Hi all,

Let me say upfront, I do plan to talk to my doc about this, but wanted to hear from others who may have had to make this choice.

I am heading to Cambodia and Vietnam in Feb/March, including malarial regions. I am considering not taking a malaria prophylaxis because I am trying to get pregnant, and because of my age, really would rather not put off trying for an additional 6 months (what my doctor told me the last time I took malarone). I realize if I end up getting malaria, then I will have to take the drugs anyway, but am trying to weigh the statistical likelihood that this will happen. Wonder what others have done/would do?

Thanks for your thoughts...
Amy

What about doxycycline, which is an anti-biotic perscribed as an anti-malarial?

This is a complex question, and one that is worth taking to a doctor that specializes in tropical medicine.

Are you currently trying to get pregnant? This obviously influences what you can/cannot take. Doxy, for instance, cannot be taken by pregnant women beacuse it harms the teeth of the fetus.

Also, malaria in a pregnant woman is considered a medical emergency.

I don't know the current guideleines on how long you have to wait after taking the various medications to get pregnant. 6 months sounds quite long for malarone. I wonder if the guideline has to do with ensuring that you don't have malaria rather than ensuring that the medication is out of your system.

Amy, I don't remember exactly where you are going, but if it is very important to you to get pregnant as soon as possible, you may wish to change your destinations to places where malaria is very low risk.

I was thinking about the same thing and got the info on malarone from glaxo smith kline. it should be out of your system after 24-48 hours of the time you stop taking it. are you in NYC? Do you have a travel dr? I'm in nyc too.

Hi, thanks everyone for the replies, which are helpful.

In fact, thinking back, it wasn't that my doctor exactly said 6 months was necessary. She said that we should definitely wait after the Malarone, and back then we still had almost 6 months until our planned "start date" - hearing that she said that "should be" fine. But she never suggested that it could be as little as a couple days! I remember she had a disdainful look on her face which fed my impression that definitely the longer we could wait the better, and that even 6 months might be risky. But then, I am prone to think the worst about almost all medications... so...

I must admit I am a bit paranoid about anti-malarials. I took Mefloquine (Larium) almost a decade ago, came down with a case of malaria anyway, and dealt with all the nasty side effects of the drug along the way. I had no side effects with Malarone, luckily, and I don't really know how it works compared with Larium (which is incredibly toxic and stays in the body a long time). Could probably do some quick research to find out what they know so far about how it is eliminated from the body.

Anyway, not yet trying to get pregnant (this trip is a honeymoon of sorts, if you get my drift)... the malarial regions we would be in are the Mekong Delta and Angkor Wat. It is too late to reorient our trip... more likely we will reorient our baby-making : )

Sorry this is probably too much information for some Fodorites! Please forgive...

Shothyme77 I am indeed in NYC, and do not have a travel doc - last time I spoke to my primary care (who is very good and well versed in travel medicine). For this I was going to talk specifically to my OB. Unfortunately I don't have much faith in the manufacturers to tell the whole truth about side effects, especially drugs that haven't been on the market so long. In this way, maybe doxy is the best bet, at least there should be a lot of info about how long it stays in the system...anyway, where are your travel plans to?

I would speak to a travel doctor. I first spoke to our regular internist as well as our pediatritian, then later went to a travel doc - It turns out the two regular doctors were not up to date on various SE Asia issues.

AmyNYC - I asked our travel doc some similar questions. Depending on the time of year, you may not have to worry about malaria risk for those regions. We are going in December/January and only south Thailand, some areas around Bangkok and Laos showed any malaria risk. My doctor suggested waiting about a month after taking the medication before trying to get pregnant. Hope this info helps - as others have mentioned, a travel doc will provide the most accurate info. Have fun! Sara

Talking with a travel med doc is a very good idea. Often, internists or ob/gyns have little knowledge of tropical medicine. Good point, crosscheck.

Amy, do read the info at www.cdc.gov/travel It is one of the best travel med websites and is updated frequently.

Sara you might want to look at that website as well, as the info you are giving about where malaria is a risk is not accurate.

Kathie - you're absolutely right, I gave wrong information (I guess another signal that a travel doc would be best The only thing is that I know risks change depending on the season, and the cdc site seems to offer country based rather than country plus season. in any case, I'm finding it a useful info source. Thanks!

Sara, in some places, malarial risk is very seasonal, in other places it is not. SE Asia malarial risk is not as seasonal as some places in Africa and India, for instance.

Perhaps the question that could be posed is not about the risks of anti malarials, but rather which is more important to to you, a trip to SE Asia or getting pregnant?

Whatever you decide will be right for you because it is being done in a thoughtful manner.

Hi, and thanks for the advice. I will definitely seek out a travel doctor.
-Amy