Your mosquito patches and net are packed, you’ve loaded up on insect repellent and your suitcase is chock full of long-sleeved shirts and track pants. These are definitely some of the measures that you should be taking before travelling to any country or region that carries a risk of transmission of malaria.
After all, all it takes is a single bite from an infected mosquito for you to be hit by the high fever, chills and excruciating muscle aches that are characteristic of the disease.
However, one can never be too safe when it comes to malaria. There is a good chance that you may be bitten even after taking all the aforementioned precautions – this is where anti-malarial medication comes in.
While mosquito nets and sprays help you to avoid getting bitten, anti-malarial medication, usually in the form of tablets, help in stopping the infection from establishing and its symptoms from developing.
These tablets significantly reduce your chances of acquiring the infection and this may be especially crucial in areas that have swarms of infected mosquitos. So if you’re heading to regions where the risk of malaria is present such as Africa or South America, remember to speak with your travel health provider about which type of anti-malarial medication to stock up on.
Clari Health Singapore has put together a go-to guide for you so that you can be in the know about which malaria tablets are best suited for you.
Which malaria tablets are most commonly used?
Singhealth, the largest provider of healthcare in Singapore, recommends four main types of malaria tablets:
Atovaquone/Proguanil
- Common brand name: Malarone
- How and where to get it: Can be prescribed by a licensed medical practitioner and collected from pharmacies
Mefloquine
- Common brand name: Lariam
- How and where to get it: Can be purchased from retail pharmacies without a doctor’s prescription
Doxycycline
- Common brand names: Vibramycin
- How and where to get it: Can be prescribed by a licensed medical practitioner and collected from pharmacies
Chloroquine
- Common brand names: Avloclor, Resochin or Aralen
- How and where to get it: Can be purchased from retail pharmacies without a doctor’s prescription
Which tablets can be taken by children?
Singhealth has provided the following recommendations in terms of which of these tablets can be safely taken by children:
Atovaquone/Proguanil
- Suitable for children? : Yes, there is a paediatric version of the tablet and its dosage can be adjusted according to child’s body mass.
MefloquineMefloquine
- Suitable for children? : Yes, dosage can be adjusted according to child’s body mass.
Doxycycline
- Suitable for children? : No, doxycycline can cause discolouration of teeth and damage of tooth enamel in children so it can only be prescribed to children above the age of 12.
Chloroquine
- Suitable for children? : Yes, dosage can be adjusted according to child’s body mass.
Who shouldn’t take these tablets?
Singhealth has determined that the following antimalarial medication may have contraindications:
Atovaquone/Proguanil
- You shouldn’t take these tablets if you are: pregnant or breastfeeding
- You shouldn’t take these tablets if you have: severe kidney problems
Mefloquine
- You shouldn’t take these tablets if you are: epileptic or depressed
- You shouldn’t take these tablets if you have: seizures, mental health problems, severe heart or liver problems or close relatives who have the aforementioned problems
Doxycycline
- You shouldn’t take these tablets if you are: a child below the age of 12, pregnant or breastfeeding or sensitive to tetracycline antiobiotics
- You shouldn’t take these tablets if you have: liver problems
Chloroquine
- You shouldn’t take these tablets if you are: an alcoholic or anaemic from Pyruvate Kinase and glucose-6-phosphate dehydrogenase (G6PD) deficiencies
- You shouldn’t take these tablets if you have: seizures, psoriasis, liver problems or porphyria
Which regions are these tablets effective in?
Atovaquone/Proguanil
- Regions: All parts of the world
Mefloquine
- Regions: All parts of the world, but to be used with caution in South East Asia
Doxycycline
- Regions: All parts of the world
Chloroquine
- Regions: Central America and the Caribbean
When, for how long and how often should you take the tablets?
According to Singhealth, the dosage and frequency that you should take each of the antimalarial pills varies:
Atovaquone/Proguanil
- When? : 1 or 2 days before you travel
- How often? : One tablet daily
- For how long? : Every day that you’re in an area with a risk of infection and for a week after you’re back from your trip
Mefloquine
- When? : 3 weeks before you travel
- How often? : One tablet weekly
- For how long? : Every week that you’re in an area with a risk of infection and for a month after you’re back from your trip
Doxycycline
- When? : 2 days before you travel
- How often? : One tablet daily
- For how long? : Every day that you’re in an area with a risk of infection and for a month after you’re back from your trip
Chloroquine
- When? : 1 week before you travel
- How often? : One tablet weekly
- For how long? : Every week that you’re in an area with a risk of infection and for a month after you’re back from your trip
What are the side effects of these tablets?
These are some of the potential side effects of the tablets:
Atovaquone/Proguanil
- Possible side effects: skin rash, mouth ulcers or an upset stomach
Mefloquine
- Possible side effects: dizziness, headaches, sleep disturbances (insomnia, vivid dreams) or psychiatric reactions (anxiety, depression, panic attacks, hallucinations)
Doxycycline
- Possible side effects: heartburn, upset stomach, sunburn because of increased light sensitivity or thrush
Chloroquine
- Possible side effects: nausea, headache, temporary hair loss, muscle weakness, vomiting, diarrhoea or stomach cramps
The information above should give you a clearer picture on how malaria tablets may be best used and which types may be suitable for you. However, make sure to consult a travel health professional before you go ahead and take any anti-malarial medication!
Don’t forget also to take measures to avoid bites, such as spraying your clothing with insecticides such as permethrin and wearing loose clothing with maximum coverage.
Make an appointment with us today to see which malaria tablet is suitable for you – you can stock up on these before you head off on your trip in order to keep yourself and your loved ones protected from malaria.
