Malarial drugs
 

Any thoughts on Malaron vs. doxicycline vs. larium? I understand Larium can make you "loopy" and doxicycline makes you photosensitive.....the obvious then would be malarone except doxicycline is an antibiotic and would preempt any other infection. Any difficulties taking any of the above while in the bush in Botswana?

Thanks!

We took Mararone and had no troubles with it. Our travel doctor at the time (3 years ago) felt it was the one with the fewest complications. I had heard of some people who had problems with Larium (loopy).

Travel specialist at the Mayo clinic told us Larium is cheaper and you don't have to take it daily but some people get vivid, weird dreams from it. Malarone is more expensive and you need to remember to take it daily but it seems to have fewer side-effects and those are less serious. We took Malarone and were fine with it.

Have taken Malarone on two trips to Africa, one in '03 and again very recently. Both times the medication did not seem to cause any side effects that were noticeable. It does seem to be the best antimalarial drug available.

It's not simply a case of cherry-picking which of the various anti-malarials sounds like it might be less unpleasant - it's also worth checking which anti-malarial is deemed to be most effective in the area you are travelling too - not all are as effective in all areas - partly because there are different strains of malaria and partly because the strains in some areas have built up resistance to one or other of the drugs used.

So do check with your doctor (ours all have lists of countries showing which of the drugs are effective there) and make your choice from within those recommended.

It's also my understanding that malarone has a higher rate of efficacy than some of the others but you'd need to check into that.

I was in Ethiopia last fall and took Malarone - no side effects, but I suspect that it has the potential to cause liver damage if you take it frequently. So, if you travel 1-2 times per year to a malaria-risk area, I would suggest alternating between malarial drugs - don't take the same one for each trip unless you have a good year between trips.

Malarone is perfectly safe for your liver. Even if you have mild to moderate hepatic impairment - you can still take it! Malarone has good safety data for up to 12 weeks of continuous use.

I always use Lariam (mefloquine), as I am not affected by any of its adverse effects. Lariam has good safety data for up to 12 months of continuous use!

Even if you travel to Africa 5 times per year, it is safe to use both antimalarials on a regular basis, so do not worry.

You should assess which drug is most suitable for yourself (in terms of side-effects) and stick to it. Regarding travel to Africa, both are currently very good for malaria prophylaxis but things may change in the future depending on resistance patterns of plasmodium falciparum in Africa.

Both drugs can also be used to "treat" malaria, but this requires different doses to those used for prophylaxis and you should seek the advice of a health-care professional. I carry extra supplies of Malarone and Lariam with me to Africa "just in case", me or my wife require "treatment" - but we have had no need to use them so far.

Regards

Gaurang

My sister's doctor gave her a round of Larium prior to departure to ensure that she wouldn't have any side effects. If you're concerned about it, you might try that. I've used Larium on every one of my Africa trips with no side effects, other than the occasional weird dream.