Antimalarials - Malaria

Antimalarial tablets prevent and treat malaria.

Consider taking antimalarials if you're travelling to an area where there's a risk of malaria. They can significantly reduce your risk of getting infected.

Contact your GP or local travel clinic for malaria advice as soon as you know that you will be travelling.

Take the medicine as your GP tells you to and finish the course of treatment. You often need to continue taking the medicine after you return from travelling to a high risk area.

If you're unsure, ask your GP or pharmacist how long you should take your medicine for.

Types of antimalarial tablets

Your GP will prescribe an antimalarial depending on:

• where you're going
• your family history
• your medical history, including any medicine allergies
• any medicine you're currently taking
• any problems you've had with antimalarials in the past
• your age
• whether you're pregnant

The main types of antimalarials used to prevent malaria are:

• atovaquone plus proguanil
• doxycycline (also known as Vibramycin-D)

Atovaquone plus proguanil

The adult dose is 1 tablet a day.

The child dose is 1 tablet a day. But the amount depends on the child's weight.

Take atovaquone plus proguanil:

• 1 or 2 days before your trip
• every day you're in a risk area
• 7 days after you return

Sometimes you are advised not to take this medicine.

Do not take this antimalaria if:

• you're pregnant or breastfeeding
• you have severe kidney problems

Possible side effects of atovaquone plus proguanil include:

• stomach upset
• headaches
• skin rash
• mouth ulcers

Atovaquone plus proguanil can be more expensive than other antimalarials, so may be more suitable for short trips.

Doxycycline (also known as Vibramycin-D)

You usually take 100mg daily as a tablet or capsule.

Take doxycycline:

• 2 days before your trip
• every day you're in a risk area
• 4 weeks after you return

It should always be taken with food, preferably when standing or sitting.

Sometimes you are advised not to take this medicine.

Do not take doxycycline if:

• you're pregnant or breastfeeding - ask your GP for advice
• you're sensitive to tetracycline antibiotics
• you have liver problems

Doxycycline is not recommended for children under age 12 because of the risk of permanent tooth discolouration.

Some possible side effects of doxycycline include:

• stomach upset
• heartburn
• thrush
• sunburn as a result of light sensitivity - wear a high SPF sunscreen of at least SPF 50

Doxycycline is relatively cheap. If you take doxycycline for acne, it will also provide protection against malaria as long as you're taking an adequate dose. Talk to your GP about the dose.

Treating malaria

Malaria is a potentially serious illness that can be fatal. Especially for people who did not take anitmalarials to prevent malaria or who have a weak immune system.

But if malaria is diagnosed and treated quickly, most people will make a full recovery. Treatment should start as soon as malaria is diagnosed.

Malaria is most often treated in hospital.

Many of the same antimalarial medicines used to prevent malaria can also be used to treat the disease. You should not use the same one to prevent and treat it.

You will be prescribed an anitmalarial depending on:

• the type of malaria you have
• where you caught malaria
• how severe your symptoms are
• whether you took an antimalarial to prevent malaria
• your age
• whether you're pregnant

Your doctor may recommend using a combination of antimalarials. This is to treat strains of malaria that are resistant to 1 type of antimalarial.

You will have follow up testing to make sure you have not developed anaemia. You may be referred to an infectious disease clinic.

Emergency standby treatment

In some cases, you may be prescribed emergency standby treatment for malaria before you travel.

This may be the case if you are travelling to a remote area that:

• is high-risk for malaria
• has little or no access to medical care

Antimalarials in pregnancy

If you're pregnant, it's better to avoid travelling to areas where there's a risk of malaria.

If you get malaria while pregnant, you and your baby have a higher risk of serious complications.

If you're pregnant and must travel to an area where there's a risk of getting malaria, it's important to take the right antimalarial medicine.

Not all antimalarials are suitable if you're pregnant. They may cause side effects for you and your baby. Your GP will tell you which ones to avoid.