There are several different types of antimalarial medication, the choice of which depends on such factors as area to be visited, length of stay, your own medical history, medication you may already be taking, type of holiday (hotel, cruise, trekking etc).

These drugs can be loosely divided between the older formulations (Chloroquine and Proguanil) and the more recent preparations licensed for antimalarial use (Doxycycline, Mefloquine and Malarone).

Chloroquine has been used for around 50 years and during that time vast areas of the ‘malarious world’ have become resistant. As a 4-aminoquinoline derivative chloroquine prevents nucleic acid synthesis in actively dividing erythrocitic malarial parasites and thus DNA synthesis is affected. The drug is taken as two tablets weekly on the same day of each week, Countries still sensitive to Chloroquine include Costa Rica, Belize and Mexico.

Proguanil is a Biguanide which is metabolised in the body to cycloguanil, an active form that blocks the production of folic acid and subsequent synthesis of DNA. The human cells are not affected by this action except during pregnancy where your doctor will usually give a folic acid supplement to counteract a possible shortfall in the mothers cells.

As with Chloroquine there is widespread resistance now to Proguanil and it is often given in areas where the traveller is unable to take Chloroquine for some reason (such as sensitivity to the product). The Chloroquine and Proguanil when combined in one pack as Paludrine/Avloclor travel pack form a more formidable antimalarial and can be used in many more areas where the individual drugs would not be effective enough.

In the Travel Pack of Paludrine/Avloclor produced by Astra Zeneca the dosage of Proguanil is two daily which would be taken at the same time and the Avloclor (Chloroquine) is two weekly, also taken together. (A calendar pack gives an easy format and prevents mistakes in dosage whilst away.) Proguanil/Chloroquine is used in countries such as Sri Lanka, Nepal and most of India. These preparations can be purchased without prescription from Pharmacies.

The ‘newer’ group of antimalarials are helping to prevent malaria in areas where resistance has become a major problem, the malaria parasites being incredibly adept at mutating and hence overcoming the drugs used against them.

Malarone is Atovoquone and Proguanil combined to give a combination of an antiprotozoal and a biguanide. The dosage is one tablet daily for adults usually taken one or two days before entering the malarious area, during and for seven days on leaving. There is also now a paediatric formulation for children.

Lariam (Mefloquine) is a 4-aminoquinoline (as in Chloroquine) and in adults is taken as one tablet weekly. To check for side effects your doctor will often prescribe these at least two and a half weeks before travel, during and for four weeks on return.

Last but not least is Doxycycline a well tried and tested tetracycline antibiotic given as the hyclate. This was found to have marked antimalarial properties as well as being an antibiotic. It is usually given one week before travel (if it has never been taken before), during and for four weeks on return.

These last three products are prescription only and can only be obtained from a Pharmacy on supply of a private prescription issued by your doctor or travel clinic. Depending on your medical history etc., your doctor will decide which of these preparations are suitable for your travels.

Chloroquine for example is not normally given if you suffer from psoriasis or epilepsy. If taking Warfarin for blood thinning always check this out with your doctor, and likewise if pregnant or hoping to become pregnant then again you must consult your doctor first before taking an antimalarial drugs.

Your G.P. or Travel Nurse will check out the area you are about to visit and together with medical history and knowledge of the type of holiday will prescribe the relevant antimalarial.

For prices and supply of any of these preparations you can log on to www.travelpharm.com or ring us on 01395 233771