Proguanil (Paludrine) can only be used for prophylaxis and only in combination with chloroquine.
Use
Proguanil (Paludrine) can only be used for prophylaxis in combination with chloroquine in areas with moderate chloroquine resistance.
Dose
The usual dose for adults of proguanil is 2 tablets daily starting at least one day before departure and continuing 4 weeks after leaving the area with malaria. It is important that the dose is taken at the same time of the day every day. Proguanil tablets of 100 mg each.
Adults > 45 kg body weight: 2 tablets daily
Children 30 – 44 kg: 1.5 tablets daily
Children 20 – 29 kg: 1 tablet daily
Children 10 – 19 kg: 0.5 tablet daily
Children < 10 kg: 0.25 tablet daily
Pregnancy
Proguanil can be used during pregnancy. It has been used for over 50 years with very few reports on adverse events and is considered safe during pregnancy. Proguanil inhibit the folate metabolism of the malaria parasite and pregnant women using proguanil are recom-mended folate tablet 5 mg daily during the pregnancy.
Malaria infection during pregnancy is a risk for mother and child. Pregnant mothers travelling to areas with malaria should ensure they use efficient prophylaxis or postpone their travel until after delivery.
Lactation
Lactating women can use proguanil, but the small amounts of proguanil passing into the child do not provide any protection of the child.
Side effects
Nausea, vomiting, itching and rash are seen. Small ulcers in the mouth are found in about 2% of users and stomach pain, loss of appetite are not uncommon.
Who can not use chloroquine
People with previous side effects from proguanil. Proguanil is excreted through the kidneys and the dose should be reduced with impaired kidney function.
Interactions with other drugs
Inform your doctor if you use other drugs, also drugs which do not need a prescription. Drugs containing fluvoxamin may decrease the blood levels of proguanil and should be avoided.
Note
No antimalarial drug provides 100% protection even if used strictly according to the recommendations. Malaria drugs reduce the risk of infection with around 80% to 95% depending of your destination and living conditions.
Prevention of mosquito bites is therefore still important even if you take malaria drugs regularly.
