It’s so confusing, how do you choose medication to prevent malaria? How will you select one to suit your busy schedule? Which anti-malarial medications actually work at your destination? How much do anti-malarial medications cost?
Malaria is present in many places around the globe. Travelers to these areas need to protect themselves from malaria by preventing mosquito bites and taking medication to prevent malaria infection.
Four medications are commonly used in the USA to prevent malaria while traveling: Atovone/proguanil (Malarone), mefloqine (Lariam), chloroquine (Aralen), and doxycycline.
But which medication should you take to prevent malaria when traveling? Here is a simple way to choose between the medications commonly used to prevent malaria while traveling.
Most people use 5 criteria to choose medication to prevent malaria while traveling:
1. How Often to Take Medication.
Do you have a strong preference for either daily or weekly dosing? Some medications are taken weekly and some daily.
Medicines to prevent malaria that you take daily include doxycycline and atovone/proguanil (Malrone). Whereas the ones you take weekly are mefloquine (Lariam) and chloroquine.
Weekly medications are easier to remember if you pick a memorable day such as ‘Malaria Monday’.
Daily medications must be taken daily, preferably at the same time each day.
If you forget your dose of a weekly medication, you can take your pill a day late and still have rather good protection against malaria.
2. How Long to Take Medication.
Do you have time to begin your medications 2-3 weeks prior to departure? If not avoid mefloquine which needs to be started 2 weeks prior to departure. Likewise, chloroquine is started 1 week prior to departure.
Are you able to take medication for 4 weeks after you return? All medications except atovone/proguanil (Malarone) require you to take them for 4 weeks afterwards to eradicate any malaria parasites that may be hiding in your body. Conveniently, Atovone/proguanil (Malarone) is only continued for 7 days after you return.
3. Cost of Medication.
Pick a medicine you can afford. Let’s Face it, we all have limited resources. Pick a medication which is within your budget since most health insurances in the USA don’t pay for medication to prevent malaria, they pay only treat malaria once you have it. For safety, be sure to purchase your medication in the USA.
Do NOT buy your medication abroad. Up to 40% of the malaria medications sold in Asia or Africa are counterfeit – missing effective ingredients. And some can permanently damage your heart!
Prices for anti-malarial medication vary widely. Typical costs to prevent malaria for a two-week excursion are:
- Atovone/proguanil ($210-260)
- Mefloquine ($60-75)
- Chloroquine ($25-30)
- Doxycycline ($10-50).
In general the higher the cost of the anti-malarial medication, the more convenient and less side effects the medication has.
Of course, not all medications work in all areas of the world. Your travel medicine specialist can let you know which medications work where. The CDC has a table you where you can look up which medications are recommended for each destination.
For example, chloroquine only works in Mexico, Central America, Caribbean (Haiti, Dominican Republic, etc), the Middle East and Eastern Europe. While mefloquine is not effective in some parts of Southeast Asia. Malarone works everywhere, as does doxycycline.
5. Pre-existing health conditions.
Don’t take medications which affect your underlying health:
If you have ever had anxiety, depression, or seizures avoid mefloquine; it may cause a relapse.
People with Celiac or gluten sensitivity need to avoid medications which use gluten in the manufacturing process such as Malarone. Have your pharmacist check for the fillers in doxycycline, mefloquine, and chloroquine; each has at least one generic that is gluten-free.
People with liver or kidney problems will need to check dosing with their doctor.
Pregnant or nursing women should, in general, avoid any area with malaria. And specifically should not take atovone/proguanil (Malarone) or doxycycline.
Babies and children can take chloroquine, mefloquine or atovone/proguanil. The pills will have to be crushed and mixed with food. Atovone/proguanil is not available for children under 11 pounds. Children less than 8 years old should not take doxycyline since it can cause permanent discoloration of the teeth.
Choosing a medication to prevent malaria is a personal matter; pick one that suits your style and budget. We provide this guide to help you sort through your options. Always discuss your choice in detail with your medical provider; your doctor is best able to help you select the mediction which is right for you. The right choice will allow you to relax and enjoy your travels instead of worrying about becoming ill with malaria.
If you enjoyed learning how to select medication to prevent malaria while traveling you may also enjoy:
- 4 Quick Ways to Prevent Malaria While Traveling Abroad.
- How to Prevent Insect Bites and the Diseases They Carry.
- 5 Questions to Ask Your Doctor Before You Travel Abroad.
Your turn: How do you select medication to prevent malaria while traveling? Have you ever contracted malaria? Which is your favorite medication? Why?