Choosing a Drug to Prevent Malaria
Considerations when choosing a drug for malaria prophylaxis:
- Recommendations for drugs to prevent malaria differ by country of travel and can be found in Malaria Information by Country. Recommended drugs for each country are listed in alphabetical order and have comparable efficacy in that country.
- No antimalarial drug is 100% protective and must be combined with the use of personal protective measures, (i.e., insect repellent, long sleeves, long pants, sleeping in a mosquito-free setting or using an insecticide-treated bednet).
- For all medicines, also consider the possibility of drug-drug interactions with other medicines that the person might be taking as well as other medical contraindications, such as drug allergies.
- When several different drugs are recommended for an area, the following table might help in the decision process.
Drug | Reasons that might make you consider using this drug | Reasons that might make you avoid using this drug |
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Atovaquone/Proguanil (Malarone)
Adults: 1 adult tablet daily. Children: 5-8 kg: ½ pediatric tablet daily. 8-10 kg: ¾ pediatric tablet daily. 10-20 kg: 1 pediatric tablet daily. 20-30 kg: 2 pediatric tablets daily. 30-40 kg 3 pediatric tablets daily. 40 kg and over: 1 adult tablet daily. Begin 1-2 days before travel, daily during travel, and for 7 days after leaving. |
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Drug | Reasons that might make you consider using this drug | Reasons that might make you avoid using this drug |
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Chloroquine
Adults: 300 mg base (500 mg salt), once/week. Children: 5 mg/kg base (8.3 mg/kg salt) (maximum is adult dose), once/week. Begin 1-2 weeks before travel, once/week during travel, and for 4 weeks after leaving. |
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Drug | Reasons that might make you consider using this drug | Reasons that might make you avoid using this drug |
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Doxycycline
Adults: 100 mg daily. Children: ≥8 years old: 2.2 mg/kg (maximum is adult dose) daily. Begin 1-2 days before travel, daily during travel, and for 4 weeks after leaving. |
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Drug | Reasons that might make you consider using this drug | Reasons that might make you avoid using this drug |
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Mefloquine
Adults: 228 mg base (250 mg salt), weekly.Children: ≤9 kg: 4.6 mg/kg base (5 mg/kg salt), weekly. 10-19 kg: ¼ tablet weekly. 20-30 kg: ½ tablet weekly. 31-45 kg: ¾ tablet weekly. >45 kg: 1 tablet weekly. Begin 1-2 weeks before travel, weekly during travel, and for 4 weeks after leaving. |
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Drug | Reasons that might make you consider using this drug | Reasons that might make you avoid using this drug |
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Primaquine
Adults: 30 mg base, daily
Begin 1-2 days prior to travel, daily during travel, and for 7 days after leaving |
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Drug | Reasons that might make you consider using this drug | Reasons that might make you avoid using this drug |
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Tafenoquine (ArakodaTM)
Adults only: 200 mg per dose. Begin daily for 3 days prior to travel, weekly during travel, and for 1 week after leaving. |
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