Malaria Meds

On my 1 year RTW trip, I'll be traveling to a few countries that require preventative malaria meds. These countries are grouped in 2 clusters, 1 in South America (for about 9 weeks) and the other in Africa (for about 10 weeks). 19 weeks is a long time to be on malaria pills, and I'm worried about the costs and effects of these pills. I've done my homework and it seems that the 2 drugs that I would have to choose from are Malarone and Doxycycline. Does anyone have any experience of one vs the other? I hear Malarone is the one with the least side affects but is the most expensive. What did u pay for them? Can you buy them on the road and, if so, is it cheaper? In Canada, I think Malarone is $6 CAD a pill and Doxycycline is $0.50 CAD a pill.

I took malarone while I was in Africa and it worked fine- one thing to note is make sure you don't take them on an empty stomach or before going to bed because my sister did this accidentally and got sick!

My husband & I traveled RTW for over 1yr and never took malaria medication. Although not a bad idea for a short trip for the length of time we were in malaria zones it would have been much too expensive and is also a health risk to your liver and other organs with long term use.
We did use tons of bug spray, kept covered up at dusk and dawn and used mosquito nets and, thank goodness, never had any issues. Since malaria is not the only disease you can get from an infected mosquito all of those are better options overall anyway! Have a great time!

I would suggest doxy out of the two.

It's much much cheaper and can be purchased on the road nearly everywhere as it's a simple and common antibiotic. There are minimal side effects with doxy -- it might upset your stomach a bit and make you more sunlight sensitive but you can combat that with SPF and probiotic pills...acidophilus. Which isn't a bad idea to carry on you for your digestive health. Doxy the best choice in my opinion as malarone is expensive and hasn't been tested for long-term use. Mefloquine, another common drug can have many psychological side effects. I'd suggest most people stay away from it.

As for your concern about taking it long term, I felt the same way as well. I am a peace corps volunteer in Africa and we are on malaria meds for ~116 weeks, over two years. It's up to you to take them or leave them. If you are careful about malaria, you should be ok, even if you catch it. Malaria is dangerous only if you wait on getting treatment (and by waiting I mean more than 1 day after you get symptoms). That being said, I will share with you what our peace corps doctors tell us, which is that the side effects of the medication is better than having malaria or being dead. Malaria is not fun to go through and untreated, cerebral malaria can put you in a coma in a 1 day. Yeah, they are pretty no-nonsense with us about this topic.

Taking or not taking the meds is a gamble. There are plenty of people who live their whole lives in these places without the meds. Remember though- that your hospital bills for treating malaria will be much more costly than the preventative pills.

The type of meds you need to take often depends on the region you are traveling in, as the virus has developed resistance to one or the other. Make sure you're buying the correct one.

Then I'd check the Malaria risk level of the region you're traveling to. In SA, I'd personally not take malaria prophylaxis, as the risk is moderate. I'd take one or two emergency packs and leave it at that.l (Did the same while traveling in Indonesia. Happened to actually contract Malaria and everything turned out fine with the emergency treatment. I'd do it this way again, despite the worrying and unpleasant 48 hours.)
As for Africa, that might be a different story as some areas are considered high risk areas. Question is, will you travel there? In my opinion, a lot of travelers romanticize their itinerary and believe they are heading 'way off the beaten track', while in reality, they stick to the well worn (and often relatively safe) path.

Hope this helps.
a.

If you are in west and central Africa, I would recommend you take the meds. My husband was hospitalized with the type of malaria that goes to the brain quickly and could have died. As it was, he got pretty sick. The meds are pretty strong stuff and caused me to lose some hair from using them for 6 months but I don't regret it.

Wildcat1982 wrote:I would suggest doxy out of the two.

It's much much cheaper and can be purchased on the road nearly everywhere as it's a simple and common antibiotic.

That seems exactly the reason not to take it. Around here they don't even prescribe it, as taking antibiotics preventively is obviously not a good idea. I'm surprised they do it in other western countries.

I've always taken Malarone. No side effects. Got malaria once out of 4 trips to sub-Saharan Africa.

There are plenty of threads about this on this board already. I don't really feel like repeating everything I said before, so do a search.

Just purchase Coartem, which is a treatment instead of prophylactic. Up to 97% effective.

The FDA approved it over a year ago. So talk to your physician about this.

Has anyone found Malarone for substantially cheaper $ on the road? It's $6 CAD a pill here! Based on my itinerary, Malarone pills for my wife and I would be $1500 CAD!!!! YIKES!

If we want cheaper drugs in the US, we often buy them from Canada. So, I can't help ya there.

I find Mayo Clinic one of several helpful tools when deciding to take a drug. They offer a thorough description of the drug and an exhaustive list of side effects. Could also be helpful if you're determining whether to take a more economical drug verses a more expensive one (with presumably less side effects).

Artemether and Lumefantrine (brand: Coartem)
http://www.mayoclinic.com/health/drug-information/DR602909/DSECTION=side-effects

Doxycycline
http://www.mayoclinic.com/health/drug-information/DR601831/DSECTION=side-effects

Atovaquone and Cholorguanide (brand: Malarone)
http://www.mayoclinic.com/health/drug-information/DR600021/DSECTION=side-effects

...and so on.

Good advice in this old thread if anybody would like further insight.

PLEASE PLEASE PLEASE DO NOT ask these type of questions on this website.

I'm sure there are well meaning people answering this question but this is a website for asking general travel questions not anything with regard to health.

You cannot put a price on health and you should always ask a HEALTHCARE PROFESSIONALS.

The above is likely good advise in some cases but I can see nothing wrong with asking other travelers experiences as in fact some "health care professionals" are anything but either professional or knowledgeable. Also always consult a travel med clinic as the average average GP would be hard pressed to even know where some countries are let alone be qualified to recommend the appropriate precautions or meds.