I have taken Malarone a number of times when in malarial risk areas of SE Asia. Indeed, I'm going to be taking it again when I go to Sri Lanka in November. In the instructions for taking malarone, it indicates that it should be taken with a meal or a milky drink. I assumed that was to prevent stomach upset.

It turns out that taking malarone on an empty stomach reduces its absorption and therefore reduces blood levels of the medication. Indeed, eating some fatty food with it will increase blood levels significantly as Atovaquone (one of the active ingredients) is fat-soluble.

There have been cases where a person contracted malaria despite taking malarone because absorption (and therefore bood levels) were inadequate to prevent malaria. (Note that this occured NOT because of malarial resistance to malarone, but solely due to inadequatre blood levels. While there have been isolated reports of resistance to malarone, at present these remain isolated and are not indicative of developing resistance to malarone.)

My thanks to Nutraxfornerves, a regular poster on the health branch at Thorntree for this very useful information.

thanks kathie....we always take it at breakfast where there are plenty of fatty things and fatty people...

Topping for Jed.

Kathie - this is helpful info. We generally take Malarone at breakfast too (just so that we remember - same time every day), but am not sure that we always wait until we've eaten. We will certainly heed your advice in future. Thanks for sharing!