There are various anti-malarial drugs that are used to prevent malaria while traveling to a malaria endemic area and to treat it when infected. The choice of anti-malarial drug depends on the prevalence of the parasite in the area and its sensitivity to the anti-malarial drug.
The most common anti-malarial drugs that are used are:
- Malarone (combination of atovaquone+proguanil).
These drugs are either used alone or in combination to treat or prevent malaria. No drug is cent percent effective and proper measures should be taken to prevent mosquito bite as to prevent transmission of malarial parasite.
What Are The Side Effects Of Taking Malaria Pills?
Malarone is the most popular drug used in the prophylaxis and treatment of malaria. It is a combination of two drugs: atovaquone and proguanil. It is most effective against P. falciparum and where parasites are resistant to chloroquine and mefloquine. For prophylaxis, Malarone is taken once a day; it is started 1 to 2 days prior to travel, taken daily during the travel and continued until 1 week after return from travel. Though, Malarone is well tolerated and seldom has side-effects, but it is comparatively more expensive than other anti-malarials.
The common side-effects of Malarone are headache, nausea, vomiting, abdominal pain, diarrhea, weakness, loss of appetite, vivid dreams, sleeping issues, cough and fever. Rare side-effects with Malarone include increased heart rate, rapid/trouble breathing, rash, itching, swelling and erythema around the mouth, mouth ulcers, skin peeling, anxiety, seizures, hepatitis and anemia. However, these side-effects are extremely rare and most of the time Malarone is better tolerated than other antimalarials. It is usually contraindicated in pregnant and breastfeeding women and also in people with renal failure.
This is a weekly medication that is started 1 to 2 weeks prior to travel, taken during the stay and continued 4 weeks after return from travel. It is safe to use in pregnancy. The common side-effects of chloroquine are stomach upset, blurred vision, pruritic rash. Retinal damage and even blindness can happen if taken for longer periods. It should be avoided in patients with psoriasis, epilepsy, porphyria, myasthenia gravis and hypoglycemia.
Doxycycline is taken daily and is started 1 to 2 days prior to travel and continued until 4 weeks after the travel. It is the most cost effective drug amongst all. It is contraindicated in pregnant women and children less than 8 years of age. The common side-effects include yeast infection, stomach upset, heartburn, sensitivity to sunlight and it may also cause allergic reaction. It has been known to interact with contraceptive pills.
Mefloquine is taken weekly and started at least 2 to 3 weeks prior to travel and continued until 4 weeks after the trip. It is safe during pregnancy. P. falciparum, the most common parasite in African subcontinent is resistant to mefloquine. The common side-effects of mefloquine are sleeping problems (either insomnia or somnolence), vivid dreams, depression, anxiety, dizziness, headache, visual changes, vertigo, mood changes, restlessness, nausea and vomiting, diarrhea, abdominal pain, itching and may also cause allergic reactions in people who are allergic to it. It is contraindicated in psychiatric patients with a history of depression, anxiety, psychosis and epilepsy. In people who have experienced dizziness and loss of balance with mefloquine; the symptoms have been known to persist for weeks even after discontinuation of medication. When these side-effects are experienced, it is best to discontinue medication and contact a doctor.
Proguanil is taken daily and is started 1 to 2 days prior to travel and continued until 4 weeks after travel. It is usually given in combination with other anti-malarial drugs. It is one of the safest anti-malarial drugs, but mouth ulcer is the most common side-effect along with headache, dizziness, myalgia, nausea, vomiting, diarrhea, abdominal pain or fever.
Primaquine is taken daily and started 1 to 2 days prior to travel and continued until 7 days after the travel. It is the most potent drug against P. vivax. It is contraindicated in patients with G6PD (glucose-6-phosphatase dehydrogenase deficiency) and also pregnant and breast feeding women. The common side-effect of it includes nausea, upset stomach, vomiting, loss of appetite and abdominal pain.
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