Malaria prophylaxis
What is malaria?
Malaria is a potentially fatal tropical disease caused by parasites called Plasmodium, which are transmitted through the bites of certain mosquitoes. Only females from the Anopheles species are responsible for transmitting the disease. The parasites are injected into the bloodstream of humans when they are bitten by these infected mosquitoes, usually during the night or at dusk, when they are more prevalent.
What are the symptoms of malaria?
When someone contracts malaria, they may experience symptoms of headache, sweating, high fever, chills, muscle pains, vomiting and diarrhoea. Just one infected mosquito bite is enough to spread the disease, with symptoms appearing up to a week to 18 days later.
What are the treatments for Malaria?
Several drugs are available to treat malaria, including Mefloquine (brand name Lariam), Malarone and Doxycycline, which can help fight the infection and prevent it. While there are malaria vaccinations, these only reduce the chances of contracting malaria and do not guarantee protection.
How can I prevent Malaria?
There are several steps you can take to prevent malaria. These include avoiding being near stagnant water, using insect repellents and mosquito nets in areas where they are commonly found. You should also ensure you are vaccinated if you are travelling to parts of the world where the disease is endemic.
Amiry & Gilbride Pharmacy offers the following anti-malarial medications without prescription, after a short consultation with one of our pharmacists:
. Lariam (Mefloquine)
. Doxycycline
. Malarone – branded and generic
We also have a range of mosquito nets and insect repellents.
Countries at risk
You are at higher risk of contracting malaria in Africa, India, South East Asia and parts of Central and South America.
Travel precautions
When travelling outside of Europe to common destinations, we offer recommended vaccines such as Typhoid, Hepatitis A, and Diphtheria, Tetanus and Polio (DTP). For those who regularly visit the developing world or are going for a longer period of time, we also recommend the Hepatitis B vaccine. Similarly, for travellers heading to rural parts of developing countries, they should bear in mind the risk of cholera. We offer the Dukoral vaccine against this, which also reduces the risk of a common diarrhoea experienced by travellers, caused by E. coli. This oral vaccine is taken in two doses, a week apart.
When travelling to areas deemed high risk, it is vital to wear insect repellent. These should contain DEET, a chemical ingredient which is highly effective. Even if malaria tablets have been taken, if you are travelling to a high risk area, your insect repellent should contain 50% or more DEET.
Signs and symptoms
It is important to know the symptoms of malaria, particularly when travelling to areas which are high-risk. The most common are sweats and chills, headaches, fever, muscle pains, vomiting and diarrhoea.
Antimalarial medicines
. Atovaquone (250mg) 1 tablet once a day / Proguanil (100mg) 1 tablet per day
. Doxycycline (100mg) 1 tablet once a day
. Avloclor (Chloroquine Phosphate 150mg) 2 tablets, once a week
. Adult Malarone Atovaquone (250mg) 1 tablet a day / Proguanil (100mg) 1 tablet a day
. Child Malarone – based on child’s weight
. Lariam (Mefloquine 250mg) 1 tablet, once a week
Availability
Visit the page of your preferred pharmacy to enquire or come in when it suits you.
More information
Malarone
This antimalarial medication contains two active ingredients called Atovaquone and Proguanil and is used in places where other antimalarial drugs are not effective. The two substances work to prevent the P. falciparum parasite from infecting someone, so that they don’t go on to develop malaria.
What is generic Malarone?
Generic Malarone is priced lower than Malarone, but contains the same ingredients of Atovaquone and Proguanil at the same amounts, and it is medically equivalent. Both types work in the same way to prevent malaria infection in the body. A generic medicine is just as effective as the branded version and all medications of this type have to show equivalency before they are allowed to be sold in the UK.
How does Malarone work?
When someone gets bitten by an infected mosquito, the parasite which causes malaria gets into the bloodstream. Malarone is able to target this parasite and kill it before it can spread. As Malarone can prevent the development of malaria, it is best to begin the treatment before you arrive in an endemic area.
How do I take Malarone?
You should start taking Malarone 1-2 days before going to the endemic area, with one tablet a day, and continue throughout your stay and for at least another week upon your return. This is to make sure that if there is any malarial parasite in your body, it is completely eradicated. It is advised that you take the tablet with food to help maximise absorption.
Malarone or Doxycycline?
Which antimalarial treatment you choose depends on what you prefer and what sort of antimalarial drug resistance exists at your destination. Malarone has to be taken for a week after leaving the high-risk area, while Doxycycline has to be taken for a further 4 weeks after returning. Malarone also has less side effects, but Doxycycline is cheaper. If you are a woman using the contraceptive pill for birth control, it is important to note that Doxycycline can decrease its efficacy.
What are the side effects of Malarone?
Malarone is similar to other antimalarial medications, which all have side effects, with the most common being:
. Headache
. Nausea
. Diarrhoea
. Stomach pain
Can I take Malarone if I am pregnant?
If you are breastfeeding or pregnant, you should not take Malarone, unless recommended by your doctor.
Product information
View the patient information leaflet for Malarone.
Doxycycline
What is Doxycycline and what is it used for?
Doxycycline is part of a series of tetracycline antibiotics, which are a group of broad spectrum antibiotics for the treatment of bacterial infections including malaria.
How does it work?
The malaria parasite gets into a human’s bloodstream if they are bitten by a mosquito which is infected with malaria. Doxycycline can pinpoint the parasite and kill it to prevent the development of a malarial infection. It is important to begin taking Doxycycline before going to a high-risk area where there are malaria-infected mosquitoes and for around 4 weeks after returning.
How should I take Doxycycline?
Doxycycline should be taken 1-2 days before arriving in a region where malaria is endemic. Take a 100mg dose daily and continue to take while you are away and for 28 days after leaving. Take the tablets while standing or sitting up and avoid lying down for around half an hour after taking them. If the tablets cause irritation in the throat, take them with food or water.
Malarone or Doxycycline?
Doxycycline is only prescribed for areas where there is resistance to Chloroquine or where there are P. falciparum strains which are resistant to several drugs. With Doxycycline there are more side effects, but it is cheaper than Malarone.
Side effects
. Nausea
. Anxiety
. Vomiting
. Sensitivity to light
You can alleviate nausea by taking Doxycycline with food.
Can I take Doxycycline if I am pregnant?
Unless a doctor recommends it, you should not take Doxycycline if you are pregnant or breastfeeding.
Product information
View the patient information leaflet for Doxycycline Capsules BP 100mg
Lariam (Mefloquine)
What is Lariam and what is it used for?
This antimalarial medicine, which has a 250mg dose of an active substance called Mefloquine hydrochloride, is for the treatment and prevention of the P. falciparum malarial parasite in antimalarial drug-resistant areas.
How does it work?
Lariam is used to target a malarial parasite after an infected mosquito has bitten someone and passed it into their bloodstream. It will be used depending on how sensitive the malarial parasite is in the area you have travelled to.
How do I take Lariam?
If you weigh more than 45 kg, you take one tablet a week, which contains 250mg. You should start taking it 2-3 weeks before travelling to the affected area. This is so that you can be sure you can tolerate the medication before you arrive there. The treatment is continued throughout your stay and for 4 weeks after coming home. It is best to take the tablets after a meal and with plenty of water.
How is Lariam different from Malarone?
While both drugs are used for the treatment and prevention of malaria in humans, they contain different active ingredients and are taken differently. The other difference is that Lariam has more potential side effects, and these can be more severe.
If you experience any side effects during the treatment, you should immediately stop taking it and contact your pharmacist or doctor.
You should also contact your doctor if you notice changes in your mood or behaviour, any fits or mental health problems. Other signs that you should stop taking Lariam include severe anxiety, depression, feeling restless, unusual behaviour, confusion, mistrusting others, hallucinations, self-endangering behaviour and suicidal thoughts.
If you are feeling unsure about taking Lariam or if any of the cautions on the information leaflet apply to you, or if you get any mental health side effects, you should get in touch with your pharmacist or GP for advice.
Side effects
The side effects of Lariam affect around one in 10 people and there are more of them than with other antimalarial medications. They include:
. Nausea
. Vomiting
. Stomach pain
. Dizziness
. Headache
. Severe anxiety
. Depression
. Sleeping problems
If any of these symptoms are experienced while you are taking Lariam, you should stop immediately and contact your doctor. They should then give you an alternative antimalarial medication for the duration of your stay in an affected area.
Can I take Lariam if I am pregnant?
As with other antimalarials, if you are pregnant or breastfeeding, you should not use Lariam. If you are thinking about trying to get pregnant, you should wait for at least 3 months after taking the last dose.
