Malaria Tablets

Malaria is caused by a parasite that is passed into the body through a mosquito bite. Malaria tablets work to kill this parasite, which will treat and prevent the disease. The tablets are taken before, during, and after a trip where you may be at risk of catching malaria. They can prevent malaria, reducing the risk of catching it by 90%.

Malaria tablets are mainly used as a prevention strategy, meaning you start taking them before you reach your travel destination. This means if you were to come into contact with the parasite, the tablets should stop you getting the disease. You should speak to your doctor about which country you are travelling to, as they will be able to advise which malaria tablets are best for your destination.

There are 3 malaria tablets that we prescribe, 2 of which contain the same medications. Before choosing a treatment, speak to your doctor, as they will be able to inform you which malaria tablet is best for the country you are visiting.

Malarone

This malaria tablet contains two active ingredients (medications) called atovaquone and proguanil hydrochloride. It should be taken 24 to 48 hours before travel, throughout your trip, and 7 days on return. You should take one tablet a day with a milky drink or food, as this makes sure the tablet is absorbed properly. Malarone is suitable for most travellers and does not often have side effects.

Atovaquone and Proguanil

This is the unbranded or generic version of Malarone and contains the same active ingredients, which are atovaquone and proguanil hydrochloride. These malaria tablets do the same job and should be taken in exactly the same way. Like Malarone, they are a good choice if you are travelling for a short amount of time, as they only need to be taken for 7 days on return.

Doxycycline

This is an antibiotic containing a medication called doxycycline and can also be used to prevent malaria. It should be taken 24 to 48 hours before travelling and should not be stopped until 4 weeks after you have returned. It is important not to drink alcohol with Doxycycline.

Malaria tablets should be taken once daily and at the same time every day. The dosage for each malaria tablet is different.

For Malarone, and Atovaquone and Proguanil, take 1 tablet every day, 24 to 48 hours before you go, during your trip, and 7 days after.

For Doxycycline, take 100mg once a day, in the morning. Take from 24 to 48 hours before travelling, during your trip, and 4 weeks after.

Doses for children are slightly different and will depend on their weight. Speak to your doctor for more information on doses for children.

Malaria tablets can have side effects and this will depend on which tablets you are taking. Malarone, and Atovaquone and Proguanil, contain the same active ingredient, so have the same side effects. They are usually well tolerated, meaning most people do not have any side effects at all.

The most common side effects for Malarone, and Atovaquone and Proguanil, are:

• coughing
• depression
• fever
• headache
• nausea or vomiting (being sick)
• abdominal pain
• decreased appetite
• diarrhoea

If you get side effects you should:

• drink plenty of fluids
• eat or drink a milky drink when taking these tablets
• take paracetamol

If your side effects last longer than a few days, speak to your doctor about what other treatment might be available for you. It is important that you keep taking your malaria tablets if you can.

Uncommon side effects for Malarone, and Atovaquone and Proguanil, are:

• anxiety
• blood disorders
• palpitations (heart racing or pounding)
• alopecia (hair loss)
• low sodium levels in the blood

If you get any of these side effects, speak to your doctor straight away and stop using the tablets.

Doxycycline is an antibiotic so it can come with different side effects. The most common side effects are:

• headaches
• sensitivity to sunlight
• feeling or being sick

If you get side effects, take paracetamol, try to avoid the sun, and take anti-sickness medication. This should go away within a few days of taking the medication, otherwise speak to your doctor about an alternative.

Doxycycline can have some serious side effects including:

• blood disorders
• buzzing in the ears
• liver problems
• muscle or joint pain
• diarrhoea
• increased pressure in the brain
• swollen or sore mouth, tongue, or lips
• severe pain in the stomach
• problems with your oesophagus (food pipe), such as pain when swallowing or acid reflux
• a decreased appetite

If you have any of these symptoms, speak to your doctor right away.

All malaria tablets come with the chance of a severe allergic reaction. Visit a hospital straight away if you show any signs of a serious allergic reaction, including swelling, wheezing, or a skin rash.

Malaria tablets are not suitable for everyone and this will depend on which malaria tablet you are taking. Speak to your doctor before taking malaria tablets if you have any other health conditions, take any medications, or are pregnant or breastfeeding.

Doxycycline should not be taken by children under the age of 12. It is not usually recommended if you are pregnant or breastfeeding. You should not drink alcohol whilst using this medication, as it is less likely to work.

Doxycycline may not be suitable if you have:

• a condition that affects your kidneys
• a condition that affects your liver
• had an allergic reaction to doxycycline
• lupus (an autoimmune disease)
• an inflamed food pipe
• myasthenia gravis (a muscle wasting illness)
• diarrhoea, or usually get diarrhoea when taking antibiotics

Other medications may interact with Doxycycline, so speak to your doctor before taking if you also use:

• penicillin
• oral contraceptives
• rifampicin (tuberculosis treatment)
• blood thinners
• strong sleeping tablets
• drugs to control epilepsy
• ciclosporin (treatment for organ transplant patients)
• methoxyflurane (an anaesthetic)
• methotrexate
• antacids
• retinoids (skin condition treatment)

Malarone, and Atovaquone and Proguanil, can be taken by adults and children but should not be used if you have severe kidney disease. For children under 11kg, speak to your doctor as there are different tablet strengths available. You may not be able to take these tablets if you are pregnant or breastfeeding, but our doctors can give you advice on this.

Some medications can alter the way Malarone, and Atovaquone and proguanil, work.

These include:

• blood thinning medications
• metoclopramide (nausea and vomiting medication)
• some antibiotics, such as rifabutin and rifampicin
• etoposide (cancer treatment)
• HIV medications

If you are taking any of these, do not take malaria tablets until you have spoken to your doctor.

Malaria is a disease often found in foreign countries where mosquitoes are present. It is caused by a mosquito bite. The bite passes a parasite into the bloodstream, which causes malaria. The main symptoms of malaria are:

• headaches
• vomiting and diarrhoea
• fever
• muscle pains

Most people do not get symptoms straight after being infected. Symptoms may take 7 to 18 days to appear, and in rarer cases can take up to a year to appear. Malaria is mainly caused by a mosquito bite but in very rare cases it can also be spread through sharing needles and blood transfusions.

You can avoid bites by following these simple steps:

1. Use insect repellent and apply often
2. Sleep indoors where possible, away from insects
3. Use a mosquito net if you are going to stay outdoors
4. Wear clothes that cover your arms and legs, so you are less likely to get bitten

If you believe you have been bitten, seek medical advice right away, even if you are taking malaria tablets.