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If you are travelling abroad and need to buy malaria tablets, you can order them from us without needing to see a doctor face-to-face.

Check the Fit for Travel website to confirm you need malaria tablets, complete an online order and we will prescribe and send you your chosen malaria treatment.

Make sure you read our general travel advice before your trip.

Medication Length of Trip Price
Doxycycline 1 / 2 / 3 / 4 weeks £19.99 / £22.49 / £24.99 / £27.49
Malarone® 1 / 2 / 3 / 4 weeks £54.99 / £72.99 / £89.99 / £104.99
Lariam® 1 / 2 / 3 / 4 weeks £27.99 / £29.99 / £32.99 / £34.99

Who needs malaria tablets?

Malaria is a tropical disease. It is serious and can be fatal. For this reason it is important to seek a diagnosis and a course of antimalarial drugs without delay if you start to show the symptoms. Malaria tends to have a particularly severe effect on pregnant women, babies, children and old people.

Malaria is caused by a type of parasite known as plasmodium. Plasmodia parasites are carried by mosquitoes. When an infected mosquito bites you, it injects the plasmodium parasite into your bloodstream. Malaria is mostly spread by female Anopheles mosquitoes, which bite between dusk and dawn, and are therefore known as night-biting mosquitoes.

Malaria treatment - What you can do

Malaria is preventable and curable. Travellers to malarial areas should take malaria tablets (if advised), sleep under a mosquito net, cover up arms and legs with long sleeves/trousers (particularly between dusk and dawn) and use a DEET based mosquito repellent. There are three recommended types of malaria tablets: Atovaquone plus Proganil (Malarone), Doxycycline and Mefloquine (Lariam).

Malaria tablets as prevention

If you are going to travel to an area where there is a risk of getting infected with malaria, malaria tablets would normally be recommended. Speak to your doctor about what you need to do. You’ll need to discuss:

  • where you are going to be travelling
  • your family medical history where appropriate
  • your age and own personal medical history as appropriate, including allergies or any previous issues you might have had with antimalarial medication
  • your current medication
  • whether you are pregnant

Sometimes your doctor might advise you to take a short course of malaria tablets before you go away, as a trial to check you get on alright with the medication. If you have a bad reaction to it, there are other preventative options that you can try.

When taking antimalarials, it is very important that you finish the complete course as prescribed. This includes taking the tablets when you get home, as you will have agreed with your doctor.

Malaria Tablets as a cure

As long as it is diagnosed and treated promptly, nearly everyone can make a full recovery from malaria. If you have got malaria, you should start treatment as soon as your blood test results come through. If you took antimalarials when you travelled, but still got infected with malaria, you will be given a different type of antimalarial to treat it. For this reason, make sure you tell the doctor which type of antimalarial you were taking as a preventative measure.

Your doctor will advise which type of malaria tablets will be most appropriate for you, by looking at the following factors:

  • what type of malaria you’ve got
  • where you caught it
  • how severe your symptoms are
  • if you took preventative antimalarial medicine
  • how old you are;whether you are having a baby

It might be the case that you need to try two or more types of antimalarial medicine in combination, to defeat strains of malaria that are resistant to single types of treatment.

The treatment for your malaria can leave you feeling tired and frail for a few weeks.

Statistics

According to the charity Medecins Sans Frontiers, malaria kills approximately 660,000 people every single year. 9 out of 10 of these fatalities happen in Sub-Saharan Africa. Most of the people who die are children. The World Health Organization (WHO) says that a child dies of malaria roughly every 30 seconds.

Deaths from malaria have fallen by 26% since 2000. 

Medecins Sans Frontiers also estimate that 200 million people are infected with malaria every year. The World Health Organisation states that there were 219 million cases of malaria reported in 2012.

Over 1,700 travellers were diagnosed with malaria when they came back to the UK in 2010. 61% of those cases were people who had visited a malaria region in their country of origin. Seven people died.

What are the symptoms of malaria?

The most common symptoms of malaria include fever, headache, vomiting, diarrhoea and flu-like symptoms such as sweats, chills, muscle ache or feeling unwell in general. These symptoms often appear 10-15 days after being bitten by a mosquito. In some cases, people start to see symptoms within 7 days. However, it can take much longer for the symptoms to appear, in some cases 6 months or even a year.

Often the early symptoms of malaria can be quite mild and so it can be hard to diagnose. With some kinds of malaria, you might notice that the chills and fever run in a 4-8 hour cycle. The pattern is often: cold/shivering for 1 hour, followed by fever and severe sweats for 2-6 hours.

If you have been to a high risk malarial area and develop symptoms, see a doctor straight away (even if you got home several weeks or months ago, or even up to a year ago). The most serious type of malaria is called Plasmodium falciparum malaria. It is a life-threatening illness, caused by the Plasmodium falciparum parasite. People with plasmodium falciparum malaria often get very seriously ill, very quickly.

If plasmodium falciparum malaria is not treated without delay, it can result in severe complications like:

  • problems breathing
  • a blockage in the blood vessels to the brain
  • seizures/fits and coma
  • organ failure
  • severe anaemia (lack of oxygen in the blood – though this is extremely rare)

What are the causes?

Malaria is caused by a parasite called plasmodium. There are several different types of plasmodia parasites, but only five of them can cause malaria in humans:

  • Plasmodium falciparum: mostly found in Africa, causes the majority of malaria fatalities worldwide.
  • Plasmodium vivax: usually found in Asia and Latin America. The symptoms of plasmodium vivax are less severe than those of plasmodium falciparum. However, plasmodium vivax can dwell in the liver for up to three years. Relapses are therefore common.
  • Plasmodium ovale: unusual, normally found in West Africa. Plasmodium ovale can stay in your liver for a few years without producing symptoms.
  • Plasmodium malariae: quite rare, generally only found in Africa.
  • Plasmodium knowlesi: very rare, generally found in Southeast Asia.

Plasmodia parasites are carried by mosquitoes. When an infected mosquito bites you, it injects the plasmodium parasite into your bloodstream. If a mosquito bites someone who is infected with malaria, it can get infected too and pass the parasite on to other people. Malaria is mostly spread by female Anopheles mosquitoes, which bite between dusk and dawn, and are therefore known as night-biting mosquitoes.

When a person is infected with the plasmodium parasite by a mosquito, the parasite travels through the blood to the liver, where it develops. The parasite then travels back through the bloodstream and invades the red blood cells, where it grows and multiplies. At set time intervals (usually every 48-72 hours) the blood cells that are infected, burst and spread more parasites into the bloodstream. When the blood cells burst, the person will experience fever, chills and sweating.

Who can get Malaria?

Anyone can get malaria. If you are in a malarial hotspot and get bitten by a mosquito, you could get infected. There are more than 100 countries in the world that have malaria. They usually have a tropical climate. Some examples include: hefty areas of Africa and Asia, Central and South America, Haiti and the Dominican Republic, parts of the Middle East and some Pacific islands, such as Papua New Guinea. To check whether your destination is a malarial hotspot, you can look at a malaria map.

If you are travelling to a malarial area and come from a non-malarial area, you will be very vulnerable to the disease if you get infected.

Over 1,700 travellers were diagnosed with malaria when they came back to the UK in 2010. 61% of those cases were people who had visited a malaria region in their country of origin.

Many people think that they have immunity to malaria if they were born and bred in an area where it exists. This is incorrect. Any immunity that you might have built up by living in a malarial area leaves your system very quickly when you move to a non-malarial place, like the UK for example. Even if you grew up in a malarial area, you need to protect yourself against malaria. It is very easy to do this. Malaria is preventable and curable. Travellers to malarial areas should take anti-malarial pills (if advised), sleep under a mosquito net, cover up arms and legs with long sleeves/trousers (particularly between dusk and dawn) and use mosquito repellent.

Malaria Diagnosis

Visit your doctor/nearest hospital/travel clinic if you develop the symptoms of malaria. They will test for it by looking for the parasite in a blood sample. You can go and get checked whilst you are away if you start to feel ill before you get home. Don’t wait or leave it too long, as the quicker you start treatment the speedier your recovery.

Some types of malaria can take up to a year to develop, so tell your GP that you could have malaria, even if you’ve been back home for a while and even if you were only in a malarial hotspot very briefly. If your GP wants to test for malaria, he will probably send you to your local hospital to have the bloodtest. You should get the results the same day. If you need treatment, it will start straight away.

Malaria Treatment

Malaria tablets are used to treat malaria as well as to prevent it. If someone is very seriously ill with malaria, then antimalarial drugs can be given intravenously, through a drip that goes into a vein in their arm.

There are three recommended types of malaria tablets: Atovaquone plus Proganil (Malarone), Doxycycline and Mefloquine (Lariam).

If you are pregnant or breastfeeding

Pregnant women are advised not to travel to malarial areas as they are more at risk of getting severely ill and experiencing complications (both for the mother and for the baby too). If you need to travel anyway, make sure you discuss getting the right type of malaria tablets with your doctor – some types aren’t suitable for pregnant women and can result in side effects for mother and baby.

Doxycycline is not recommended for pregnant/breastfeeding women because it can harm the baby.

There is no evidence to suggest that Mefloquine (Lariam) will hurt an unborn baby, but as a precaution, it isn't usually prescribed during weeks 1-13 of pregnancy. Doctors also avoid prescribing Lariam if it is possible that you are pregnant three months after you’ve stopped preventative antimalarial medication.

Usually, atovaquone and proguanil (Malarone) are not prescribed during pregnancy or breastfeeding because there isn’t a great deal known about the effects on mother and baby. That said, if there is a high risk of malaria and there isn’t a good alternative, your doctor might recommend that you take them.

Complications/long term issues

Malaria is serious and can be fatal. For this reason it is important to seek a diagnosis and a course of treatment without delay if you start to show the symptoms. Malaria tends to have a particularly severe effect on pregnant women, babies, children and old people.

Plasmodium falciparum, mostly found in Africa, causes the majority of malaria fatalities worldwide. People with plasmodium falciparum malaria often get very seriously ill, very quickly.

If plasmodium falciparum malaria is not treated without delay, it can result in severe complications like:

  • problems breathing or fluid in your lungs
  • a blockage in the blood vessels to the brain
  • cerebral malaria – where malaria affects the brain, causing swelling, sometimes causing permanent brain damage, seizures/fits or coma
  • organ failure (especially kidney failure, liver failure and jaundice)
  • shock (a sudden drop in blood flow)
  • spontaneous bleeding
  • abnormally low blood sugar
  • swelling and rupturing of the spleen
  • dehydration (a lack of water in the body)
  • severe anaemia as a result of the red blood cells being destroyed (Anaemia is a condition where there isn’t enough oxygen in the blood – though this is extremely rare as a result of malaria)

Do I need a prescription?

It is better to discuss your options with a doctor before you choose your antimalarial medication. Different treatments work better for different areas of risk, because some countries have strains of malaria that are resistant to certain types of medications. The Fit for Travel website has useful information on this.

You can buy some antimalarials over the counter in some UK pharmacies by filling out a form outlining your medical history and requirements. Often these cost less than an NHS prescription would cost.

Can I get treatment on the NHS?

The Department of Health said in their guidance document FHSL(95)7, that medication for preventing malaria (malaria prophylaxis) should not be reimbursed under the NHS. This means that prescription-only antimalarials will be prescribed to you by your GP on a private prescription.

Where is the risk highest?

There are more than 100 countries in the world that have malaria. They usually have a tropical climate. Some examples include: hefty areas of Africa and Asia, Central and South America, Haiti and the Dominican Republic, parts of the Middle East and some Pacific islands, such as Papua New Guinea. 

How does malaria treatment work?

Antimalarial medication works by killing the plasmodia parasites that enter your bloodstream. If you stop taking your tablets and get bitten by an infected mosquito, you won’t be protected against malaria. Make sure you follow the dose as prescribed by your doctor.

Atovaquone plus proguanil (Malarone)

When used to prevent malaria, the dose of Malarone is one tablet a day (either as adult strength or, for children, this is varied in accordance with the child’s weight). You start taking them just a couple of days before you go, then take them for every day that you are in the area of risk and for a full week after you leave the area of risk. Malarone does cost more than other antimalarials, so you may prefer only to use it on short trips.

Doxycycline (Vibramycin-D)

When used to prevent malaria, your doctor will normally prescribe a daily dose of 100mg of Doxycycline as a tablet or capsule. Start the tablets two days before you go, take them every day that you are in the area of risk and then continue to take them for four weeks after you leave the area of risk. Always take the tablet with food. It is better to take it when standing or sitting. Doxycycline is reasonably cheap.

If your doctor prescribes Doxycycline to treat acne, it will also protect you against malaria if you are taking a high enough dose (check with your doctor about it).

Mefloquine (sometimes called Lariam)

To prevent malaria, adults will need to take one Lariam tablet weekly. Children can also take Lariam once a week, but they will be prescribed a dosage in line with their weight. You start taking Lariam three weeks before you travel. You then continue to take it for the whole time that you are in the risk area. After you leave the risk area, you need to take it for a further four weeks. If you haven’t taken Lariam before, it is better to do a three-week trial before you travel to check if you get on alright with the medication.

Atovaquone plus proguanil (Malarone)

There isn’t enough known about the effects of atovaquone plus proguanil on mother and baby, so it isn’t recommended for pregnant or breastfeeding women. People with severe kidney problems are also not advised to take it.

Side effects include: intestinal upset, headaches, skin rash and mouth ulcers.

Doxycycline

Doxycycline isn’t recommended for pregnant or breastfeeding women, or children younger than 12 (as it can permanently discolour their teeth). It also isn’t suitable for people who are sensitive to tetracycline antibiotics or who have liver problems.

Side effects include: sunburn due to sensitivity to light, stomach upset, heartburn and thrush. Doxycycline reduces the effectiveness of combined hormone contraceptives, such as the contraceptive pill or contraceptive patches.

Lariam

Lariam isn’t recommended if you have epilepsy, seizures, depression or other mental health problems, or if a close relative has any of these conditions. It is not suitable for people with severe heart or liver problems.

Side effects include: dizziness, headache, sleep disturbances (insomnia and vivid dreams) and psychiatric reactions (anxiety, depression, panic attacks and hallucinations). It is very important to tell your doctor about any previous mental health problems, including mild depression. Do not take this medication if you have a seizure disorder.

Drug name

Doxycycline

Malarone

Lariam

Active Ingredient

Doxycycline

Atovaquone plus Proganil

Mefloquine

How often do I have to take it

Adult dose 100mg a day (usually one tablet)

One tablet a day

One tablet a week

How long do I take it for?

Start the tablets two days before you go, take them every day that you are in the area of risk and then continue to take them for four weeks week after you leave.

Start taking just a couple of days before you go, then for every day that you are in the area of risk and for a full week after you leave the area of risk.

Start taking Lariam three weeks before you travel, continue to take it for the whole time that you are in the risk area. After you leave, take it for a further four weeks.

To consider...

Quite cheap

Expensive

If you haven’t taken mefloquine before, it is better to do a three-week trial before you travel to check if you get on alright with the medication.

Risks/Cautions

Always take the tablet with food. It is better to take it when standing or sitting. Not recommended for pregnant or breastfeeding women, or children younger than 12 (as it can permanently discolour their teeth). It also isn’t suitable for people who are sensitive to tetracycline antibiotics or who have liver problems.

Not recommended for pregnant or breastfeeding women. People with severe kidney problems are also not advised to take it.

Not recommended if you have epilepsy, seizures, depression or other mental health problems, or if a close relative has any of these conditions. It is not suitable for people with severe heart or liver problems.

 

Side effects

Sunburn due to sensitivity to light, stomach upset, heartburn and thrush. Doxycycline reduces the effectiveness of combined hormone contraceptives, such as the contraceptive pill or contraceptive patches.

Intestinal upset, headaches, skin rash and mouth ulcers

Dizziness, headache, sleep disturbances (insomnia and vivid dreams) and psychiatric reactions (anxiety, depression, panic attacks and hallucinations). It is very important to tell your doctor about any previous mental health problems, including mild depression. Do not take this medication if you have a seizure disorder.

 

If you have a question about this service, please email info@dred.com with the question, and one of our doctors will get back to you within 24 hours.

Malaria is almost always transmitted by mosquitoes and does not spread from person to person. However, patients carry the parasite in their red blood cells, which means that the infection can be transmitted via blood transfusions or when sharing needles. It is also possible for malaria to be passed from mother to baby during pregnancy and child birth.

The incubation period of malaria is not always the same. Most parasites develop within 9-30 days but some types develop in 7, others in up to 50 days. In Southeast Asia, you can even find a strain of malaria which only needs 24 hours. This “development time” is identical with the "incubation period", the time needed for the parasite to develop and your body to identify the infection and react. The frequency of the symptoms correlates with this malaria life cycle.

There is currently no vaccine for malaria. However, several products are being tested and have shown to protect a large proportion of those treated. The British pharmaceutical company GlaxoSmithKline has announced that it will apply for a license from the European Medicines Agency in 2014, so a vaccine might be available from 2015.

The three types of malaria are defined by their life cycle, which determines how often you will get the symptoms. Tertian malaria (“tertian” stems from the latin term for “three”) means that the fever comes back every third day. Plasmodium falciparum belongs to this category and is considered the most severe form of malaria. However, falciparum can also cause irregular fevers and in some cases it remains symptomsless for an extended period of time. As for quartan malaria (“quartan” is latin for “four”), it means that the fever reappears every fourth day. The third type, malaria tropica, causes irregular, less characteristic symptoms and patients are sometimes wrongly diagnosed with cold or flu.

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