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Antimalarials and Travel Essentials

About Doxycycline Taking Doxycycline Take 1 tablet at the same time each day with a large glass of water. Start taking the tablets daily 2 days before visiting a malaria risk area. Keep taking 1 tablet every day while in the area, and for 4 weeks after you leave. How it works Malaria is spread by the bite of an infected mosquito. The mosquito passes the malaria parasite into your bloodstream, infecting you. Doxycycline contains the active ingredient doxycycline hyclate, which is thought to work by preventing the malaria parasite from being able to grow and killing it in the process. Side effects Side effects from Doxycycline are uncommon but it can cause nausea, diarrhoea, headaches, a sore throat and vaginal yeast infections in some people. It can also make skin more sensitive to sunlight. For full information on side effects and correct use, see the patient information leaflet. If any side effects concern you, contact us via your Patient Record. Effectiveness You'll be protected from 1-2 days after starting your course – so you need to start treatment before you leave to ensure that you will be protected by the time you arrive at your destination. You need to take your tablets regularly and according to the instructions to get maximum protection. Remember, Doxycycline can give you 90-100% protection when used in conjunction with other measures to make sure you don't get bitten by a mosquito. Who can take Doxycycline If you're over 18 and clinically suitable, we can prescribe you Doxycycline. However, you are responsible for ensuring that it is the correct anti-malaria tablet for your destination. Check this at Fit For Travel. Important information about Doxycycline Pregnant women are not suitable for Doxycycline. You should avoid getting pregnant while taking this treatment. Women who often get vaginal yeast infections when taking antibiotics may also wish to avoid Doxycycline. Not all malaria prevention drugs are suitable for all parts of the world. You should check which tablets are recommended for your destination. Safety: taking other medicines As is true of all medication, Doxycycline can interact with other medicines. This is why it's important that you let us know which prescription, over-the-counter medicines and recreational drugs you are taking so that we can prescribe Doxycycline safely. Alternative treatments If Doxycycline is not suitable for your destination, Atovaquone with Proguanil [link to Atovaquone with Proguanil] or its branded version Malarone [link to Malarone], might be. If appropriate, we can prescribe these for you. As well as taking malaria tablets, you must take other measures to protect yourself against malaria when in a malaria area. These involve avoiding being bitten by a mosquito in the first place. You should use insect repellent such as DEET, sleep under a mosquito net that's been treated with insecticide, and wear long-sleeved shirts and trousers in the evening.

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About Lariam Lariam is a prescription-only oral tablet used to prevent malaria. Lariam is a brand name, the active ingredient is mefloquine. Take one 250mg tablet weekly, starting at least 10 days before entering malaria zone, continue for 4 weeks after leaving. Caution: Lariam may cause serious mental issues in some people. Read the patient leaflet for a full list of side effects, cautions, and interactions with other drugs. Uses of Lariam Malaria is caused by a parasite which is passed from one person to another by mosquito bites. Lariam interferes with the growth of the parasites in red blood cells. Lariam is effective in preventing malaria and is recommended in certain parts of the world. Recommendations for which anti-malaria prevention is recommended in different countries can be found at the NHS Scotland Fit for Travel website. No malaria prevention tablet is 100% effective - mosquito bite avoidance measures should also be taken. Lariam can also be used to treat malaria. Treatment for malaria should only be administered under medical supervision and after a definite blood diagnosis of malaria. The recommended adult dosage for the treatment of P. falciparum malaria is up to 6 Lariam tablets over 24 hours dependent on body weight. How to take Lariam tablets for malaria prevention Adults over 45kg: Take one Lariam tablet on the same day each week, starting at least 10 days before entering malaria areas. If you have never taken Lariam before, it is often recommended to start earlier, 2-3 weeks before travel, in case of side effects and needing to swap to a different preventative medication. Continue weekly tablets whilst in the malaria region and for 4 weeks after leaving. The minimum course of treatment is 6 weeks. Swallow tablets whole with plenty of water, preferably after a meal. Do not suck or chew the tablets. Lariam should not be taken for longer than 12 months. Cautions Checks for suitability are carried out online as part of our consultations. Alternatives to Lariam tablets for malaria prevention are available through Abbeydale Pharmacy Lariam can be taken by many people, although it is not suitable for everyone. Travel is often stressful and Lariam may exacerbate stress related symptoms. There is a very rare theoretical risk of abnormal heart rhythm if Lariam (mefloquine) is taken at the same time as some other medications - please check this list. Who should not take Lariam? Lariam should not be taken if any of the following apply: Allergy to mefloquine, quinidine, or quinine. You have - or have had in the past - any mental health problems including depression, anxiety, psychosis, suicidal thoughts or attempts, self-harming, schizophrenia. A history of fits or seizures (Lariam may increase the risk of fits and also reduces the effectiveness of antiseizure medications). Severe liver problems. Previous Blackwater fever (a complication of malaria that affects the blood and kidneys). A known heart conduction condition, e.g. heart block, long QT syndrome. You are taking medication which slows the heart rate, or fluconazole, itraconazole, or ketoconazole tablets. A traumatic brain injury - an alternative antimalarial prophylaxis to Lariam should usually be considered. Scuba divers planning to dive during their trip should not take Lariam as it can lower seizure threshold and also affect decompression symptoms. The UK Civil Aviation Authority advises against pilots using Lariam. Halofantrine (to treat active malaria) should not be used within 15 weeks of taking Lariam as the combination may slow the heartbeat to a dangerous level. Pregnancy and breastfeeding Developing malaria at any stage during pregnancy can have very severe consequences including a higher risk of death of mother or baby. Therefore pregnant women are strongly advised not to travel to malarious areas if at all possible. If travel is unavoidable, malaria prevention medication should be used. The risk from malaria is much greater than any risk to the baby from taking antimalarial medication. Lariam can be taken in some circumstances. We does not prescribe in pregnancy. A specialist in travel medicine should be consulted. See also Best use of medicines in pregnancy - Mefloquine. Breastfeeding whilst taking Lariam is not recommended. Driving and operating machinery Occasionally Lariam can affect fine coordination or the ability to visually assess distance which may impact driving, piloting an aircraft, or operating machinery. Special care should be taken when doing any of these tasks. Side effects of Lariam Most people can take Lariam without significant side effects. The most common side effects of Lariam include: Depression and anxiety. Sleeping problems. Nausea (feeling sick). Vomiting. Dizziness. Headache. Problems with vision. Loss of balance (vertigo). Diarrhoea. Stomach ache (abdominal pain). Itching. Other side effects are listed in the Lariam patient information leaflet supplied with medicine. In a few people, depression, dizziness, or vertigo may continue for several months after stopping Lariam. When should you stop Lariam? In a very few people Lariam can cause serious psychiatric symptoms. Stop taking Lariam immediately, consult a doctor, and use a different antimalarial, if you experience any of the following symptoms: Severe anxiety. Paranoia (feelings of mistrust towards others). Depression. Hallucinations (seeing or hearing things that are not there). Insomnia. Abnormal dreams/nightmares. Feeling restless. Confusion or other unusual behaviour. Suicidal thoughts. Self-harming. Also stop Lariam, swap to a different antimalarial, and consult a doctor, if any of these other problems develop: Changes to your vision. Burning sensation. Tingling. Numbness. Muscle weakness. Breathlessness. Dry cough. Other measures to prevent malaria In addition to taking recommended malaria tablets, malaria risk can also be reduced by avoiding mosquito bites. Mosquitoes can bite at any time of day. Most bites by malaria mosquitoes occur in the evening and overnight between dusk and dawn. In contrast, dengue fever mosquitoes tend to bite during the day. Wear long-sleeved clothing and long trousers if you are out at dusk, dawn, and at night. Several companies sell insect resistant travel clothing pre-treated with insecticide (permethrin). Use insect repellent containing DEET on exposed skin and under thin clothing, particularly around the ankles. The best strength DEET is 50% There is no added benefit to using higher concentrations. Other repellents containing picaridin 20% or lemon eucalyptus 30% are less effective than DEET and must be reapplied very frequently. Insect repellent room sprays, mosquito coils, and heating insecticide impregnated tablets all reduce the risk of bites and should be used to kill mosquitoes in bedrooms before going to bed. Where possible sleep in screened rooms and use a mosquito net, preferably one impregnated with insecticide (permethrin). Mosquitoes are deterred by air conditioning but not fans. Ultrasound devices, mobile phone apps, garlic, Vitamin B, marmite, homeopathic products, tonic water, alcohol, tea tree oil, and citronella DO NOT prevent bites. For further information see Travel Health Pro - Insect and tick bite avoidance and NHS - Malaria Prevention. Patient Information Leaflet Illustration of patient leaflet from medicine packet The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine and must be read before taking the medicine. It is written for patients and gives information about taking or using a medicine. The Patient Alert Card is included in the pack with Lariam tablets. It must be read before taking the medication and should be carried by the patient whilst taking Lariam. Lariam Patient Leaflet Lariam Patient Alert Card

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Taking Malarone Take 1 tablet at the same time each day with food or a milky drink, where possible. Start taking the tablets daily 2 days before visiting a malaria risk area. Keep taking 1 tablet every day while in the area, and for 7 days after you leave. How it works Malaria is spread by the bite of an infected mosquito, which passes the malaria parasite into the bloodstream. Malarone contains two active ingredients (atovaquone and proguanil hydrochloride) which prevent malaria by killing the malaria parasite. Side effects Side effects from Malarone are uncommon and usually mild, but the medicine can sometimes cause stomach pain, dizziness, headaches, nausea, diarrhoea, coughing, low mood and skin reactions. You may experience vivid dreams. For full information on side effects and correct use, see the patient information leaflet. If any side effects concern you, contact us via your Patient Record. Effectiveness You'll be protected from 1-2 days after starting your course – so you need to start treatment before you leave to ensure that you will be protected by the time you arrive at your destination. You need to take your tablets regularly and according to the instructions to get maximum protection. Remember, Malarone can give you 95% protection when used in conjunction with other measures to make sure you don't get bitten by a mosquito. Who can take Malarone If you're over 18 and clinically suitable, we can prescribe you Malarone. However, you are responsible for ensuring that it is the correct anti-malaria tablet for your destination. Check this at Fit For Travel. Important information about Malarone Not all malaria prevention drugs are suitable for all parts of the world. You should check which tablets are recommended for your destination. Safety: taking other medicines As is true of all medication, Malarone can interact with other medicines. This is why it's important that you let us know which prescription, over-the-counter medicines and recreational drugs you are taking so that we can prescribe Malarone safely. Alternative treatments If Malarone is not suitable for your destination, Doxycycline might be. If appropriate, we can prescribe this for you. As well as taking malaria tablets, you must take other measures to protect yourself against malaria when in a malaria area. These involve avoiding being bitten by a mosquito in the first place. You should use insect repellent such as DEET, sleep under a mosquito net that's been treated with insecticide, and wear long-sleeved shirts and trousers in the evening.

Malarone (Atovaquone and Proguanil 250mg/100mg) in Sheffield

Malarone or non-branded generic atovaquone/proguanil malaria tablets available to buy online

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