a serious tropical disease – you should take precautions before you travel. However, if you do suffer symptoms either during your visit, or when you return, you must act immediately and seek medical help as malaria can be fatal if not treated straight away. We offer a range of effective anti-malarial treatments.
What are malaria tablets?
Malaria tablets, or antimalarials, are the group of medications used to prevent and treat malaria. Anyone travelling to a country where there is risk of contracting malaria should take these tablets.
Different types of malaria tablets
There are various different kinds of malaria tablets. All require a prescription and doctor assessment, and recommendations will be based on a number of factors, including where you will be travelling, medical history and family medical history, current medication and any reactions you may have had to malaria tablets in the past.
Lariam, doxycycline, Malarone, chloroquine and atovaquone with proguanil (a generic form of Malarone) are all common options for malaria prevention and treatment.
Lariam, Malarone and chloroquine are generally only used to prevent malaria. They all work in a similar way, killing the malaria parasites which enter the bloodstream and so preventing the disease from taking hold, or stopping its spread in the case of malaria treatment. However, chloroquine is only effective in certain countries (more on this later on).
Doxycycline is an antibiotic which is also effective in the treatment and prevention of malaria. As such, it works to stop the bacteria that causes the malaria infection.
Who can take malaria tablets
In the case of prevention, anyone who is planning to travel to a country where there is a risk of contracting malaria should take some kind of malaria tablet. Each of the different pills have different ingredients and cautions, and so one course of treatment may be more suitable for you than another. Speak to your doctor to make sure you choose the right one.
It’s advised that, if at all possible, women should avoid travelling to malarious areas during pregnancy as their risk of contracting severe malaria is increased. If you are pregnant and must travel, speak to your doctor about your options for preventing malaria. Breastfeeding women should avoid malaria tablets where possible.
Malarone and/or atovaquone with proguanil shouldn’t be taken by children, or by adults who weigh less than 40kg. If you have severe kidney or liver problems you should let your doctor know before you begin taking Malarone.
Children can take Lariam, but those weighing under 5kg should avoid these tablets. Anyone with a history of mental health problems also shouldn’t take Lariam as it can exacerbate symptoms of mental illness. You should also tell your doctor if you have epilepsy or convulsions of any other origin, severely decreased liver function, allergic reactions to quinine or quinidine, severe kidney or liver problems, or blackwater fever.
Doxycycline should be avoided by children under the age of 12 and anyone who has liver or kidney disease, asthma, sensitivity to sunlight, myasthenia gravis, porphyria or increased pressure inside your skull.
Chloroquine is only effective against certain strains of malaria which are only found in some countries. If you’re visiting Guatemala, Dominican Republic, Haiti, North or South Korea, Honduras or Nicaragua, chloroquine could help. Aside from that, anyone taking amiodarone should avoid chloroquine, and you should check with your doctor first if you suffer from epilepsy, have psoriasis, have porphyria or it runs in your family, have liver problems or have blood problems.
How to take malaria tablets
Your doctor will advise you on duration and dosage of your malaria tablets, and you should follow their recommendations closely.
Malarone and doxycycline both need to be taken daily, whereas Lariam and chloroquine are weekly tablets. Daily tablets should be taken at the same time each day, and weekly tablets should always be taken on the same day each week.
You should start taking Malarone 1-2 days before travel to ensure you are protected when you arrive. You will also need to continue taking the tablets for 7 days after you leave the malarious area. The usual dosage is 1 tablet taken each day.
It’s best to take Malarone with a meal or milky drink, as this will increase the amount of the drug that can be absorbed into your body, and you should take the tablet(s) at the same time each day. Some antacids can reduce the absorption of Malarone, so it’s advised you avoid taking these kind of medicines within 3-4 hours of taking your Malarone dose.
Similarly, a course of doxycycline must be started 2 days before travel, and has to be continued for 4 weeks after your return. You should make sure you take each doxycycline pill with a full glass of water, and that you drink plenty of water over the course of your treatment. Tablets should be taken while standing or sitting to avoid irritating the throat, and you should avoid taking the medicine just before going to bed.
You should not take any iron tablets, multivitamins, calcium supplements, antacids, or laxatives within 2 hours before or after taking doxycycline. If you have trouble swallowing the pills, you can crumble them over a tablespoon of applesauce. Eat the sauce immediately, and swallow without chewing.
Lariam needs to be taken once a week, and you should start at least 2 weeks before you go away. If you are worried about side effects, it’s recommended you begin your course 3 weeks before travel, as 75% of side effects manifest before the third dosage. Dosage of Lariam is based on body weight, and will be advised by your doctor.
You should take Lariam just after your main meal, and should make sure to swallow the tablet with a full glass of water. If you have problems swallowing it, you can crush the pill into a powder and mix it into a small glass of milk or water, or sprinkle it over a spoonful of honey or jam.
A course of chloroquine must start a week before travel. It will need to continue throughout your stay, and then for another 4 weeks after you leave the malarious area. The usual dose is 500mg, and this should be taken on the same day each week, after a meal and with a full glass of water.
When taking any malaria tablets, you should also make sure you’re using other precautions to avoid getting bitten by mosquitoes, which can lead to the contraction of the disease. This includes wearing insect repellant, using mosquito nets and wearing appropriate, insect proof clothing.
Most commonly, people taking Malarone can experience mild side effects which include headaches or stomach problems, i.e. nausea, diarrhea or abdominal pain. If you experience dizziness, do not drive, and if you are affected by any severe problems, contact a doctor immediately.
Malarone can react unfavourably with some other medications. Let your doctor know if you are taking any blood thinning medications (like warfarin), boosted protease inhibitors for HIV infection, rifabutin, tetracycline, metoclopramide or rifampin as you may be better off with a different malaria tablet.
The most common and least severe side effects of doxycycline include nausea, stomach problems and sickness, diarrhea, itchy skin or vaginal irritation. Do not use anti-diarrhea medication unless instructed by your doctor. Doxycycline also reduces your tolerance for sunlight meaning you can burn more easily in the sun. Use at least SPF 30 when going outside and avoid using sunbeds for the duration of your course.
If you experience severe, persistent headaches while taking doxycycline, or if you experience any of these symptoms, you should stop taking the tablets immediately and contact a doctor. There are also some medications which interact with doxycycline. If you take any blood thinners (such as warfarin), retinoids, methotrexate, barbiturates, carbamazepine, fosphenytoin, phenytoin, primidone or rifampin, let your doctor know.
The most important side effects to look out for when taking Lariam are the psychological ones. As mentioned above, these will usually manifest sometime before you take your third dose of the medication. This kind of reaction could cause anxiety, depression, mood changes, behavioural shifts, suicidal thoughts, hallucinations, paranoia or aggression. You may also experience difficulty sleeping or strange dreams. If you experience any of these feelings or any other physical changes, contact a doctor immediately.
Lariam can interact with a range of other medications. You can find a comprehensive list of them here.
Common side effects of chloroquine include mild stomach disturbances, headaches and rashes. In the rare case that you experience anything else, contact a doctor. Again, there is an extensive list of other medications with which chloroquine can react. Tell your doctor if you are taking anything else, and have a look at the major drug reactions here.
Where can I buy malaria tablets online?
To legally and safely purchase malaria tablets, you need a prescription from a General Medical Council (GMC) registered doctor. Our online service allows you to do this quickly, easily and from the comfort of your own home by submitting a questionnaire to one of our GMC doctors.
Once you’ve chosen your medication and submitted your information, one of our doctors will review your request. If the medicine is deemed appropriate for you, the request will be accepted and your prescription will be issued. Your medication will then be dispensed by our UK-based pharmacy and sent, with full tracking, to your chosen address. Medicines are usually dispatched within 24 hours of ordering.