In this article, we thought we’d explore an extremely important malaria topic that, for some reason, is less talked about. This topic is antimalarial medications (antimalarials). These will protect you from getting this mosquito-borne disease in places with malaria-carrying mosquitoes.
What Are Antimalarials?
Drugs that cure malaria are often called antimalarials or malaria prophylaxis. Prophylaxis basically means disease prevention. There are many different antimalarial drugs designed for different situations and cases. No matter which drug your doctor chooses for you, there are a few things that you need to consider before you start taking any medication.
- No drug meant for malaria prevention is or ever will be 100% protective. There’s still a chance that you will develop malaria, even if you’re taking antimalarials. Granted, these drugs do increase your body’s ability to prevent malaria by at least 90%. But antimalarial medications aren’t 100% effective so you’ll need to combine these with personal mosquito protection measures like insect repellents, mosquito nets, and wearing long sleeves and long pants. This will stop mosquitoes from coming in contact with your skin and biting you in the first place.
- Antimalarials are drugs. If you’re taking any other medications, these antimalarials could react to that other medicine. This could weaken the effects of one of the drugs or, in the worst cases, cause drug allergies or other health complications. So, definitely ask your doctor about antimalarial drugs and any possible interactions with the other medications you’re taking.
- You also need to ask your doctor about the best antimalarial for you and your specific travel destination. The availability of antimalarials and the products recommended differ from country to country. You should also check the recommendations from the country you’ll be traveling to. In most cases, the local doctors and scientists will know more about their country, their mosquitoes, and the strains of malaria found there, making them better prepared to give those recommendations.
Types of Antimalarials
Now, let’s look at the five antimalarial drug types recommended by the CDC and when you should use each of them.
This medication is best for those who are going on a last-minute trip to countries with malaria-carrying mosquitoes. It’s also good for those who are going on shorter trips to these countries. You only need to start taking this medicine 1 to 2 days before traveling and continue to take it for only 7 days after returning home.
You’ll have to take these pills daily, which might result in upset stomachs for some. These drugs can’t be used during pregnancy, by women who are breastfeeding, or by those who have a glucose-6-phosphate dehydrogenase (G6PD) deficiency.
So, if you’re going to Southeast Asia or the Western Pacific, you should consider this antimalarial medicine. These are the places with the highest number of P. vivax malaria cases.
This second drug is also recommended for last-minute travelers or those taking short trips to countries with known malaria cases. You can start taking this medicine only 1 to 2 days before your trip and stop taking it 7 days after returning from your travels.
The downside of these types of antimalarials is that you’ll have to remember to take them every day. Pregnant women, women who are breastfeeding, and people with severe renal impairment can’t take this medication.
This particular drug tends to be pretty expensive. But since it’s a very well-tolerated medicine with no known side effects, it might be worth the cost.
Doxycycline is another antimalarial drug that you’ll have to take daily, starting 1 to 2 days before your trip. It’s both inexpensive and efficient. With doxycycline, you won’t only prevent malaria, but can also prevent other infections, making it perfect for those who will be hiking or swimming.
Pregnant women and children under the age of 8 can’t take doxycycline. You’ll also have to continue to take these drugs for up to 4 weeks after returning home. For this reason, you might not want to take this medicine if you’re going on a short trip. It can also cause sun sensitivity or upset stomach, which can make your vacation a bit less fun.
The good thing is that if you’re taking a prescription acne medication, you might already be taking doxycycline. If this is the case, you won’t have to take any additional antimalarials.
Next, we have chloroquine, which is a weekly drug you start taking 1 to 2 weeks before your trip and continue to use for 4 weeks after returning. This antimalarial is perfect for long trips and planned vacations. You’ll start taking it a few weeks before your trip and only have to remember to take it once per week.
On top of that, pregnant women can use chloroquine in all three trimesters of pregnancy. Some people with rheumatologic conditions might already be taking this medicine, so they’re already protected against malaria.
The downside of this drug? It might exacerbate psoriasis. You also shouldn’t use it in areas with known chloroquine or mefloquine resistance. Mosquitoes that carry the Plasmodium falciparum and P. vivax strains of malaria are resistant to chloroquine, so using chloroquine in these areas would be pointless.
Finally, there’s a weekly antimalarial medicine called Mefloquine or Lariam. This is great for those taking longer planned trips. You can take these drugs only once a week, starting no less than 2 weeks before your trip and finishing 4 weeks after returning home.
This medicine is also safe to use during pregnancy. It’s not recommended for use in areas with mosquitoes that are resistant to Mefloquine (areas with Plasmodium falciparum). People with some psychiatric conditions, seizure disorders, or cardiac conduction abnormalities should not use this medication.
So, when you’re choosing an antimalarial to use for your next trip, there are a number of things to consider.
- Where you’re going. You don’t want to choose a medication that is ineffective against the mosquitoes you’ll be faced with.
- Your health. This includes any other medicines you’re taking and your medical history. You don’t want to take any antimalarials that could harm your health!
- Your age. You also need to consider the age of any children or other adults that might be taking the medication as well.
- Pregnant or breastfeeding? Pregnant women need to take an antimalarial that is safe during pregnancy. The same goes for breastfeeding women. You don’t want to harm your child by taking drugs that aren’t suited for pregnant women.
- The length of your trip. Is it planned or spontaneous? Will you have enough time before the trip for the medicine to kick in?
- The possible side effects the antimalarials could cause. Once you find out, you need to prepare for these side effects.
- The dosage of the antimalarials your doctor prescribes. You don’t want to skip a dose and leave yourself vulnerable to malaria.
Once you’ve weighed the pros and cons of all these points, deciding which antimalarial drug you should use for your next trip should be easy.