Malaria

Malaria tablets, particularly Malarone, function as a protective shield against malaria, a disease transmitted through the bites of infected Anopheles mosquitoes. Malarone contains two active ingredients: atovaquone and proguanil hydrochloride. 

Together, these substances work synergistically to attack the malaria parasite at two critical life stages. Atovaquone interferes with the parasite’s energy production within the host’s red blood cells, while proguanil hydrochloride halts the parasite’s replication by blocking dihydrofolate reductase, an enzyme crucial for DNA synthesis. 

This dual-action approach makes Malarone an effective prophylactic treatment, significantly reducing the risk of developing malaria in areas where the disease is prevalent. For optimal protection, it’s essential to follow the prescribed regimen, starting before exposure to malaria and continuing through the duration of the risk period and after returning from a malaria-endemic region.

Malaria poses a significant risk to individuals travelling to or living in certain tropical and subtropical areas where the disease is endemic. 

High-risk regions include parts of Africa, Asia, Central and South America, the Caribbean, the Middle East, and some Pacific islands. Factors that can increase the risk of malaria include the travel destination’s specific malaria species, the season of travel, and activities that expose travellers to mosquito bites, especially between dusk and dawn. 

People with weakened immune systems, pregnant women, infants, and travellers from non-endemic countries are particularly vulnerable and should take preventive measures, including the use of malaria tablets like Malarone, application of insect repellent, and sleeping under mosquito nets. 

Assessing the risk of malaria is a crucial step in preparing for travel to ensure the appropriate precautions are taken to prevent the disease.

Start taking Malarone 1-2 days before entering a malaria-endemic area. The tablet is taken daily, ideally at the same time each day, with food or a milky drink to enhance absorption. 

Continue taking the medication every day while in the risk area. Importantly, to ensure that any remaining parasites in the blood are eradicated, continue taking Malarone for 7 days after leaving the endemic region. 

This continuation after exposure is vital for the complete effectiveness of the prophylactic treatment. Missed doses significantly reduce protection effectiveness and should be avoided. If a dose is missed, take it as soon as remembered and resume the regular schedule. 

Do not take a double dose to make up for the missed one. Consulting with a healthcare provider for personalised advice is always recommended, especially for extended stays in endemic regions.

To ensure maximum protection against malaria, adhering to the Malarone tablet schedule is crucial. 

A pack of 12 paediatric Malarone tablets costs £24.

Travellers are advised to consult with their healthcare provider or a travel medicine specialist to receive a prescription that accurately reflects their itinerary.

Remember, investing in Malaria tablets is not just purchasing a product; it’s investing in peace of mind for your travels.

Common side effects are generally mild and may include headache, nausea, vomiting, stomach pain, and diarrhoea.

Like all medications, Malarone can have side effects, although not everyone will experience them. These symptoms are often temporary and may resolve as the body adjusts to the medication.

Taking Malarone with food or a milky drink can help minimize gastrointestinal discomfort. Rare, more serious side effects include allergic reactions, severe skin rashes, mouth ulcers, and visual disturbances. While these severe reactions are uncommon, it’s important to stop taking Malarone and seek immediate medical attention if you experience symptoms such as difficulty breathing, swelling of the face or throat, or a severe rash.

The benefits of preventing malaria typically outweigh the risks of side effects, but any concerns should be discussed with a healthcare provider to ensure that Malarone is the right prophylactic option for you.

Malarone begins to work soon after the first dose is taken, providing protection against malaria when taken correctly.

Starting the medication 1-2 days before entering an area where malaria is prevalent allows Malarone to reach effective levels in the bloodstream to prevent the malaria parasite from developing in the body.

This timing ensures that travellers are protected from their first potential exposure to malaria-carrying mosquitoes. However, the full protective effect is achieved only if the medication is taken regularly, without missing doses, and continued for 7 days after leaving the malaria-endemic area.

 Adhering to the prescribed schedule is crucial for ensuring that Malarone provides the intended level of protection against malaria.

The protective effects of Malarone against malaria last for the duration of the medication regimen plus 7 days after the last dose.

This duration is designed to cover the incubation period of the malaria parasite in the human body, ensuring that any parasites introduced during the travel period are effectively eradicated.

It is crucial to complete the entire course of Malarone as prescribed, including the 7-day post-travel period, to ensure full protection.

Failure to complete the regimen can lead to insufficient protection and the potential for malaria infection. Malarone’s effectiveness as a preventive measure depends on strict adherence to the dosing schedule, highlighting the importance of planning and consistency in malaria prophylaxis.

What is malaria?

Malaria is a serious and sometimes fatal disease caused by Plasmodium parasites, transmitted to humans through the bites of infected Anopheles mosquitoes.

Once in the human bloodstream, the parasites migrate to the liver to mature and reproduce.

Malaria’s symptoms can range from mild to severe, including fever, chills, headache, muscle aches, and fatigue, potentially leading to life-threatening complications such as severe anaemia, cerebral malaria, and organ failure.

Malaria is prevalent in tropical and subtropical regions of the world, where climatic conditions favour the breeding of Anopheles mosquitoes.

Efforts to control malaria include preventive drug treatments like Malarone, mosquito control programs, and the use of bed nets and insect repellents. Despite these measures, malaria remains a significant global health challenge, particularly in less developed countries.

What are some of the symptoms of malaria?

Symptoms of malaria can vary but typically include fever, chills, headache, sweats, fatigue, nausea and vomiting, and muscle pains.

These symptoms can appear about 10-15 days after being bitten by an infected mosquito but can sometimes be mild and difficult to recognize as malaria.

In severe cases, malaria can lead to more serious problems such as kidney failure, seizures, mental confusion, coma, and death.

The severity of malaria symptoms can depend on the Plasmodium species causing the infection, the individual’s health, and the promptness of treatment. Recognizing symptoms early and seeking medical attention is crucial for effective treatment and recovery.

What is the difference between Malarone and Atovaquone/Proguanil?

Malarone is a combination of two antimalarial medications: atovaquone and proguanil. Essentially, Malarone is a brand name for this combination, while atovaquone/proguanil can also be found as a generic medication.

Both the branded (Malarone) and generic versions contain the same active ingredients in the same doses and offer equivalent effectiveness in preventing and treating malaria.

The primary difference lies in the branding with generic versions often being available. When choosing between Malarone and its generic counterpart, considerations may include availability and personal preference, with the assurance that both offer comparable protection against malaria.

What is the difference between Malarone and Doxycycline? 

Malarone and Doxycycline are both used to prevent malaria, but they differ significantly in their composition, side effect profiles, and dosing schedules.

Malarone, a combination of atovaquone and proguanil, is taken daily and requires a shorter period of continuation after leaving a malaria-endemic area (7 days).

Doxycycline is a tetracycline antibiotic that is also effective against malaria when taken daily, but it must be continued for 4 weeks after exposure.

Doxycycline can make the skin more sensitive to sunlight and may not be suitable for individuals with certain health conditions or who are taking specific medications. Choosing between Malarone and Doxycycline often depends on medical history, length of stay in a malaria-endemic area, and potential side effects.

How long do you need to take malaria tablets before travelling?

It’s recommended to start taking malaria tablets 1-2 days before traveling to an area where malaria is prevalent.

This lead time allows the medication to reach effective levels in your bloodstream to prevent malaria should you be bitten by an infected mosquito soon after your arrival.

The specific timing can vary slightly depending on the type of malaria tablets prescribed. For Malarone, starting the medication 1-2 days before travel is sufficient.

Ensuring that you continue taking the medication daily during your stay and for 7 days after returning from a malaria-endemic area is crucial for maintaining protection against the disease.

Can I take malaria tablets whilst pregnant?

It is generally not recommended to take malaria tablets whilst being pregnant.

Malaria poses a significant risk during pregnancy, leading to adverse outcomes for both the mother and the foetus, including severe illness, premature delivery, and increased mortality.

However, the use of certain malaria prophylaxis, including Malarone, is generally not recommended during pregnancy, particularly in the first trimester.

Alternative preventive measures, such as the use of bed nets and insect repellents, are advised for pregnant women. In situations where travel to a high-risk area cannot be avoided, consultation with a healthcare provider is essential to determine the most appropriate course of action, considering the specific risks and benefits of using antimalarial drugs during pregnancy.

At what age can you take Malarone tablets?

Malarone is approved for use in children weighing more than 11 kilograms (approximately 24 pounds).

The dosage for children is based on body weight, making it a suitable option for young travellers in malaria-endemic regions.

Paediatric Malarone tablets are available for children, offering a lower dose of the active ingredients to ensure safe and effective protection against malaria.

It’s important for guardians to administer the medication as prescribed and to continue the treatment for 7 days after leaving the endemic area. As with any medication, consulting a healthcare provider for personalised advice and dosing instructions based on the child’s weight and health status is crucial.

Written by Travel Health and Vaccination Lead Derek Evans