What are the best malaria tablets to take?

• Atovaquone/Proguanil (Malarone) – These malaria tablets are effective in all countries where malaria is present.
• Doxycycline – These malaria tablets are also effective in all countries where malaria is present.
• Lariam (Mefloquine) – These malaria tablets are effective in all countries where malaria is present. This excludes Afghanistan, Argentina, Belize, Bhutan, Bolivia, Cambodia, Costa Rica, Dominican Republic, Guatemala, Haiti, Honduras, Indonesia, Iran, Laos, Mexico, Myanmar, Nepal, North Korea, Panama, Paraguay, Peru, Philippines, Saudi Arabia, Tasjikstan, Thailand, Turkey, Venezuela, Vietnam and Yemen
• Avloclor (Chloroquinine) – Only effective in Central America and the Caribbean

Each malaria tablet is different and will have their own dosing regime:

• Atovaquone/Proguanil (Malarone) – You should start taking Malarone 2 days before entering the malaria zone, whilst there, and for 7 days after leaving.
• Doxycycline – You should start taking doxycycline 2 days before entering the malaria zone, whilst there, and for 28 days after leaving
• Lariam (Mefloquine) – You should take Lariam once a week, starting 3 weeks before entering the malaria zone, whilst there, and for 4 weeks after leaving
• Avloclor (Chloroquinine) – You should take two tablets once a week on the same day each week, starting one week before travel, whilst you are in the malaria zone, and for 4 weeks after leaving.

It is important to check that the malaria tablets you want to take, are suitable for the destination you are travelling to. The NHS Fit For Travel website has an updated list of countries, and which malaria tablets are effective within that region. Atovaquone/Proguanil (Malarone) and doxycycline are generally considered to be effective in most regions. There are instances where a certain antimalarials will not be suitable for a particular individual, depending on their medical status. It is important to check with your doctor or pharmacist, to find out which malaria tablets you are able to take.

Malaria tablets have side-effects, but not all people are affected by them. Side-effects can also vary depending upon which antimalarials you are taking.

• Atovaquone/Proguanil (Malarone) – Common side-effects include nausea, stomach pain, diarrhoea and vomiting. Taking atovaquone/proguanil after a meal helps to reduce stomach related side-effects.
• Doxycycline – Common side-effects include nausea, heartburn and thrush. Doxycycline can also cause your skin to become sensitive to sunlight. You should stop taking doxycycline and seek medical attention if you notice that your skin has become increasingly sensitive to sunlight (e.g. if you develop a rash, itchiness, redness or severe burning).
• Lariam – Common side-effects include depression and anxiety. You should stop taking Lariam if you develop any signs of these, and seek medical attention.

If you develop any symptoms of a serious allergic reaction, you should stop taking your antimalarial tablets and seek urgent medical attention. Examples of a serious allergic reaction include difficulty breathing, chest pain, swelling of body parts and chest pain.

Most malaria tablets are not suitable for those that are pregnant or breastfeeding. Those that are pregnant or breastfeeding are advised not to travel to areas where malaria is present, unless absolutely necessary. This is because pregnant women have a higher chance of developing severe malaria, which can cause complications for both the baby and mother. Your doctor will make a judgement in deciding whether the benefits of taking malaria tablets outweigh the risk.

• Atovaquone/Proguanil (Malarone) – You should avoid taking Malarone if you are pregnant. Your doctor will decide whether the potential benefit outweighs the risk. Malarone should only be used for those that are breastfeeding, if there is no suitable alternative.
• Doxycycline – You should never use doxycycline if you are pregnant or breastfeeding, as it is harmful to babies.
• Lariam (Mefloquine) – There is no evidence to suggest that Lariam is harmful to an unborn baby. However, due to lack of evidence, Lariam is not routinely prescribed to those that are pregnant. Lariam is present in breastmilk but the risk to the infant is minimal.
• Avloclor (Chloroquinine) – The benefit of using Avloclor in preventing malaria outweighs the risk for pregnant women. The amount in breastmilk is too small to be harmful to a child who is breastfeeding.

If you are pregnant or breastfeeding and require malaria tablets, you should make an appointment to see your doctor.

There is currently no vaccination available to prevent malaria. Malaria tablets help to reduce the risk of getting malaria by around 90%. It is important to take your malaria tablets as prescribed, and to complete the course.

You are not able to get malaria tablets on an NHS prescription. This is because travel is seen as non-essential, and the government will not pay for this.

You are able to buy malaria tablets online by completing an online questionnaire. This allows a clinician to assess whether or not the malaria tablets you want to take are suitable for you. You can also buy malaria tablets from your local chemist.