Chemoprophylaxis
(Taking Antimalarial Medication)
Atovaquone/Proguanil
Doxycycline
Mefloquine
(Lariam)
Dose
One tablet daily
1-2 days before travel
Continued throughout travel
7 days afterwards
100mg dose daily
1-2 days before travel
Continued throughout travel
4 weeks afterwards
One tablet weekly, always on the
same day
One week before travel
4 weeks afterwards
Paediatric dose
Yes (11-40kg)
Not for children less than 12 years
Scored tablets need to be split
For children between 5kg-45kg
98-100%
92-100%
>90%
Abdominal Pain, headache
Anorexia, cough, nausea,
vomiting and diarrhoea.
Nausea, Diarrhoea, vomiting,
Photosensitivity, loss of appetite,
dyspepsia and rash
Nausea, diarrhoea, vomiting,
Headaches, dizziness or vertigo,
somnolence, sleep disturbances
(insomnia, abnormal dreams) and
abdominal pain.
Lack of clinical data in human
pregnancy means that the
potential risk is unknown and
that it should be avoided in
these circumstances unless
there is no suitable alternative.
Breastfeeding: Excretion in
breast milk therefore use is
contraindicated in nursing
mothers.
Proguanil can delay the
metabolism of the anticoagulant
warfarin, resulting in bleeding.
Contraindicated in pregnancy and
nursing mothers.
Lack of clinical data in human
pregnancy means that the potential
risk is unknown and that it should
be avoided in these circumstances
unless there is no suitable
alternative. Breastfeeding:
Excretion in breast milk therefore
use is contraindicated in nursing
mothers.
Permanent tooth discolouration
may occur during tooth
development (pregnancy, infancy
and children under 12 years)
In severe renal or liver failure avoid
if alternatives are available
The clinical
efficacy of
recommended
antimalarials
Side effects
include:
Refer to the SPC
for full details of
the adverse events
of each drug
Pregnancy
Caution
In patients with severe renal
impairment, alternative
treatments should be
recommended whenever
possible.
Absorption of Malarone may be
reduced un individuals with
diarrhoea and vomiting
Concomitant use of
tetracyclines, metoclopramide
and especially rifabutin is
associated with a significant
reduction of plasma
concentrations of Malarone
When patients are likely to be
exposed to direct sunlight or UV
light an exaggerated sunburn
reaction can cause photosensitivity
The use of antibiotics may
occasionally result in the
overgrowth of non-susceptible
organisms, including Candida
In patients with impaired hepatic
function and renal impairment
Heartburn is common so the
capsule should be taken with a full
glass of water and preferably
while standing or sitting upright
Alcohol may decrease the half-life
of doxycycline
Patients with a history of
psychiatric disturbances, including
depression
Avoid use in patients taking anticonvulsant therapy
Patients with heart rhythm defects
and in those taking anti-arrhythmic
agents