panecott

An acquaintance who went to SA and Botswana last November told me she bought malaria pills at the airport pharmacy in Jo'burg, no prescription needed, at a fraction of the price here in the US. Has anyone ever heard of this? Pros/cons? TIA

Celia

Yes, I've done that many times over the last 25 years. The drug you get over the counter in South Africa is not Malarone, though. I forget which drug it is -- actually I think it's combination of 2 drugs. For our last two or three trips, we've gotten Malarone here in the US, because supposedly it works better than the OTC combo. But there's nothing fishy about buying the OTC product in SA. Locals do it all the time.

panecott

Thanks, Celia. Do you recall if you had to take the OTC pills any days in advance of your entering malaria country? I will have only two days in CPT before starting safari in Namibia.

Pumbavu

I've bought Palodrine and Cloroquine over the counter. But checked its efficacy first before using it. At the time it was second or third to other treatments... but a load cheaper. Always check with a hospital that specialises in Tropical Medicine and has up to date information. GPs seem to know very little about Malaria Treatments... and why should they... there's so much they have to think about day to day. Go to the people who are doing the research and treatment on a day to day basis for up to date information. In the UK that seems to be Liverpool.

Yes, the OTC drugs are started I think a week before. and for a couple of weeks after. I'll just check...

Pumbavu

Actually mine say Chloroquine and Proguanil. Start seven days before and continue 4 weeks after.

jasher

Hello,

In the UK I'd check with the London School of Tropical Medicine -- the name says it all.

Chloroquine resistance is becoming an increasing problem all over the world, so definitely double-check that the area where you are travelling does not feature chloroquine resistant malaria.

Cheers,
Julian

safarinut

panecott

You can get Malanil(Atovaquone/Proguanil) over the counter in South Africa.Malanil is called Malarone in North America.

Controlled studies have shown a 98% overall efficacy of Malarone/Malanil in the prevention of P. falciparum malaria.

Celia

Panecott, the pills we got in SA were the kind you start several days in advance; but this was at least 6 years ago.

Safarinut, I'm delighted to hear that Malarone (by whatever name) is now available in SA!

Pumbavu

I know you should always take the right drugs... but what about some tips on not getting bitten in the first place?

Marmite,a yeast extract spread from the UK, has been shown to reduce mosquito bites. People who eat marmite are less likely to be bitten! Any other tips?

panecott

Thanks, everyone for your replies. There's a Travelers' Medical Service here in the city that specializes in these things so I'm going to run all these substance names by them. I get the impression that Malarone is the best??

Pambavu, did you take those two drugs in combination as Celia did?
And, are chloroquine, proguanil and palodrine brand names or generic names?
Also, can anyone give me an idea of the cost? I'll be in Africa just under 4 weeks, so it looks like I'll need an 8-9 week supply. Yikes! I hate taking pills!
One more thing, I will take the pills regardless, but I was wondering if the risk is somewhat reduced because of the cooler temps in May/June? Thanks.

jasher

Hello,

The risk is definitely reduced during the cooler months as there are fewer insects (one of many reasons I prefer those months). However, that doesn't mean you should forego the meds or the insect repellent.

The cost depends on where you are getting the drugs -- I believe Malarone costs about $2 per pill in the US, but sometimes your insurance will cover it.

Cheers,
Julian

sandi

Though my drug plan has always covered my malaria meds (Lariam for first few safaris and Malarone since it's become available), from previous posts, the price for Malarone tabs for a 14-day trip (2+14+7 = 23 tabs) costs about $100 +/- depending on where purchased. You often have to shop around if your insurance won't cover.

Celia

Where exactly will you be, and for how long, Panecott? You don't need malaria meds in the cities of South Africa, and not all the rural areas are malaria areas. And in May/June, depending on where you go, repellent may be all you need.

panecott

I'll be in Namibia for 13 days, then Botswana for 8, and 2 in Vic Falls.

Patty

Costco in the US sells Malarone for about $4.30 per pill. I believe that's about the cheapest you'll find.

panecott

I was just doing some research and read that Malarone has some pretty scary side effects. Has anyone experienced this? What do you do if you have the side effects and have to stop taking it?
Why is it so popular if you can have so many problems? Is it that much more effective than other drugs?

Patty

I think you might be confusing Malarone with Larium. I've not read anything that indicated scary side effects with Malarone.

panecott

Patty, I was thinking of Malarone, but used the wrong word. I should have said "unpleasant", rather than "scary". The article said side effects include "abdominal pain, nausea, vomiting, headache, diarrhea, or dizziness". I'm just wondering how common they are.

Also wondering how common the side effects of Larium are, such as the depression and hallucinations. Those are scary!

sandi

panecott -

Have you read the side effects of aspirin.

There isn't a pill/med out there that doesn't have some possible side effects.

While Malarone has some possible side effects, all of which have to be listed, these are rare. It is recommended these be taken with food, preferrably dairy. If you happen to toss it, it's suggested you take another and continue thru the end of the total script written for you.

We've taken both Lariam and Malarone. I'll take Malarone any day, never having any side effects. The Lariam only gave me interrupted sleep, though nowadays I can blame that on having coffee late in the day. My partner, however, had the weirdest dreams, as do many others. Some people have had no problems with Lariam, but if you or even a family member have any type of psychological problems, Lariam should not be taken.

Unfortunately, there aren't many options for meds specifically for malaria. The doxycyline which is often recommended for those who can't (for whatever reason) take Lariam or Malarone, is only an generic antibiotic, less expensive (by lots), but these too have side effects - sun sensitivity you must always use sun protection) and for women, yeast infections; you have to take for 30-days after returning home.

These meds are only preventatives (not an inoculation) to be used in conjunction with repellents during mossie biting time - dusk to dawn.

Do a search on this board for a thread about Kavey's dad who came down with a case a malaria, not having taken any malaria meds - not a pretty picture.

I'd rather toss my cookies (from any of the meds) or have some of these minor side effects, than have to deal with a case of malaria.

Pumbavu

>Pambavu, did you take those two drugs
>in combination as Celia did?

Yes, I did and do. But it's my choice and can't recommend. Take advice from professionals.

>And, are chloroquine, proguanil and
>palodrine brand names or generic
>names?

I think generic... I ask the pharmacist for Palodrine and chloroquine and get the right stuff. I usually pay about $30 for a four week trip. Like I say, cheaper but not considered as effective!