From the Guidelines
The recommended medications for malaria prophylaxis include atovaquone-proguanil (Malarone), doxycycline, mefloquine, and chloroquine (in areas without chloroquine resistance).
Malaria Prophylaxis Medications
The choice of medication depends on various factors, including destination, medical history, pregnancy status, age, and duration of travel 1.
- Atovaquone-proguanil is taken daily starting 1-2 days before travel, throughout the stay, and for 7 days after leaving the malaria-endemic area.
- Doxycycline is taken daily starting 1-2 days before travel, during the stay, and for 4 weeks after departure.
- Mefloquine is taken weekly starting 2-3 weeks before travel, during the stay, and for 4 weeks after leaving. It is essential to note that compliance with the prescribed medication regimen is crucial to prevent malaria, as most deaths occur in individuals who do not comply fully 1.
Additional Prevention Measures
In addition to medication, using insect repellent, wearing protective clothing, and sleeping under insecticide-treated bed nets can reduce the risk of mosquito bites and malaria transmission 1. It is recommended to consult a travel medicine specialist before the trip to determine the most appropriate prophylaxis for the specific itinerary 1.
From the FDA Drug Label
For the prophylaxis of malaria: For adults, the recommended dose is 100 mg daily. For children over 8 years of age, the recommended dose is 2 mg/kg given once daily up to the adult dose. Prophylaxis should begin 1 to 2 days before travel to the malarious area. Prophylaxis should be continued daily during travel in the malarious area and for 4 weeks after the traveler leaves the malarious area The recommended medication for malaria prophylaxis is doxycycline (PO), with a dose of:
- 100 mg daily for adults
- 2 mg/kg given once daily up to the adult dose for children over 8 years of age 2
From the Research
Malaria Prophylaxis Medication
The recommended medication for malaria prophylaxis depends on various factors, including the region of travel, patient characteristics, and preferences.
- Atovaquone/proguanil is a highly effective option for the prevention of Plasmodium falciparum malaria, including drug-resistant strains 3.
- It is generally well tolerated and has an improved tolerability profile compared to other commonly used antimalarial agents 3.
- For areas with high co-circulation of P. falciparum and P. vivax, primaquine should be considered as the chemoprophylactic agent of choice 4.
- Other options for chemoprophylaxis include mefloquine, doxycycline, and chloroquine, but the selection should be based on patient characteristics and preferences 5, 6.
- The World Health Organization recommends treating uncomplicated cases of malaria with artemisinin combination therapy, except in the first trimester of pregnancy 7.
- Intravenous artesunate is the treatment of choice for severe malaria 5, 7.
Considerations for Specific Patient Groups
- For pregnant women, the selection of chemoprophylaxis should be based on the region of travel and the patient's comorbidities 6.
- For people diagnosed with epilepsy, the selection of chemoprophylaxis should be based on the potential adverse effects of the medications to be used 6.
- For children, the dosage of atovaquone/proguanil should be based on body weight 3.