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Side effects of malaria tablets

Side effects of malaria tablets

Antimalarial medication is a must when travelling to a country where malaria is widespread. This includes over 200 destinations across large areas of Africa, Asia and Central America.

Taking malaria tablets is the best way to prevent infection alongside insect repellent and bite prevention. Like all medicines, they can cause side effects, however not everybody gets them.

If you’re travelling abroad and concerned about taking malaria tablets, read on to find out more about side effects and which type of medication might be best for you.

Types of malaria tablets

When it comes to choosing malaria tablets, you have a few different options depending on where you are travelling to and how much time you have before you set off. The following types are available from our online clinic.

  • Doxycycline

    Doxycycline is a cost-effective antimalarial tablet that offers 90-100% protection when taken correctly. It contains the active ingredient doxycycline hyclate which works by halting the growth of the malaria parasite and thereby killing it. It comes in the form of a daily tablet that is started two days before travel and for another four weeks after you return.

  • Malarone

    Malarone is one of the most popular types of antimalarials. It is a branded malaria tablet that contains two active ingredients, atovaquone and proguanil hydrochloride. It works by killing the malaria parasite. To be effective you must take one tablet at the same time each day, starting two days before visiting a malaria risk area and for seven days after you leave.

  • Atovaquone with proguanil

    Atovaquone with proguanil is the unbranded form of Malarone. It’s a more cost-effective option with the same active ingredients that work to kill the malaria parasite.

  • Mefloquine (Lariam)

    Mefloquine, sometimes known by the brand name Lariam, is another antimalaria tablet that can be taken when you’re travelling to areas where there’s a risk of malaria. Usually, adults take one 250mg of mefloquine a week to prevent malaria. It’s normally recommended you start taking this between two and three weeks ahead of you travelling, and keep taking them for four weeks after your return.

    Mefloquine isn’t advised if you:

    • Are pregnant, breastfeeding or trying for a baby
    • Have epilepsy
    • Have a heart condition
    • Have had severe anxiety, have had depression or some other mental health conditions
    • Have any liver or kidney problems
    • Have had Blackwater fever
    • Have hypersensitivity
    • Have had an allergic reaction to quinine

Side effects of Doxycycline

It is uncommon for Doxycycline to cause side effects. On occasion, some people may experience:

  • Nausea
  • Diarrhoea
  • Headaches
  • Sore throat
  • Vaginal yeast infections

Get more information on the side effects of Doxycycline.

Side effects of Malarone

The most common side-effects of Malarone are usually mild, but more serious side-effects can occur occasionally. Please have a look at the patient leaflet.

Most commonly reported side-effects are:

  • Headache
  • Abdominal pain
  • Nausea
  • Vomiting
  • Diarrhoea

Learn more about the side effects and correct use of Malarone.

Side effects of atovaquone with proguanil

Atovaquone with proguanil is the generic version of Malarone, and so the side effects are the same. They’re usually mild, but more serious side-effects can occur occasionally. Please have a look at the patient leaflet. Most commonly reported side-effects are:

  • Headache
  • Abdominal pain
  • Nausea
  • Vomiting
  • Diarrhoea

Find out more about atovaquone with proguanil to get more information or side effects and correct use.

Mefloquine side effects

Some people might experience side effects when taking mefloquine, the most common ones include:

  • Feeling nauseous or being sick
  • Tummy ache
  • Diarrhoea
  • Headaches
  • Dizzy spells, losing balance
  • Problems with vision
  • Itchy skin
  • Problems sleeping
  • Nightmares
  • Feeling panicky, restlessness or anxiety
  • Depression
  • Confusion

If you experience any of the mental health side effects, you should try and get a different antimalarial as soon as a possible. Speak to a clinician and they’ll be able to advise you on what might be the best alternative.

Rare side effects of malaria tablets

As with any medication, other side effects can occur. Rare side effects occur in fewer than one in 1000 people.

Doxycycline can cause rare side effects including:

  • Anxiety
  • Difficulty swallowing
  • Flushing of the skin
  • Tinnitus
  • Loss of appetite
  • Diarrhoea
  • Abdominal pain
  • Severe headache and blurred vision
  • Jaundice
  • Inflammation to the liver
  • Loosening of the nail from the nail bed

Atovaquone with Proguanil and Malarone can cause vivid dreams or hallucinations. Other side-effects have also been reported, however their exact frequency is unknown. This includes peeling skin, blisters, mouth ulcers, indigestion, nightmares, panic attacks, seizures, inflammation of blood vessels, increase in heart rate, liver inflammation and blockage of the bile ducts.

Severe reactions to malaria tablets

Allergic reactions or serious side-effects are rare, but they occasionally happen. If you experience any of the below side effects after taking malaria tablets then you must see a doctor and stop taking the medication.

  • Allergic reactions

    Allergic reactions can happen when taking any drug. Signs to look out for include:

    • Sudden wheezing
    • Difficulty in breathing
    • Swelling to the face, lips, tongue or eyelids
    • Chest pain

    If any of the above occur you should seek emergency medical help by calling 999 or going to A&E

  • Skin reactions

    Allergies can also appear on the skin, causing a rash or itching. This may present as a widespread rash with blisters and peeling skin, or one that may look like small targets with central dark spots.

    Contact a doctor immediately if you experience a skin reaction after taking malaria tablets.

Which is the best anti malaria tablet?

Different malaria tablets are better suited to different people depending on their age, weight and health:

  • If you are pregnant or planning to conceive you need to discuss your travel plans with your GP or travel clinic. This is because most antimalarials are not ideal in pregnancy and a full risk vs benefit assessment is needed.
  • Also children under 12 years old cannot take Doxycycline.

Compare the differences between malaria tablets side by side to find the best medicine for you.

Conclusion

In summary, there are a number of different types of malaria tablets that can help to protect against the disease. Each of which are available through dedicated travel clinics, in some pharmacies and some GP surgeries or online with the Lloyds Online Doctor service.

Like all medication malaria tablets to cause side effects however sometimes people can experience symptoms such as nausea, diarrhoea and headaches. If you experience any severe side effects such as abdominal pain or an allergic reaction, you should seek urgent medical attention.

References

https://www2.hse.ie/conditions/malaria/
https://travelhealth.ie/malaria-map/
https://www.medicines.org.uk/emc/files/pil.947.pdf
https://www.medicines.org.uk/emc/files/pil.13082.pdf
https://www.medicines.org.uk/emc/files/pil.638.pdf
https://patient.info/medicine/mefloquine-for-malaria-prevention-lariam

    Authors and editors

    Reviewed and updated by: Our clinical team Date reviewed: 22-04-2024