With this itinerary, when should I start taking the malaria pills. They are so expensive, don't want to start before needed.
2 days JB
4 day Capetown
2 Days Chobe
3 Days VF area
6 Days KZN/Hhuluwe area

Your doctor that prescribed them should cover this with you, I was told to start one day before entering malaria area so that would be one day before you get to Chobe.

I've just got back from Peru.

I took Malerone 2 days before I left and 7 days after I got home.
Your doctor should have prescribed enough to cover you.

Regards

No need to take the tabs in JNB or CPT, as these aren't malaria area.

As Carla indicated, commence before arriving Chobe, so on the 3rd morning while in CPT earliest.

Accordingly, you will need 20/tabs (2/CPT, 2/Chobe, 3/VFA, 6/KZN, 7/when home). Be sure to take with food, dairy is suggested (cheese, milk, yougurt) often served at breakfast. Though some prefer to take after dinner, so if any reaction, they sleep through it.

I've never had any problems with Malarone regardless whether taken with breakfast or after dinner.

Thank you so much. That is exactly the information I was hoping to get.

I have my doctor appointment next week and wanted to be sure that I had the right number of pills prescribed.

Julien, This may seem very detailed. I used the world clock URL and time zone converter at:

http://www.timeanddate.com/

to figure the best time of day to take the malarone pills each day. Knowing that the difference in time zone between SA and time zone MDT in US was about 9 hours, the conversion helped me determine when to take my pills at the appropriate time in SA so that I was not getting up at 2AM in USA to take my pills.

I believe that I figured that if I took my pills at the dinner hour (approx 8PM SA time) with meals that I would be taking them around noon in the USA (Salt Lake City or Mountain Time).

This also allows you take any other medications that you might be taking on a daily basis at approximately the same time each day.

I did not want to be taking the 5 days worth of malarone, once back from trip, at 2AM or some weird time in the middle of the night.

- Granny Joan

Unlike some pills, if not taken same time, each day, i.e., birth control, where you may have break-thru bleeding, this isn't the case with malaria tabs. For that matter, most pills.

I take my pills at the same time whether in Africa or at home... i.e., 6am, in both. For those pills I take at night, then it's 10pm, in both places.

Unless your physician orders otherwise, coordinating time in Africa with that at home, is one less thing to think about while you're on your vacation.

Sandi, Are you a doctor or pharmacist?

I go by this rule:

To obtain the maximum benefit from medicines and minimize the potential for side effects, patients must always follow exactly the doctor's instructions for taking a medicine and complete the full course of the medicine.

- Granny Joan

We were just at the travel clinic on Friday and the nurse told us, regarding the malerone, it really didn't matter when the pills were taken. As long as we took then each day at some point. SHe did say to take them with food though.

My PREVIOUS GP gave me a prescription for 10 pills for a month-long trip to SE Asia. He said the directions were "take 3 days prior to trip and 7 days after the trip". Needless-to-day, I changed doctors. My pharmacist knew the correct dosage and provided me with enough Malarone for the entire trip.

JaneB - good move to change docs! 10/pills for a month long trip... amazing.

Granny - not a doctor or pharmacist. I indicated what I do and mentioned "unless otherwise advised by your doctor"

As stated by theras, Malarone can actually be taken anytime with food, but one should not to skip a day till all pills are gone.

Boy....I am just lucky if I remember to take my pills at all, whether here or on a trip.

I have not been to the doctor yet...go next week. I just wanted to be sure which areas I needed to be covered in.

My husband went in today. His doctor prescribed typhoid as well. We are not going to be in any really rural areas and will be in well known lodges along the way. Opinions on typhoid pill necessitity?

I went to the travel clinic at Northwestern today. The doctor did not recommend Typhoid because my trip to South Africa is less than 3 weeks.

I did have to get the polio booster and start over with hep A (never got the second shot). I also chose to get Hep B, just to get it done. She also recommended Tetanus/Diphtheria, but I had it 5 years ago. The written literature says every 10 years, but she said anyone who hasn't had it in 2 years should get it. I had such a bad reaction last time, that I passed.

As for the malaria pills, read the article in this month's National Geographic. I guarantee you won't forget to take the pills. The article scared the living daylights out of me. And also convinced me to write a big fat check towards malaria treatment for children.

Btw, if anybody lives in Chicago and wants information on the Northwestern Travel Medicine & Immunization Center:

http://www.nmff.org/travelmedicine/index.asp

Julienk, my doctor also prescribed typhoid pills for me and my family for our upcoming trip to South Africa. The CDC recommends it as well for travel to S.A. The cost of the medication was about $20, so I thought it was well worth the piece of mind.

The travel clinic (Ontario, Canada)we went to last Friday recommended NOT taking the typhoid since we were not going to be there for a protracted period (less than 3 weeks).They did give us polio boosters though, as well as Hep A and tenanus. Also Malorone perscription for the correct period (one day before entering, # of days there and 7 days after leving). We also got perscriptions for Ciperol.

From the malarone.com website:

"Q: How do I take MALARONE?

A: MALARONE once-daily dosing starting <b>two days</b> before departing on your trip. You should continue taking MALARONE once a day during your trip and for just one more week after you return home.&quot;
Other sites say take 1 day before. Follow your doctors advice.

julien -- I don't think you will have a problem remembering. I've been 5 times and have never forgotten. (Although when I was taking Larium I wished I had forgotten altogether.) It seems that popping pills, slathering on bug repellent before dinner, sunscreen in the morning, etc., are all part of the rituals of safaris, with everyone having a great time talking about it at meals, on game drives, etc. You will probably do just fine.

Okay....I will take the typhoid vacine since we have plenty of time before trip and will be there just over 3 weeks. I will ask about getting a polio booster. I know I need a DPT booster. And I am really glad someone mentioned the Ciperol antibiotic. I would have forgotten that.
Thanks for all your advice.

Don't forget Hep.