Anti-malarials in India

grikoo · Jun 6th, 2008, 02:43

Quote:

Originally Posted by Frenchy

My wife and I are travelling through Kerela, Delhi, Jaipur, Then Dharamsala, Varanasi ans Bodhgaya From November to mid-December (6weeks). And what I surmise from the 5 pages of posts is that the risk is minimal but if you do contract malaria you'll regret not having taken preventive medication. Our nurse at the local travel clinic here in Canada suggested either Doxycycline (cheap but not so great for women because of yeast infections and some unpleasant side-effects) or Malarone (expensive at $5/day).

We will of course take all the nessesary precautions (deet, long sleaves, nets over beds...) and it sounds like we should take the malarone for the whole trip and dish out about $350.

That would be the safest bet I think.

Any opinions?

If you don't mind the outlay of money, Malarone is probably the best tolerated with the least side effects. If you take doxycycline, just take along some diflucan for your wife. It's a single dose treatment and works pretty quick.

wonderwomanusa · Jun 7th, 2008, 08:18

I've taken doxycycline on several visits to India with no ill effects, but each woman has a different tolerance for this. As Grikoo suggests, the medication for yeast infections is easy to get (the creams are OTC in California) so you might want to bring them along.

And don't forget the mossie repellant -- the first line of defense is to not get bitten.

Frenchy · Jun 7th, 2008, 10:18

Thanks for the advice. I think I'll take doxycycline myself.

Freereedsqueezer · Jun 7th, 2008, 11:05

I took Doxycycline until I got Giardia and couldn't keep anything down! Never got a single mosquito bite though in either Delhi or Kolkata in November.
I don't know if the Doxy contributed to my catching Giardia or not but the only side effects which I discovered later were that my fingernails got much thinner, strange....
Taking Malorone next time I think as I'll have my young son with me and he can't take Doxy....

LJ

grikoo · Jun 9th, 2008, 21:21

The only way doxy might potentially contribute to getting giardia is by continually killing off beneficial bacteria in your GI tract, which might decrease you ability to fight such a parasite. Otherwise I don't think it would have anything to do with it.

Interesting about your fingernails.

edwardseco · Jun 10th, 2008, 02:05

Quote:

I took Doxycycline until I got Giardia and couldn't keep anything down!

Now that is logical given the symptoms of the big G. Doxy is tough on digestion so it was logical to stop at that point. I use Doxy but must take it with extreme care for that reason. Imagine those people that don't read the directions and quaff it like aspirens..

all-one-heart · Jun 11th, 2008, 19:32

I'm going to check out and see if we have Malarone here in france and what it's called. AFTER I call my homeopathic doctor! and ask her for her advice. She goes to India regularly, too...

Nick-H · Jun 11th, 2008, 23:45

Please note that the British Health Service advises against herbal or homoeopathic anti-malarials. There are none* that are considered effective.

This view is also, I believe, endorsed by the London Homoeopathic Hospital, so far as homeopathy is concerned.

*yes, I do know about artemesia. I understand it is not used as a prophylactic

grikoo · Jun 12th, 2008, 00:05

Quote:

Originally Posted by Nick-H

*yes, I do know about artemesia. I understand it is not used as a prophylactic

It's also not given in doses considered 'homeopathic', and is a fairly strong medicine- not something I'd like to take regularly.

Would advise against ANYTHING homeopathic recommended for malaria prophylaxis. It's just not how homeopathic medicine works. We're not talking about minutely adjusting your body's system, but killing a parasitic organism.

machadinha · Jun 12th, 2008, 00:45

Isn't artemisia the family that includes wormwood and which got absinthe banned back in the days?

While the reasons and merits of that ban are a matter of some eternal debate, it's not something I'd feel particularly inclined to fool around with in any medicinal sense. But I'll gladly be instructed to the contrary.

grikoo · Jun 12th, 2008, 01:10

Same genus yes, and probably contains the same general compuonds. However, the active ingredient in absinthe- thujone, is removed, and artemisinin (or it's derivatives) isolated. The malaria prep is usually a combo of artemether and lumafantrine.

The traditional prep- Qinghaosu- is a raw extract, and probably not too enjoyable or safe.

A whole range of artemesias have been used as various parasiticides, most often as a wormer.

Edit.....

There are actually a wide range of active ingredients in absinthe, and many of them actually come from the aromatic oils of the included spices, though it is generally assumed that thujone from artemesia plays the most important role.

Nick-H · Jun 12th, 2008, 01:26

Mach, it (or extracts thereof) is The new wonder drug of the world for treating malaria!

Not new to China, though: it has been used there in trad medicine for centuries.

Certainly one would not fool around with it, no; but --- self-diagnosis and prescription for malaria? We've been there before; not a good idea.

grikoo · Jun 12th, 2008, 01:37

Yes, I think it's supposed to be to fastest acting anti-malarial currently out there.

Another score for mother nature!

Nick-H · Jun 12th, 2008, 01:52

I think the thing that the docs are gleeful about is that it acts so fast the organism doesn't get a chance to build up resistance. Like it never even saw it coming!

Years back, when doctors that competely poo-pooed herbal medicine were more common, would could enquire of them what percentage of the modern drugs, even if now synthetic, had their origins in plants or plant extracts. It rather destroyed their argument, and I don't imagine that things have changed.

So, although the long fingers of the pharmaceutical companies may have done their extracting and refining and synthesising, mother nature does actually score quite highly down the local pharmacy

grikoo · Jun 12th, 2008, 02:01

While that's true, it's also true that few of those original substances are still used today, partly because of business dynamics but mostly because we simply developed more efficient versions of those natural compounds. The argument goes both ways.

I don't poo-poo herbal medicine at all, by the way, but I think currently there's WAY more hype in that industry than the pharmaceutical industry (and there's quite a bit there). About what you'd expect in an industry with no regulation, little research and a lot of snake oil salesmen.

Jun 11th, 2008, 19:32	#82
all-one-heart Member Join Date: Sep 2007 Location: FRANCE Posts: 98	I'm going to check out and see if we have Malarone here in france and what it's called. AFTER I call my homeopathic doctor! and ask her for her advice. She goes to India regularly, too... __________________ all-one-heart

Jun 11th, 2008, 23:45	#83
Nick-H Loud-mouthed, Noisy Bird Join Date: Oct 2004 Location: Chennai, India Posts: 27,692	Please note that the British Health Service advises against herbal or homoeopathic anti-malarials. There are none* that are considered effective. This view is also, I believe, endorsed by the London Homoeopathic Hospital, so far as homeopathy is concerned. yes, I do know about artemesia. I understand it is not used as a prophylactic __________________ . Just one member of the IndiaMike Mod Team*

Jun 12th, 2008, 00:45	#85
machadinha Not Your Guru Member Join Date: Jan 2005 Location: yörp Posts: 10,917	Isn't artemisia the family that includes wormwood and which got absinthe banned back in the days? While the reasons and merits of that ban are a matter of some eternal debate, it's not something I'd feel particularly inclined to fool around with in any medicinal sense. But I'll gladly be instructed to the contrary. __________________ Reading tips, all picked up at IndiaMike : INDAX's A Comprehensive Guide To India / Dinoj Surendran's Desi Humor / ITHVC on Culture Shock & Travel Health / JetLag Travel Guides For the Undiscerning Traveller / India Travel Links Last edited by machadinha : Jun 12th, 2008 at 01:49.

Jun 12th, 2008, 01:10	#86
grikoo Disclaimer- He who knows not what he speaks of Join Date: May 2008 Location: Here Posts: 463	Same genus yes, and probably contains the same general compuonds. However, the active ingredient in absinthe- thujone, is removed, and artemisinin (or it's derivatives) isolated. The malaria prep is usually a combo of artemether and lumafantrine. The traditional prep- Qinghaosu- is a raw extract, and probably not too enjoyable or safe. A whole range of artemesias have been used as various parasiticides, most often as a wormer. Edit..... There are actually a wide range of active ingredients in absinthe, and many of them actually come from the aromatic oils of the included spices, though it is generally assumed that thujone from artemesia plays the most important role. Last edited by grikoo : Jun 12th, 2008 at 02:08. Reason: additional info

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Jun 7th, 2008, 08:18	#77
wonderwomanusa Maha Guru Member Join Date: May 2003 Location: Dhaka Posts: 3,567	I've taken doxycycline on several visits to India with no ill effects, but each woman has a different tolerance for this. As Grikoo suggests, the medication for yeast infections is easy to get (the creams are OTC in California) so you might want to bring them along. And don't forget the mossie repellant -- the first line of defense is to not get bitten.

Jun 7th, 2008, 10:18	#78
Frenchy Member Join Date: Jun 2008 Location: Vancouver Island Posts: 5	Thanks for the advice. I think I'll take doxycycline myself.

Jun 7th, 2008, 11:05	#79
Freereedsqueezer Member Join Date: Aug 2007 Location: Seattle, WA USA Posts: 33	I took Doxycycline until I got Giardia and couldn't keep anything down! Never got a single mosquito bite though in either Delhi or Kolkata in November. I don't know if the Doxy contributed to my catching Giardia or not but the only side effects which I discovered later were that my fingernails got much thinner, strange.... Taking Malorone next time I think as I'll have my young son with me and he can't take Doxy.... LJ

Jun 9th, 2008, 21:21	#80
grikoo Disclaimer- He who knows not what he speaks of Join Date: May 2008 Location: Here Posts: 463	The only way doxy might potentially contribute to getting giardia is by continually killing off beneficial bacteria in your GI tract, which might decrease you ability to fight such a parasite. Otherwise I don't think it would have anything to do with it. Interesting about your fingernails.

Jun 12th, 2008, 01:26	#87
Nick-H Loud-mouthed, Noisy Bird Join Date: Oct 2004 Location: Chennai, India Posts: 27,692	Mach, it (or extracts thereof) is The new wonder drug of the world for treating malaria! Not new to China, though: it has been used there in trad medicine for centuries. Certainly one would not fool around with it, no; but --- self-diagnosis and prescription for malaria? We've been there before; not a good idea.

Jun 12th, 2008, 01:37	#88
grikoo Disclaimer- He who knows not what he speaks of Join Date: May 2008 Location: Here Posts: 463	Yes, I think it's supposed to be to fastest acting anti-malarial currently out there. Another score for mother nature!

Jun 12th, 2008, 01:52	#89
Nick-H Loud-mouthed, Noisy Bird Join Date: Oct 2004 Location: Chennai, India Posts: 27,692	I think the thing that the docs are gleeful about is that it acts so fast the organism doesn't get a chance to build up resistance. Like it never even saw it coming! Years back, when doctors that competely poo-pooed herbal medicine were more common, would could enquire of them what percentage of the modern drugs, even if now synthetic, had their origins in plants or plant extracts. It rather destroyed their argument, and I don't imagine that things have changed. So, although the long fingers of the pharmaceutical companies may have done their extracting and refining and synthesising, mother nature does actually score quite highly down the local pharmacy

Jun 12th, 2008, 02:01	#90
grikoo Disclaimer- He who knows not what he speaks of Join Date: May 2008 Location: Here Posts: 463	While that's true, it's also true that few of those original substances are still used today, partly because of business dynamics but mostly because we simply developed more efficient versions of those natural compounds. The argument goes both ways. I don't poo-poo herbal medicine at all, by the way, but I think currently there's WAY more hype in that industry than the pharmaceutical industry (and there's quite a bit there). About what you'd expect in an industry with no regulation, little research and a lot of snake oil salesmen.

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