I will be going to New Delhi in mid-October for two weeks and am trying to find the best anti-malaria medication. My family physician recommended Larium and Malarone, with Larium having the worst side effects of the two. Does anyone have any thoughts, experiences with either or any other recommendations?

Do read about malaria and anti-malarials at www.cdc.gov/travel

Larium is the anti-malarial with the most side effects. Approximately one-third of people who take it have some kind of neuro-psychiatric side effects, most commonly, vivid dreams which are often disturbing, but it can also produce depression and paranoia. (see the report in Consumer Reports) Malarone has the fewest side effects of any anti-malarial. It is also effective in areas that have malaria that is resistent to larium (not a problem in India). Less than 5% of people who take malarone have side effects that are troublesome. Another advantage of malarone is that you only have to take it for 7 days after leaving the malarial risk area, rather than a month for both larium and doxycycline. While malarone is expensive, you may find (as I did) that you medical insurance will cover it.

Personally, I have taken malarone on two trips (Cambodia and Laos) and had absolutely no side effects.

I was prescribed a daily pill (2 a day) to take one week before the holiday, during it, and for four weeks afterwards and a pill to be taken once a week (in fact, you take two of them) for the same duration. It was Paludrine and Chloroquine - P was taken daily, C was taken weekly. FYI, we could buy them off prescription in the UK. The whole lot cost about $22.

Nigello, that combination of drugs is not considered effective and is no longer recommended at all by the cdc. Health Canada recommends it only if a perosna can take no other anti-malarial. It's still pushed by pharmacists in Britian, as it's the only anti-malarial sold without a prescription in the UK.

The inexpensive alternative anti-malarial which IS effective everywhere is doxycycline. You have to start it a couple of days before entering the malarial risk area and continue it for four weeks after leaving the area. It must be taken at the same time every day. About 3% of peope who take doxy develop photosensitivity severe enough that they have to stop taking it. Taken as directed it is effective and has few side effects.

One of the advantages of malarone is that you start it one or two days before entering the risk area, and only have to take it for a week afterward.

After having taken Larium for three trips to Africa, was glad when Malarone became available in U.S. We found no side-effects at all. As long as you take it with food, same time daily (breakfast, best with a dairy product - yogurt, cheese) you should be fine.

As mentioned above "doxycycline" might be less expensive, but you have to take more pills and the photos-ensitivity as well as likely yeast infections for women, are the downside.

If you have a drug plan Malarone will be covered with whatever your copay might be. If not, check around various pharmacies for best price, but a normal script for about 20-22 pills runs about $100+/-; all to be considered as the cost of your trip to India.

Have you checked whether you require any innoculations for your trip to India? If needed, get them at least 10-days prior departure. Enjoy your holiday.

My family and I have taken Lariam for 2 trips to India and have had no problems at all.

Stay away from Lariam!

The incidence of adverse side effects is quite high.

Why risk it when you can get Malarone?

Lariam is takenonce per week, not for seven days post trip. I recall you take it once per week for 2 weeks after return.

jacketwatch -

Lariam should be taken for 3-4/wks after return.

Alma - Regardless, pass on the Lariam and go with the Malarone.