medical opinion malarone vs mefloquine?
 

My husband and I have been to different travel clinics to get our shots and prescriptions for our trip in June. Both clinic doctors recommended similar vaccinations (yellow fever, hep A, hep B, tetanus, polio, typhoid and measles/mumps/rubella booster update for me not him). <BR><BR>The interesting difference is that one doctor is very pro-malarone for malaria meds because of lack of side effects, while the other is anti-malarone, pro-mefloquine because he feels there is not yet sufficient evidence from the field that malarone works as well/better than mefloquine and that that outweighs the potential side effects.<BR><BR>Our current opinion is we should leave things as they are since many travellers have been fine with both of them and we believe that both travel clinics/doctors are very competent, but has anyone out there had a similar dilemma? Particularly any other medical opinions or medical references I can look up? I currently have the malarone prescription and my husband has the mefloquine, if male vs. female makes a difference.<BR><BR>Also, I believe my husband starts the mefloquine a week before the trip - if he has a bad reaction to the first dose, will he have a problem going to a doctor and getting a malarone prescription so close to date of travel? Any problem with changing medication after the one dose? <BR><BR>Advice from the board suggests that taking mefloquine with food will help cut down potential problems - any other advice?<BR><BR>Thanks very much for your help!

Free medical advice? Are you kidding? LOL, seriously, I wanted 3 opinions on medicine once and found this great site.<BR>http://www.allexperts.com<BR>You can ask as many doctors as many questions as you like; sure helped me!

Dear NKH<BR> If it's ANY help to you, I went to the &quot;top&quot; medical clinic where I live and they all decided to put me on malarone;there was no question for them. I had no problems with it-I went to south africa &amp; zimbabwe and thank heavens -it worked like a charm! In zimbabwe, I met a group of people who were on the way to kenya &amp; tanzania so naturally, I asked them what they were on-they also were on malarone. Hope this helps. Have a great time.<BR>

Also if its any help as well, my husband and I were on Malarone for our trip to Kenya and Tanzania last year. We had absolutely NO problems with it.. We were both fortunate that our insurance paid for it which was unexpected and wonderful. I would do a google search and on the two various medicines and see what comes up. We were initially prescribed Larium, but after reading a few horrific reports of side effects,we opted for Malarone and were extremely pleased with the results.

Thanks very much for replies so far. <BR><BR>Indeed what I am worried about is side effects for my husband since he has had fairly bad reactions to drugs that I have no reaction to in the past. I am not worried about efficacy of mefloquine, simply reaction to it!<BR><BR>Malarone based on what I had read up on before going to the clinic was our choice also - it has sort of thrown us for a loop that a doctor isnt convinced about it! I will keep digging info on my own as well to help make a decision.<BR><BR>Our health insurance does (thank goodness :-) ) cover both malarone and mefloquine so no financial discriminator.<BR>

Dear NKH<BR><BR> Isn't that funny-as soon as I went to the medical clinic for tropical diseases that was there recommendation-malarone. I'm just thrilled that it worked for me. Let me know what you find. Thanks

If cost is no issue I would personally recommend Malarone. I tend to get allergic reactions or side effects to anything and everything, so was very happy to find that Malarone posed absolutely no problems at all. My doctor in France recommended it over the alternatives.

Just about the best website for advice on travel health is http://www.cdc.gov/travel/. Few people have any serious problems from mefloquine, but it is far better to start taking it two or even three weeks before departure. Then, if you are one of the unlucky people who do have side effects, there is still time to change to another drug.

Last year I had the worst allergic reaction to the injections that I was given. My whole face puffed, especially around the eyes, and my eyes watered/teared uncontrollably, so bad that I had to go home from work.<BR><BR>Still, I guess it beats Malaria, although I am a little worried that next time the injections may give off an even worse reaction the next time around.<BR><BR>Honestly, I didn't take my prescribed pills more than a couple times on my trip and fortunately nothing bad happened.<BR><BR>Given that the side-effects to Malarone seem to be less than the side effects to Mefloquine, I will probably try to get the Malarone for this trip. I will be on the Luangwa River for five nights in a season when it may still be on the damp side, possibly attracting even more mosquitos than the usual for the Luangwa River.<BR><BR>I sure wish I knew which of the injections gave me the bad reaction but there were at least three separate injections, so I have no ay of knowing.

Other than anti malaria pills, are there any other medications or shots required for travel in Botswana and South Africa?

DE, go to the CDC reference I gave in my earlier reply, and it will give you the information you need. Better to get your info from an official source than from unknown &quot;experts&quot; on the internet.<BR><BR>Roccco, at least you will probably be covered for several years with most of the injections you received. As each expires, you could get your boosters one at a time, and that should reveal which is the culprit. As for not taking the malaria tablets, either you were lucky or you took all the right precautions to avoid being bitten. Don't push your luck again - all it takes to get malaria is one bite from the wrong mosquito.

Dear De, Take typhoid, Hep. A and for Botswana-go to a tropical disease centre and they will advise.

In 1998 &amp; 1999 I worked in Luanda, Angola. I was prescribed Mefloquine as the best antimalarial for Southern Africa before I departed the States. Malarone wasn't an option back then.<BR><BR>I don't normally have nightmares, but they started perhaps a month after I began taking the Mefloguine and occurred roughly once a week to ten days. These were very vivid nightmares from which I would wake completely covered in sweat to find out I actually had not been killed by one thing or another. After three months I threw the prescription away, bought a mosquito net for my bed and kept myself sprayed with DEET. The nightmares never returned.

An update for those interested on the two-clinic-two-different-drugs situation.<BR><BR>I asked my doctor (the one that prescribed malarone for me) about the mefloquine prescribed by the other clinic for my husband. He was reassuring and said the following specifically:<BR><BR>Nothing wrong with mefloquine for efficacy if my husband has no history that would contraindicate it (no contraindications present).<BR><BR>Apparently side effects from mefloquine are more common for women than men - hence my prescription for malarone. <BR><BR>If I were someone who felt they would have had trouble remembering a daily pill he would have prescribed mefloquine - not only is it only weekly, but it is more forgiving than malarone in terms of remembering. Apparently the one problem with malarone is you do need to take it every day and even at approximately the same time every day to get the best malarial protection. Mefloquine you can take a day late and still be OK<BR><BR>One suggestion he did have for first-time mefloquine users is to start taking it 2 weeks before instead of the 1 week before that is required immunity - this gives extra time to see if there will be any problems. This seems like good advice to us, so my husband will try the mefloquine before we go and he will make a decision to change prescription or not based on any reactions experienced.<BR><BR>Thanks again to everyone for useful opinions.

Dear NKH,<BR><BR> Like I said earlier I was on malarone but I was somewhat remiss-I did not take it at the same time every day and was really bad as I took it with beer or wine etc(not all the time) but I would not advise doing that JUST IN CASE

NKH:<BR><BR>In preperation for our trip we went to seperate travel clinics, near our work, and the two doctors had the same opinions as our's so I used malarone daily (as my doctor said your going all that way, spending all that money so why take mefloquine &amp; not be able to enjoy it) while she used mefloquine weekly (her doctor indicated that malarone was to new, as it only became available in Canada late '01) ... <BR><BR>I had no side effects from malarone &amp; it took her 2 days to recover from each does of mefloquine (upset stomach, no sleep/nightmares) ...<BR><BR>As for the costs, malarone was more expensive per pill &amp; needed a lot more pills (but for 8 days in Kenya that was ~$120 vs ~$30 ... but our medical plan is we pay the first $5 &amp; are covered for 75% of the rest, so in real terms it was ~$22 difference ... not a lot compared to the cost of the trip ...<BR><BR>Hope this helps,<BR><BR>Z

Thanks that does help - for several reasons! It is good to know we arent the only ones who have run into this &quot;malarone is too new&quot; opinion. I hadnt realized that malarone had only been available in Canada since 2001 (we are in Toronto, so your situation is very similar to ours) - definitely sheds some light on the reasoning <BR>behind one of the doctors opinions.<BR><BR>My husband is definitely going to ask for the extra week of mefloquine so he can start it early and check for problems in time to switch if he reacts.<BR>The experience you had shows that sticking to mefloquine if there is an initial problem is NOT the best way to do things. <BR><BR>Money isnt an issue with the choice between, luckily - we are fortunate that both malarone and mefloquine are covered by our health plans, and even if they werent we agree that it is never a waste of money to take the best medication for the job!<BR><BR>Thanks again for the info.<BR><BR>N

Mefloquine is named as the cause of permanent brain damage, most recently among soldiers stationed in the Middle East. Hallucinations have always been identified as a possible side effect, but it goes far beyond that. Don't take this drug!

That was digging deep for a 10 year old post.

Agree, digging deep, deep, deep for this very old thread.

So much has changed since including the fact that the military isn't issuing Lariam any longer (though I wonder what took them so long to switch to Malarone).

I still though use either Lariam or Malarone... depends on my mood; no side-effects from either, nor difference in price to be a determining factor. And, nowadays the Malarone is available as a generic at a reduced cost.