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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.

You can use the Fit for Travel website to check whether you need malaria tablets. To place an order, complete our consultation questionnaire and select your preferred treatment. Our online doctor will review your order and approve an appropriate antimalarial.

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

Medication Length of Trip Price
Doxycycline 1 / 2 / 3 / 4 weeks (bigger pack sizes available) £24 / £27.50 / £31 / £35
Malarone® 1 / 2 / 3 / 4 weeks (bigger pack sizes available) £50 / £70 / £89 / £100
Generic Malarone 1 / 2 / 3 / 4 weeks (bigger pack sizes available) £37 / £51 / £65 / £81
Chloroquine 1 / 2 / 3 / 4 weeks (bigger pack sizes available) £20 / £21 / £22 / £23

What is Malaria?

Malaria is a serious illness that is caused by a parasite Plasmodium that is carried in a certain type of mosquito, the female Anopheles mosquito, and is transmitted to humans when they bite them infecting the body’s bloodstream in particular the red blood cells. Although malaria can make you very ill with high fevers, muscle ache and flu-like symptoms, and in serious cases can lead to death, in most cases it is treatable and preventable. Therefore it is really important to protect yourself properly against malaria when travelling by taking appropriate antimalarial medication and avoiding being bitten by mosquitos.

How can I avoid getting malaria?

Malaria is endemic in more than 100 countries and mainly stretches across the tropical regions of the world. The 2015 World Malaria Report published by the World Health Organisation (WHO) estimated there were 214 million cases of malaria worldwide in 2015, and an estimated 438,000 malaria deaths. In 2014 around 1,586 travellers were diagnosed with malaria after returning to the UK and three people died.

Malaria can be avoided, and Public Health England have published an ABCD approach to prevention: 

  • Awareness of risk: seek advice to find out whether or not you are at risk of malaria (www.fitfortravel.nhs.uk)
  • Bite prevention: avoid getting bitten by mosquitos by using DEET based insect repellents, sleeping nets and clothing that covers your arms and legs, especially between dusk and dawn
  • Check to see if you need antimalarial tablets: check the Fit for Travel website, if you do need antimalarials make sure you have the right tables and the correct number to finish the course. Antimalarial tablets are commonly referred to as malaria tablets, but the right term is antimalarial tablets because they are a prevention against malaria, not treatment for it.
  • Diagnose quickly and without delay: if you think that you might have malaria even after up to a year from when you returned from travelling, seek immediate medical advice.

Malaria tablets as prevention

If you’re travelling to an area where there’s a high risk of getting malaria you should take a course of antimalarial tablets. It’s important to research where you’re going and to see which tablets are effective in that region. However bear in mind that antimalarial tablets only reduce your risk of infection by around 90% so it’s also really important to take measures to avoid being bitten.

There are different types of antimalarial tablets:

  1. Malarone (Atovaquone-Proguanil): one tablet once a day starting 2 days before you go, during your stay and for 7 days after you return
  2. Doxycycline: one tablet once a day starting 2 days before you go, during your stay and for 4 weeks after you return
  3. Avloclor (Chloroquine): two tablets taken once a week starting 1 week before you go, during your stay and for 4 weeks after you return
  4. Lariam (Mefloquine): one tablet taken once a week starting 3 weeks before you go, during your stay and for 4 weeks after you return

What are the symptoms of malaria?

The symptoms of malaria are

  • fever
  • headache
  • vomiting and diarrhoea
  • flu-like symptoms such as sweats, chills, muscle ache or feeling unwell in general 

The time from being bitten to when symptoms of malaria start is called the incubation period. This is normally 7-18 days and depends on the specific parasite that you’re infected with. However in some cases it can take up to a year before symptoms appear. 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 48 hour cycle. The pattern is often: cold/shivering followed by fever and severe sweating and fatigue. If you have been to a high risk malaria area and develop these symptoms, see a doctor straight away (even if it was up to a year after you went away). The most serious type of malaria is called Plasmodium falciparum malaria and this can cause life-threatening illness, as you can get very seriously ill, very quickly.

What are the causes of malaria?

Malaria is caused by a parasite called Plasmodium that is carried in the female Anopheles mosquito and transmitted to humans through the mosquito bite.When an infected mosquito bites you, it injects the plasmodium parasite into your bloodstream. If a mosquito bites someone who is infected with malaria, the mosquito 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.

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 are less severe than those of plasmodium falciparum, however it can remain in the body (the liver) for up to 3 years which can result in a relapse.
  • Plasmodium ovale: unusual, normally found in West Africa, and can remain in your liver for years without producing symptoms.
  • Plasmodium malariae: quite rare, generally only found in Africa.
  • Plasmodium knowlesi: very rare, and found in parts of Southeast Asia.

How is malaria diagnosed?

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’re 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 see your GP and let them know you have been to a malaria endemic area if you start to develop symptoms, even if you’ve been back home for a while.If your GP wants to test for malaria, he will probably send you to your local hospital to have the blood test. You should get the results the same day. If you need treatment, it will start straight away.

Malaria Treatment

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

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

If you are pregnant or breastfeeding

If you’re pregnant or trying for a baby it’s advisable to avoid travelling to areas that have a high risk of malaria. Pregnant women are at a higher risk of developing severe malaria due to the changes in the body’s physiology, and so could develop dangerous complications.

If you do have to travel to a malaria endemic area, please consult with your doctor about the best antimalarial medication that is safe to take.

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

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’s a high risk of malaria and there isn’t a good alternative, your doctor might recommend that you take them.

Do I need a prescription?

In Britain, chloroquine and proguanil can be bought over the counter from pharmacies, all other antimalarial medications need a prescription. Talk to your pharmacist, doctor or travel nurse for the best option for you.

Can I get malaria tablets 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.

How does malaria medication work?

Antimalarial medications work by interfering with the malaria parasite’s life cycle in the body. Some antimalarial medications interfere with how the parasite develops within the liver and prevent it from multiplying and invading the red blood cells. This is how malarone works. Other antimalarial medications stop the parasites from multiplying within the red blood cells and prevent illness. This is how doxycycline works, which is why it needs to be taken for four weeks after leaving the malaria area to ensure it effectively kills all the parasites.

Atovaquone plus proguanil (Malarone)

When used as an antimalarial the dose is one tablet daily (contains 250mg of atovaquone and 100mg proguanil). You should start taking them 1-2 days before you enter the malarious area and continue to take them after you return for a further 7 days. So if you were going on a 7 day trip you would take 16 tablets (2 before you go, 7 whilst on your travels, and another 7 when you return).

Take the tablet with food, and if you miss a dose or vomit within one hour of taking it, take another dose and carry on with the course.

Side effects include stomach upset, diarrhoea and headaches. It can also interact with certain other medications such as tetracycline antibiotics, rifampicin, rifabutin and metoclopramide.

Doxycycline

When used as an antimalarial the dose is one tablet daily (contains 100mg of doxycycline).You should start taking them 1-2 days before you enter the malarious area and continue to take them for 4 weeks after you return. So if you were going on a 7 day trip you would take 37 tablets (2 before you go, 7 whilst on your travels and another 28 when you return).
Take the tablet with food at the same time each day, if you miss a dose take one as soon as remember and then carry on with the course. As it can cause irritation to your food pipe, try to stay sitting or standing for at least 30 minutes after you have taken it.

Side effects include heartburn, nausea, diarrhoea, thrush, headaches. It can also interact with other medications such as retinoids (for psoriasis) or cyclosporin so please let your doctor know which medications you’re currently on.

Chloroquine (Avloclor)

The dose of chloroquine is two tablets (one tablet is 250mg so the total dose is 500mg) taken together once a week with food, starting on week before you enter the malarious area and for 4 weeks after you return. So if you were going on a 7 day trip you would take 12 tablets, remember it is 2 tablets at the same time each week (2 before you go, 2 whilst on your travels and another 8 when you return).

Take the tablets with food, if you miss a dose take it as soon as you remember.

Common side effects are nausea, vomiting, diarrhea and stomach cramps, headache and skin rash or itching. You shouldn’t take it if you have a history of epilepsy, and it can aggravate psoriasis.

There’s a lot of resistance to chloroquine so it’s only suitable to take as an antimalarial if you are going to one of the following countries:

  • Dominican Republic
  • Guatemala (Rural areas only at altitudes below 1,500 m (4,921 ft). None in Antigua, Guatemala City, or Lake Atitlán)
  • Honduras
  • Mexico (States of Chiapas, Chihuahua, Durango, Nayarit, and Sinaloa)
  • Nicaragua (For Boaco, Masaya, Carazo, and Rio San Juan: Mosquito avoidance only.)
  • Panama (C. Ngobe Bugle only)
  • South Korea (Limited to the months of March–December in rural areas in the northern parts of Incheon, Kangwon-do, Kyonggi-do Provinces including the demilitarized zone (DMZ))

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

Avloclor

Active Ingredient

Doxycycline

Atovaquone plus Proganil

Chloroquine

How often do I have to take it?

One tablet a day

One tablet a day

Two tablets once a week

How long do I take it for?

2 tablets before you enter the malarious area.

Every day you are in the area.

Continue for 4 weeks after you leave the area.

2 tablets before you enter the malarious area.

Every day you are in the area. 

Continue for 1 week after you leave the area.

2 tablets together one week before you enter the malarious area.

2 tablets every week you are in the area.

Continue for 4 weeks after you leave the area.

Risks/Cautions

Always take the tablet with food and avoid lying down for at least 30 minutes.  Not recommended for pregnant or breastfeeding women.  Not suitable for those who are sensitive to tetracycline antibiotics or who have liver/kidney 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, or severe kidney or liver problems.

 

Side effects

Sunburn due to sensitivity to light, stomach upset, heartburn and thrush. 

Intestinal upset, headaches, skin rash and mouth ulcers.

Nausea, headaches, rashes or itchy skin.

 

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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