Mefloquine is a common alternative. It’s taken once weekly, starting one week before travel and continuing for four weeks after leaving a malaria-risk area. However, mefloquine can cause gastrointestinal upset and neurological side effects in some individuals. Consider your personal risk tolerance and consult your doctor.
Atovaquone-Proguanil
Atovaquone-proguanil (Malarone) offers a different approach. This combination drug is taken daily, starting one day before travel, and continuing for seven days after departure. It generally has a better side effect profile than mefloquine, although nausea and diarrhea are possible.
Primaquine
Primaquine is used in conjunction with other antimalarials, particularly chloroquine, for prophylaxis in certain regions. It’s particularly helpful against Plasmodium vivax and Plasmodium ovale malaria, which can have a dormant liver stage. Important Note: Primaquine can cause hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Testing for G6PD deficiency is Crucial before starting this medication.
Choosing the Right Option
The best prophylactic medication depends heavily on your travel destination, the level of malaria risk, your personal medical history, and potential drug interactions. Your doctor will help you determine the most suitable option based on these factors.
Comparison Table
| Mefloquine | Once weekly | 1 week before travel | 4 weeks after leaving | Gastrointestinal upset, neurological side effects |
| Atovaquone-Proguanil (Malarone) | Daily | 1 day before travel | 7 days after leaving | Nausea, diarrhea |
| Primaquine (with chloroquine) | Daily | Consult doctor for specific regimen | Consult doctor for specific regimen | Hemolytic anemia (in G6PD deficient individuals) |
