Doxycycline instead of Malarone for Malaria??
 

I was given a prescription of Doxycycline since I'll be visiting a malaria area in Sabi Sabi. Others I know seem to take Malarone. Has anyone else been prescribed Doxycycline as an anti Malaria drug?

One of my friends has used the antibiotic Doxycycline as a malarial prophylactic. The main thing you need to be aware of is that it makes you sun-sensitive,so use lots of sunscreen and cover up.

We took Malarone without problem.

CDC lists the options:

http://wwwn.cdc.gov/travel/contentMa...ugsPublic.aspx

Sorry I can't help further. ((*))

I took Doxy while traveling in the wilds of Ethiopia. 6 months after my return I was veryyyy ill -

I used it on our first trip to Tanzania. No problems other than a little sunburn and fingernail sensitivity (told by my doctor "a very unusual but not unheard of" reaction). Second trip I took Malarone--different doctor, different scrip although same hospital.

On our trip to Tanzania we took doxycycline, but when my older son went back last year he took Malarone.

No problems with either one.

I'm one of the few people who get canker sores from Malarone -- not earth shaking side effect but not something I wanted to put up with for 3 weeks. Took Doxy instead -- it's considered equally effective (NO antimalarial is 100% effective). I'm blonde but had no sun sensitivity; just be careful until you know if you do. Main difference: much less expensive but you do have to take it for 4 weeks after leaving malaria area (not just one week as with Malarone)

I've taken Doxy on two safaris with no problems.

regards - tom

part 2 from my previous posting...sorry I was cut short and had to log off.

I was in bed for 1 month after my trip from Ethiopia with malaria.

As posted before nothing is 100% effective.

I've taken Doxy several times with no reaction, but we are all different.
We took them at night, and had the most amazing technicolour dreams. Oh, and my Mum talked in her sleep nearly all night.

Years ago, I was prescribed Doxy supposedly because I have high blood pressure, although I've certainly met others with high BP who were prescribed Malarone -- I don't quite understand the difference. My travel doctor continues to give me script for Doxy since I tolerate it well -- better the devil you know, I guess. I seem to tolerate drugs well (!) and the sun thing doesn't bother me. I surely will admit that it's a pain to have to continue taking it for 4 weeks.

For women specifically, as Doxy is an antibiotic, you might get "thrush" which is a discharge... ugh, not something I'd want while on holiday. Then there's possibility of sun sensitivity, so besides repellent for warding off mossies, you should apply SPF during daytime hours. And, finally, Doxy has to be taken longer (28/days) upon returning from the infected area.

As long as you are aware that any of the meds might have pros/cons... go with what you feel most comfortable.

I've used Lariam in the past with few side-effect till Malarone became available and haven't had any side-effects with this med.

i took it once and never again because my skin became extremly sensitive to sun exposure.
as i was told later doxy is good but not for blonde, blue-eyed pale skinned people.
so i went back to malarone.

div

You can also have side effects from Malarone. My sister and another one of our group traveling to Tanzania last year had problems with nausea, which was attributed to Malarone. I've used Larium on nine safaris without any problem, but everyone is different. Malarone is supposed to have fewer side effects than Larium.

jill1125 - do you have time to try Doxy for say a week or 10 days now, before you go? I know you'd have to get more to replace those but at least you'd know if you're likely to have problems.

regards - tom

Doxy offers reasonable protection against malaria and is certainly an improvement (for me) on Larium. I've taken it for 6 overseas trips to India and Africa and only twice experienced slight sun sensitivity. Once I was dreadfully sick when I took it too soon before breakfast.

It works best for me if I take it halfway through breakfast.

My doctor recommends taking Doxy for 2 weeks after leaving a malarial area - may be I should get this checked :-/.

Cheers,


Pol

Hi jill1125

I have taken Doxycycline for all trips to Southern/Eastern Africa with no problems whatsoever. I think I have been given them due to other medication I am taking. I always take mine at breakfast.

Pol

I would check, as it used to be 2 days before and 2 weeks after, now it has been for quite a while, 2 days before and 4 weeks after. A bit annoying, but not nearly as annoying as getting malaria!

I would say if you have been given this prescription by a specialist travel doctor, there would be a reason for it, so ask.

Kind regards

Kaye

I do not know why you are taking Doxycycline as it is certainly not the best medication for malaria.

1. Lariam used to be the best drug for Malaria.. but its side effects like causing seizures, depression, panic attacks and cardiac depression led to its own gradual donwfall.

It is still an okay drug if you are healthy with none of the listed medical problems.

2.Chloroquin:

This is really a non-specific drug and it is also used ( or used to be used) for Arthritis and Lupus.

It's major drawback was it's blurred vision and you really needed an eye exam after using it.

It is only used for travel to Central America now, because malaria in all the other parts of the world is resistant to Chloroquin.

3. Doxycycline:

This drug is an antibiotic and its only use is for areas where the malaria parasite is resistant to both Lariam and Chloroquin!!

Do you know where these areas are ??.. because I do not !

This would be my last choice of an anti-malaria drug !

4.Malarone:

This is the newest drug for malaria.
It is actually a two drug combination.
If you are taking short trips ( 10 days) ..then this is the better drug of the lot.

5. About DEET:

There is NO better insect repellant than DEET.
But don't get fooled about getting DEET with very high concentrations.

Let me tell you this.

The higher concentration last longer BUT...it plateaus at 30-35 % concentration.
Therfore ANY concentration of DEET higher than 35% has NO added benefit.

30% DEET is just as effective at 90% DEET...so save your money.!

And remember 30% DEET lasts only for 6 hours maximum....this is not a "spray in the morning ,good for the whole day " type of topical medication!

Now ask your doctor which is best for you.

Percy

I have used Doxycycline as a malaria prophylactic for over 20 years travel in Southern Africa (including the Sabi Sands).

It is an excellent and cheaper alternative to malarone. Contrary to what a few others have stated here.

As a side benefit being an antibiotic it will work against a number of bacterial infections that you may encounter on your trip.

I believe it is also used in the treatment of Anthrax.

As already stated one disadvantage is that some individuals develop a sun sensitivity whilst using Doxy'.

Geoff.

..also

Percy,

Try using DEET with tsetse flies. I even tried Bushman (80% DEET) it made no difference to them.

Luckily jill1125 will not have to contend with tsetse flies in the Sabi Sands.

Geoff.

I've used it for the past few years for lots of trips and have had no side effects.

For Anthrax, it's Cipro that was prescribed when there were threats in the States in '01/'02.

Difference between 30% & 90% Deet is that you don't have to reapply the 90% as often, but the higher the %, the more toxic.

Deet, for sure doesn't work for tse-tse, but then nothing does. Best to just avoid them or roll up those windows.

Re: DEET. You can buy "controlled release" formulas in 20-35% concentrations that really DO last up to 12 hours unless you get REALLY hot and sweaty. No need to use a higher percentage of chemicals. You will find these (Sawyer's, Ultrathon, etc) at camping stores, not drug stores.

There are two schools of thought if you also use sunscreen. I recommend (I work in a travel clinic) using the DEET first as a base coat; then add sunscreen as needed throughout the day. Sunscreen seems to work best if it's on top. (This assumes 20-35% DEET; if you 90% DEET you might have toxicity issues.) There are some combination (DEET + sunscreen) products. If you use these, use the combo in the morning and evening, but just a plain sunscreen throughout the day -- otherwise you are applying too much DEET.

I used Doxycycline to cure tick bite fever (prescribed in Kenya, mid-trip). I was extremely sensitive to the sun. I had on long pants, long shirt and a hat with bare hands and sandals. When I was in the sun my hands and feet felt like they were in a toaster oven. They really hurt and were burned with very little sun exposure.

I did not think that DEET would ward off tsetse flies!!

GeofG...I am glad that you have used Doxycycline for many years with no problems.

However, since there are better medications for malaria and if I was able to use them...then I would want to use the best the market has to offer.

Doxycycline is in the Tetracycline family of drugs and one of its good reasons for use is that it is a once a day drug as opposed to 4 times a day for Tetracycline.

It's mode of action is not potent against all organisms....that is why it is called a
Bacteriostaic agent.

bacteriostatic means that the drug does NOT kill the organism...it only stops its growth.!

You want a Bacteriocidal drug...this drug KILLS the organism.

Also , taking prophylaxis for malaria does NOT stop the infection ...it stops the disease.

When the malaria parasite enters your body you ARE infected... whatever drug you are taking for malaria is suppose to STOP the parasite once it has entered your blood stream.

Now it is in your blood stream....so you want the best anti-malaria medication you can possibly have ...you want to KILL this parasite, NOT just stop it from growing !

Doxycycline'smode of action is that it inhibits protein synthesis in the parasite.....however, this action is reversible once you stop the Doxycycline !!!
and also

the parasite is still present ...you have just stunted or stopped its growth.

I could give you the mechanism of action of malarone but it is rather complex...as it involves mitochondral electron transport... and let
us not get into that !:)

Can Doxycline be used in Anthrax....yes..but I would never use it...why ? ...because Cipro is around and it is a 100% better drug and it is Bacteriocidal ( it kills the bacteria).

However , I will add this:

If you are going to an area where the malaria parasite is resistant to Lariam and Chloroquin and you are not able to use Malarone .THEN..by all means use Doxycycline...
just know its limitations !

I would not want you getting sick GeoffG. :)

Also whereever you are....and if you are sick in a malaria infected place.....then GET a blood test..this is simple to do.

Do not take No for ananswer.!

You take a small amount of your blood... place it on a slide....add a few chemicals and look at it under the microscope......if the culprit is there..it WILL be seen.

Finally and I do not know why people do not do this:

ASK for the slides of your blood smear...so you can take it home with you and have your local doctor or lab have a look at it in your own country.

ASK FOR THE SLIDE ..IT IS YOURS.

Percy

Wow....what a variety of opinions. We are going to a game reserve called Savanah for 3 nights. It's in Sabi Sabi. The rest of the time we will not be on a safari.
Maybe we would be fine taking it 2 days before (as prescribed) and 2 weeks afterwards instead of 4. I'm blonde and fair skinned.

Jill - talk to you doctor and read the CDC website. We are not doctors here (well most of us aren't) and there is no point in arguing what is the best. Talk to your doctor and let him tell you what to do. If you get sick I can promise the doctor will want to know why you chose to listen to a bunch of people on a travel forum instead of sound medical advice. I will also add if you can go to a travel clinic or travel doctor that is even better as they specialize in travel and are the most up to date in what works best where and what may no longer be effective! Parasites and germs develop resistance to drugs over time, so what was effective even last year may not be the best thing to take this year. Take advice from a medical professional that makes it his or her business to be up to date on such things! My father is a doctor and he sends me to a travel nurse for this very reason!!

Jill: I think aowens is right; see a specialist if you have concerns. But PLEASE, if you take Doxy, take it for 4 weeks after leaving the malaria area, not just two. In our travel clinic the people who return with malaria usually either: took a drug to which there's resistance in the country they visited, stopped the meds part way through the recommended time, or decided they had some magic protection and didn't take any antimalarials.

The other suggestion to try out Doxy for several days before you go is another option; 3 days ought to do it. That's how I discovered (before I invested in a 3 week supply) that Malarone gave me canker sores. I did a test run with Doxy too, including some time in the sun, just to be sure I wouldn't have problems. I'm a blonde with light blue eyes and had NO problem, yet someone else in my office (not a blonde) got sunburn blisters on her feet (where she forgot to put sunscreen while at the beach.)

jill
frankly - it sounds redicilous to me to take chemicals for almost 3 weeks for a duriation of stay of 3 days.

if you consider malarone you start day 0, 3 days safari plus 7 days afterwards.

speak to a doctor who is uptodate and ask - depending on time of year you are travelling which makes abig difference to anopheles occurance! - whether a repellent and coving skin would suit your needs.

div

Gee ...that is exactly what I said after my first posting:

" Now ask your doctor which is best for you."

Also at the Travel Clinic or Travel doctor's office they have charts...like a world map.....which shows them what part of a country is most prone to a certain infectious disease at any given time.

For example you do not need Yellow Fever vaccine to go to Rio de Janeiro Brazil....but you do if you are going from Rio to the Amazon.

See what I mean.!

You have paid a lot of money for a holiday.....pay a bit more to see a Travel Clinic doctor and set your mind and health at ease !

Have a gooooood safe trip :)

Percy

Yes, for only 3 days at risk (sorry I missed that) I'd certainly be inclined to go with Malarone...it's ideal when you are in a malaria area for only a few days.

I wish an M.D. would weigh in here. I would think that using an antibiotic as a prophylactic when the medical profession worldwide is wringing its hands about the over-prescribing of antibiotics (leading to drug resistant bacterium) is kinda wrongheaded. Except in rare cases when a person can't take it, why wouldn't most people take Malarone, which is the undisputed drug of choice these days?

Laleslie

I agree with you and I gave the reason in my posting when to use Doxycycline.

Knowing the pro and cons of all the malaria medications...Doxycycline would be my last choice IF I was able to use Malarone !

Good Night all

Percy

While it's not the case in this situation (with only 3 days at risk), Doxy is often selected for longer trips due to its low cost. The cost of Malarone (about $6 per day if not covered by insurance) can be prohibitive for someone who will be in malaria risk areas for several months.

PS - Doxy may also be the antimalarial of choice for someone traveling to areas where there has been a cholera outbreak. Cholera vaccine is not available in the US, so if someone has to travel to an area with high cholera risk, we put them on Doxy to protect against both malaria and cholera.

I was prescribed Doxy in 2005 for a 6 week trip to Kenya. I managed a week. I was so sick with nausea, 24-7, that I decided I could not take it any longer. I have traveled many times prior to this with Larium with no side effects however I understand from a recent trip to the travel clinic that that doesn't mean that I would be immune to the side effects should I take it in future. I have also taken Malarone and for me this was the drug of choice. But I mimic others in this forum, what works for one person might not work for the next.
As far as protection from malaria, used with an insect repellent, I am sure you would be as safe on Doxy as any other drug, or at least that is what I was told.

i had a similar experience to elijay-- i was in india for six weeks of summer 2007 and felt quite ill from the doxycycline i was taking. so, i quit it, used copious amounts of insect repellant and crossed my fingers.

did the same when i went to thailand this summer and made it out alive.

but to answer your original question-- doxycycline is commonly prescribed as an anti-malarial. (oh and for some people, it has the added effect of clearing up skin problems).

Interesting skibumette, thanks. Guess I was thinking the difference in cost wouldn't matter to most people if they can afford to go to AFrica anyway. But to me theh cost of bacteria resistent diseases, which are really spreading throughout the world, is scary.

Myata, as a matter of fact I'm taking doxycycline right now for a nasty rosacea breakout, but I don't think it's going to make your skin lovlier if you haven't got a real problem!

<i>Guess I was thinking the difference in cost wouldn't matter to most people if they can afford to go to AFrica anyway.</i>

Not everyone is going for vacation though especially those who are going for longer periods of time.

I spoke with the Travel Clinic nurse and she gave me a prescription for Malarone instead. I'm happy to only take it 1 day before and 1 week after !! Thanks for all your help Fodorites.