Doxycycline and Malarone
Liverpool School of
Malaria Prophylaxis
Tropical Medicine
Malarone tablets
Adult dose 100 mgs, 1 capsule daily
Adult Dose: 250 mgs Atovaquone and 100mgs
Proguanil Hydrochloride, 1 tablet daily.
Doxycycline should be taken 2-3 days before you Available on private prescription only.
arrive in a malarious area, continue whilst you are Malarone should be taken 1 or 2 days before you
there and for 4 weeks after you leave.
arrive in a malarious area, continue whilst you are there and for 7 days after you leave. Tablets should Doxycycline is unsuitable if you:
be taken at the same time each day ideally with food  Are allergic to Tetracycline antibiotics Malarone is unsuitable if you:
 Have Systemic Lupus Erythematosis (SLE),  Are travelling for more than 12 months  Are allergic to Proguanil (Paludrine) or  Have Achlorhydria (a lack of stomach acid). Drug interactions: warfarin, ciclosporin, antacids,  Have kidney problems.
iron and zinc, retinoids (acitretoin, isotretinoin,  Taking Warfarin
tretinoin), methotrexate, methoxyflurane, malarone  Weigh less than 40kg
(atovaquone), quinipril, barbiturates, lithium and Malarone is licensed for trips up to 4 weeks. However, it is considered safe to use for trips up to
Doxycycline may interfere with the combined 12 months according to UK malaria guidelines and
hormonal contraceptive pill and patch. Additional possibly longer in certain circumstances.
contraceptive precautions, such as condoms, Drug interactions include: metoclopramide
should be used for the first 3 weeks after starting (maxolon), tetracycline, rifampicin, rifabutin, indinavir Doxycycline. If the pill or patch free interval and warfarin. coincides with the first 3 weeks of Doxycycline use, the pill or patch free interval should be omitted.  Effectiveness: Malarone is very effective at

Effectiveness: Doxycycline is very effective at
preventing severe (falciparum) malaria. For preventing severe (falciparum) malaria. For effective prevention you must take the full course effective prevention you must take the full course of capsules. It can be taken safely for up to at  Side effects include: abdominal pain, headache
least 2 years.
and diarrhoea. Other problems may include nausea, vomiting, skin rashes and mouth ulcers.  Side effects: In a few people (approx 3%),
Doxycycline may cause a skin rash due to sun  If you are unable to tolerate Malarone, you
exposure – usually mild and transient (use a
should change to a suitable alternative drug for sun screen minimum SPF15). Doxycycline may cause some indigestion. You are advised to  Children can be prescribed paediatric Malarone
take the capsule with food, swallowing it with a
tablets on an individual basis. The dose is large glass of water whilst sitting up/standing. calculated according to weight (minimum weight Use may also result in vaginal thrush - consider travelling with treatment for thrush. Should headaches associated with eye sight problems start while taking Doxycycline, seek medical advice urgently. No antimalarial drug is 100% effective, careful anti-mosquito measures are important and if you have
any “flu like illness” or fever (a week after you arrive in a malarious area and for 1 year after you return) it is important to seek medical advice and a blood film obtained urgently. You must discuss your own particular needs and contraindications to either Doxycycline or Malarone
during your travel consultation or with your own doctor or nurse. Leaflet Name: Doxycycline and Malarone Prophylaxis Page 1 of 1

Source: http://www.welltravelledclinics.co.uk/media/19383/doxycyclineandmalaroneprophylaxisv203.03.08.pdf

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