Antimalarials - Malaria

Antimalarial medication prevents and treats malaria. You should consider taking antimalarial medicine when travelling to areas where there's a risk of malaria.

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

It's important to take the correct dose and finish the course of antimalarial treatment. If you're unsure, ask your GP or pharmacist how long you should take your medication for.

Preventing malaria

Antimalarial tablets can reduce your risk of malaria by about 90%.

The type of antimalarial tablets will be prescribed based on:

  • where you're going
  • any relevant family medical history
  • your medical history, including any allergies to medication
  • any medication you're currently taking
  • any problems you've had with antimalarial medicines in the past
  • your age
  • whether you're pregnant

Types of antimalarial medication

The main types of antimalarials used to prevent malaria are:

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

Atovaquone plus proguanil

Dosage

The adult dose is 1 tablet a day.

Child dosage is also once a day, but the amount depends on the child's weight.

It should be started 1 or 2 days before your trip and taken every day you're in a risk area, and for 7 days after you return.

Recommendations

A lack of clear evidence means this antimalarial shouldn't be taken by pregnant or breastfeeding women. It's also not recommended for people with severe kidney problems.

Side effects

Possible side effects include:

Other factors

It can be more expensive than other antimalarials, so may be more suitable for short trips.

Doxycycline (also known as Vibramycin-D)

Dosage

The dose is 100mg daily as a tablet or capsule. You should start the tablets 2 days before you travel and take them each day you're in a risk area, and for 4 weeks after you return.

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

Recommendations

Doxycycline is not normally recommended for pregnant or breastfeeding women, but your GP will advise you.

Doxycycline is not recommended for:

  • children under the age of 12 because of the risk of permanent tooth discolouration
  • people who are sensitive to tetracycline antibiotics, or people with liver problems

Possible side effects

Some possible side effects of doxycycline include:

  • stomach upset
  • heartburn
  • thrush
  • sunburn as a result of light sensitivity

Other factors

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. Ask your GP.

Treating malaria

If malaria is diagnosed and treated promptly, a full recovery can be expected. Treatment should be started as soon as a blood test confirms malaria.

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.

The type of antimalarial medicine and how long you need to take it will depend on:

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

Your GP may recommend using a combination of different antimalarials to overcome strains of malaria that have become resistant to single types of medication.

Treatment for malaria can leave you feeling tired and weak for several weeks.

Emergency standby treatment

In some cases, you may be prescribed emergency standby treatment for malaria before you travel. This is usually if there's a risk of you becoming infected with malaria while travelling in a remote area with little or no access to medical care.

Your GP may decide to seek advice from a travel health specialist before prescribing standby emergency treatment.

Antimalarials in pregnancy

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

When you're pregnant you have an increased risk of developing severe malaria. Both baby and mother could experience serious complications.

It's very important to take the right antimalarial medicine if you're pregnant and have to travel to an area where there's a malaria risk.

Some of the antimalarials used to prevent and treat malaria are unsuitable for pregnant women. They can cause side effects for you and your baby.

Your GP will tell you which ones to avoid if you're pregnant.


Content supplied by the NHS and adapted for Ireland by the HSE

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 23 March 2021
Next review due: 23 March 2024

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