Side effects to mefloquine (Lariam)

My husband, son and I have been taking Mefloquine weekly since 14/12/07 (one week before we travelled to Gambia (21/12/07) staying only a week)so now have taken 5 tablets. We are all experiencing increased bad side effects do we have to take the final tablet.

No, you should definetely stop taking mefloquine. There is a small risk of experiencing malaria because you stop a week too early, but taking more mefloquine will just make the sidee effects worse. This also mean that you can not use mefloquine next time to visit an area where you need malaria prophylaxis.



Impregnated bed nets

Could you recommend the best anti-malaria impregnated bednet on the market and explain the advantages of getting one in home country b4 leaving, or purchasing it in Africa?

I do not have an exhaustive overview of the market. There are many suppliers and in general you have to took for permethrin or deltamethrin impregnated nets which has a working life of about six months. The advantage of purchasing beforeleaving is that you have a better guarantee that the net is really impregnated, but it is of course more expensive compared to buying in a thrird world counry.



Long term use of Malarone

I am currently working in Afghanistan and will probably spend the next year here. I have been taking Malarone as a prevention of malaria (2 months already), but I do not know much about its long-term use. I do not feel any side-effects (yet) and think that Mefloquin and Doxycycline have too many side-effects.

There are very few data on the long term use of Malarone. We followed Danish peace keeping troops in Eithrea for 6 months all taking Malarone, and saw no serious side effects. This is the longest systematic follow up that I know of. If you feel alright, I would take Malarone for a year, but you can not obtain any absolute guarantee for long-term side effects, because we simply have no data.



Side effects to Paludrine

MY HUSBAND WAS PRESCRIBED PALUDRINE TABLETS FOR MALARIA AS WE TRAVEL TO DOM.REPUBLIC IN A COUPLE OF DAYS.HE ALSO HAS HAD VACCINATIONS FOR TRAVELLING. HE HAS STARTED WITH FLU LIKE SYMPTOMS ALSO GOES TO THE TOILET TO MOVE HIS BOWELS OFTEN. IS THIS POSSIBLE SIDE AFFECTS TO THE TABLETS AND SHOULD HE CONTINUE TO TAKE THEM.

Paludrine has few side effects but stomack pain is typical. However, diarrhoea is not and i doubt the symptoms has anything to do wuth the tablets. Another point is that Paludrine is never used as a single drug against malaria. The risk of malaria in the Dominican republic is very small and we usually do not recommend any prophylaxis.



Long-term use of malaria drugs

I am working (mostly offshore but staying a few hours in town) in Angola one month and leaving one month and so on all along the year. Some companies request us to take Lariam or Doxycycline or Malarone to prevent the malaria. This is meaning taking these drugs all along the year. Would you recommend to take the drugs for a long period ? What are the side effects ?

I understand your question so that you spend one month at the platform and one month out of Angola, presumably in a non.malaria area. Yuo are at risk of getting malaria from you land in angola and until you leave for the platform. there is no risk at the platform if situated more than a mile off shore. the sensible thing to do would be to take malarone around you transit in Angola. Malarone is only taken for 7 days after leaving the maalrious area which mean that you will be free of pills for the last 3 weeks of your stay at the platform and back home. concerning side effects they are few, some slight stomack pain and an occasional allergic rash.



Malaria prophylaxis and Coumarin

I am traveling to India in three weeks. I take COUMADIN daily. I have been prescribed Doxycycline for Malaria prevention but find the restrictions a little difficult. Would any other anti Malaria drug be better for me considering I am taking a blood thinner or would you suggest sticking with Docyclycine. I started taking this medication today but still have time to switch if necessary. The reason for taking this so far in advance was to check my PT results every four days before I go to get myself balanced.

You could use Malarone or Lariam. Neither of these or Doxycycline has anye effect on Coumarine and Coumarine like drugs. Malarone would the drug of choice considering its few side effects.



Switch from one antimalarial to another

We are currently in Sri Lanka and taking Avloclor (chloroquine) & Proguanil We are travelling on to Thailand for 3 weeks before going on to Laos and Vietnam for which we plan to use Doxycycline. Since all tablets require starting before and continuing after departing we would like advice on when to stop taking Avloclor & Prouanil and when to start Doxycycline, should we be taking it before we leave Sri Lanka or first in Thailand and Laos? I would be grateful for your advice on how to switch from one anti malaria product to another.

You need to take antimalarials for 4 weeks after leaving a malarious area, except for Malarone. It is no problem to switch to a more effective drug as you do in this case so taking Doxycykline is sufficient instead of Avloclor and Proguanil. You need either to continue Avloclor and Proguanil during the 3 weeks stay in Thailand and switch to doxycycline the day before entering Laos or switch to doxycycline any time after leaving Sri Lanka. There is no interaction between Avloclor and Doxycycline so it is not important when the last dose of Avloclor was taken, so you just stop Proguanil one day and start doxycycline the next and take no further dose of Avloclor.