Can malaria medicine be purchased in India?

debala

Hello all,

I apologize in advance if this question has already been asked and answered in this forum...

I'm currently living in India and have decided to extend my stay a bit -- so I'm going to need more anti-malaria medication. I'm currently taking mefloquine (aka lariam), but I'd be willing to switch to one of the dailies. My question is: Does anyone know if any of these medications is available for sale in India?

Thanks!
Debbie

edwardseco

Doxycycline, Chloroquin easy.
Malarone not at all.
I believe Mefloquine is available but less easily.
Hopefully, someone who uses it can confirm.
The search engine doesn't always work here but there are quite a few lengthy threads on the M topic..

edwardseco

Doxycycline & Chloroquin yes, Malarone no, Mefloquine I have heard is available but not as easily..

Nick-H

One would hope it is reasonable to assume that, whatever strains of malaria exist in India, appropriate anti-malarials are available here.

I emphasise the words 'hope' and 'assume' .

But I think they are.

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wonderwomanusa

No problem getting Doxycycline, just walk in any pharmacy and buy it!

grikoo

India has chloroquine resistant malaria, so don't go for that one. Try to continue mefloquine if you can, though you may want to have an eye and liver screen if you take it longer than a year.

machadinha

Debala, since you indicate you are in Bhubaneswar (or somewhere in India in any case), is it not wisest to discuss your options with a local or nearby doctor or hospital? They should be able to advise you on what's available and recommended, also for your particular area.

I'm sure you could walk into any pharmacist's and they will just sell you what they have over the counter (I think) so I don't think that's the problem, but I'd get some expertise in first.

(btw Not to sidestep the esteemed fellow posters above. Just that local advice on it should be readily available.)

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Nick-H

Big place! I was recommended it: but that was three years ago now and things change. I was also given it for suspected malaria a few weeks ago, but along with artimesia.

If you are staying in one place, the local docs should know what you need. If you are travelling, then something more general may well be required.

Either way, best advice will be from a doc.

<cross-posted with Mach>

Yes, agree absolutely. You can go to a pharmacy and ask, and what they sell you may be all you need --- but I'd make that visit to a hospital/doctor for advice.

grikoo

It doesn't surprise me that they still prescribe chloroquine, and it's possible that certain local mosquito populations still carry cholorquine susceptible strains. However, given that we highly mobile HUMANS are the co-vector in malaria transmission, and that most strains are now cholorquine resistant, it's better to err on the side of caution. An influx of chlorquine resitant strains into a local population could cause population dynamics to change considerably in a short time.

I don't know of anyone who likes taking it, but if you've tolerated mefloquine thus far, it's probably still the best choice.

Doxy is probably your other best option, but be aware: It tends to cause stomach upset, and long term use might not be too good for your stomach. It also causes photosensitivity in some people(i.e. heightened susceptibility to sunburn), though I've read if you take the daily dose in the evening, that this is much less of a problem. I've personally experienced this as a kid, so I'm reluctant to take it myself.

edwardseco

I would reverse the order of the above. It takes only a little bit of research to find cases of irreversible mental illness as a result of Lariam (mefloquine). Learning how to properly take Doxy is important but a small price to pay to avoid a permanent or even temporary LSD trip. I experience the photosensitivity side effect of Doxy for a week or so. But, I appreciate the very positive side effect of better health. Last trip no illnesses in my troop!!

With Doxy you avoid the stomache problems by reading how to take it..

Nick-H

It's true that there are some side-effects that I am just not prepared to take the risk of, especially when there are alternatives. Larium is on my list of would-never-take.

grikoo

Right. Debbie however has been taking larium already, so it's unlikely the acid trip scenario will pan out for her. One note though- women are 48% more likely to experience psychological side effects than men.

That said, these side effects generally show themselves fairly quickly, usually within the first 6 weeks or so. If she's made it that far, she should be ok. For long term use a liver checkup is probably the most important factor. Various eye problems have been observed in rats, but not humans. Still, one should pay attention to one's eye-sight.

And about that acid trip scenario- thanks for bringing it up. The typical side effects of mefloquine should not be particularly alarming to anyone having dabbled in such substances.

For me, the day I take the dose, I feel a bit uh...disembodied?....that's the best I can describe it. Just a little weird and out of sorts, like I'm inhabiting my body rather than the owner of it. It's a fairly interesting perspective, though somewhat annoying if you're trying to navigate complex situations. It's not constant, and tends to ebb and flow throughout the day. The day after it's much less severe, and the rest of the week I feel more or less normal. That first night I often have very strange, though not typically nightmarish, dreams. Those are actually a fairly interesting side effect too, and I remember a few feature length, movie quality sci fi scenarios I dreamt on my first trip to India. I'm a lucid dreamer though, and that might make a big difference.

Anyone considering taking it over long term should take 2-3 doses well in advance of your trip to see how you react to it. Don't take it with the oral typhoid vaccine though, as it's a live vaccine and likely to be much less effective if taken within 2 weeks of mefloquine.

Edwardseco- you say you experience the doxy photosensitivity for only a week? You mean to say it goes away over time? I've never taken doxy except as a standard 10-14 day antibiotic. Something to consider though if that's the case.

I know you're supposed to take it with food, but for example, my partner has chronic stomach issues and very fair skin, so should probably avoid it.

So these are all things to consider.

karuna

Really? That's interesting. Can you point me to the studies that established this?
I wonder why it might be.

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Mickey S

Because they're all so emotionally fragile to begin with?

I had a horrific experience with Lariam. The initial vivid dreams were awesome - like acid, but less frightening - but as time went on it turned into a real psychological emergency. It took 18 months for the effects to wear off completely, and at one point I feared I would never be emotionally sound again.

Malarone is now my anti-malaria drug of choice.

machadinha

<cross-posted. Sounds pretty heavy, Mickey. Scary. No 18-month trips for me, thank you! But I understand others get by just fine on it.>

There was an interesting Dutch study recently to suggest depression works differently in men and women, owing to their stress hormones working differently or being at different levels.

The researchers came across this studying the brains of four unmedicated suicides for their urocortin levels (they were just studying stress as such I believe, as compared to earlier studies in mice). These were naturally not all that easy to come by; owing to an interest in their findings, they ended up with eleven I think.

People in the industry noted it may take ages of further research for this to translate into adjusted medicines for both sexes if at all btw (eleven brains aren't very many after all, to name but one thing). Anyway the above just reminded me of it; might have something to do with it. A different susceptibility to psychiatric disorders between men and women due to a number of (biological, social) factors has been noted or at least suggested often I think.