Once again- Malaria Tablets!

Ricco

I apologise if this seems to be one Malaria thread to many! I have a specific question though, so I thought it appropriate to start a new one.

I've been in India for 2 months. I've been taking the Chloroquine/Proquanil combination, as recomended by my Doctor in the U.K. I've taken these without suffering any noticeable side effects.

I brought 2 months supply with me, reasoning that I could replenish my stocks here, at a more favourable price.

I've enquired at several chemists locally (Rishikesh). They can all sell me Chloroquine, very cheaply, but tell me that Proquanil is not available in India.

So, what to do?

Do I take a chance, and just take the Chloroquine tablets only? Should I ask a relative in the U.K. to post supplies to me here? Or could I perhaps take an alternative pill that may be available in India?

I'm quite concerned about this, as I'm one of those people that always gets bitten, despite taking all possible precautions. Also, I intend to visit the Delhi/ Agra/ Jaipur areas soon, the risk is higher there than where I'm currently staying.

I welcome all your opinions.

iloveindia1234

i wonder how millions of people survive in india without taking any malaria tablet

Nick-H

Malaria is still one of the world's biggest killer diseases.

That's how they get on.

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federica

If you have someone who can post it to you it would be the easiest option. Or maybe you can phone your doctor in UK to ask for an advice?

I am a little bit reluctant to post any other advice here, but if I think I would be in your situation I would be greatful for all useful infos I could get.

So I can tell you that in Germany they don't recommend chemoprophylaxis anymore for the area you will be visiting (this is new from 2007). They recommend it only for Goa, West Bengal and Assam (see www.dtg.org, unfortunately only in German). For all other states they advise to carry malaria pills as a stand-by medication for emergency case. That doesn't mean there is no malaria in the rest of India, nets and repellents are still necessary!!! And whenever you get fever, seek a doctor immediately!!!

Another option would be Doxyciclin, some countries recommend it as chemoprophylaxis (like USA), don't know about UK (Germany doesn't yet). Check for the side affects before you take your decision!!!

This is just for a first information, your final decision should be the advice of a doctor!

mairangi_vice

dont be too paranoid about malaria, that is my advice. Ive never taken any anti-malarial stuff, just used mozzie repellant and those plug in electric things at home. And after 9 months, Im still here.

shashank.aggarwal

I just talked to a friend, who is a pharmacist and is working for Sanofi Aventis (one of the largest companies)..

he says that Proquanil will not be available in India...and its a tablet to bring down the fever and not prevent malaria..

Chloroquine is the one that is critical, it can be easily procured as its a generic molecule..however he recommends 'Larigo' brand of the same.

And if you feel the fever you can have a Crocin, which again is very commonly available in India...OR alternatively PCM (Paracetamole..Spelling ??)..

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Nick-H

It has been recommended as an antimalarial for travellers to India for years, in combination with Chloroquine. Your friend is wrong. Whether it is effective against the particular strain of malaria found in a particular area is another matter; maybe this is what your friend had in mind.

Usually recommended in combination with Chloroquine, this was (is?) the classic recommendation in UK for travel to India.

Depends entirely on the strain of malaria, and some strains in some areas are now resistant to chloroquine. For instance, I was told by my local doc a couple of years ago that Chloroquine (Lariago-DS, once weekly) was the one I needed to take here, and that it would be sufficient. Again, this could be what your friend was thinking about.
Crocin is just a combination including paracetamol. It is a pain killer and a fever reducer. It is similar to stuff that can be obtained all-over the world. It may make you feel a little better if you have the flu --- but it won't cure anything. Masking the symptoms of malaria rather than treating it would be a very dangerous thing to do.

Shashank... Sorry, but not much faith in your friend's medical advice!

shashank.aggarwal

End of the day..its NOT available in India...

You mean to say this is what UK doctors assumed will work in India..

I didn't get you..now you mean to say that UK doctors prescription is no good...


I guess that is the reason Chloroquine was recommended and Crocin OR PCM was for reducing Fever only..

I am sorry Nick..its your personal call..you seem to be confused urself these days and only try to rip others apart..

federica

Seems this discussion becomes highly confusing for someone who needs help....

shashank.aggarwal

The problem is Proquanil is not available in India..

Chloroquine is available..and local pharmacy guys say that Chloroquine along with Crocin (in case of fever) should work fine..

Nick says that it will not since the doctors in UK recommended other combination...but alas that is not available in India...

federica

The OP is looking for drugs for chemoprophylaxis, not treatment... Chloroquine alone is not effective as prevention, as there are resistant strains. That's why the combination Chloroquine + Proguanil is prescribed in UK. Substituting Proguanil just with any other remedy against fever sounds doubtful....

iloveindia1234

Travelers to the countries affected by malaria usually do not have any background immunity to malaria since they are not routinely exposed to malaria in their own countries. As non-immunes, they are at high risk for malaria and its complications. Other particularly vulnerable groups include pregnant women, infants and young children, splenectomized and immunosuppressed individuals.
Drug resistance profile of the travel area determines whether the use of chloroquine is appropriate. It may further narrow the drug choice depending on the presence of highly resistant strains (e.g. mefloquine resistance in border areas of Thailand and Cambodia). Chloroquine is the prophylactic drug of choice in the regions without chloroquine-resistant P.falciparum. However, today the chloroquine-sensitive areas of P.falciparum are relatively few including including parts of the Middle East, NIS of former Soviet Union, China, Mexico, Central America north of the Panama Canal, the island of Hispaniola, and temperate South America

blackbird

As I understand it, Shashank's friend is not totally wrong: Chloroquine + Proguanil does suppress the symptoms rather than being a total cure. A friend's brother went to India, took the antimalarials as instructed until 4 weeks after returning to England, and went down with the disease the following day. Clearly he had had the disease for some time but due to the medication had been completely unaware of it.

As for the OP, unfortunately the responses on here will cause confusion because different governments make different recommendations, and not everyone trusts that advice anyway. I'm amazed that the German government is not advising prophylaxis any more for most of India -- certainly Orissa still has a high risk -- but it just goes to show how opinions vary on this even amongst European experts.

However it seems to me there's no point taking any prophylaxis if you don't go the full course (including the 4 weeks after returning, which is when most westerners who get malaria go down with the symptoms), and for most tourists this means getting enough to last your trip before you leave your home country. This won't help the OP now but maybe others can learn from their experience. The best suggestions now are either to get someone to send proguanil out from home or to just take the chloroquine and hope for the best. Either way Ricco the chances are you'll be ok.... just minimise the number of bites you get as far as possible.....

shashank.aggarwal

I agree with this..thats the right thing to do..

better still..trust a good local doctor and seek this consultation on the same..see what he says !!

End of the day you have to trust someone..

Nick-H

shashank, I am not trying to, nor will I, have a fight with you over this! Nothing personal.

I'm not a pro in any branch or medicine. I know enough to know that the information you passed on was dubious --- and any member could, and somebody should, have drawn attention to that.

Rubbish. What if you'd posted something I entirely agreed with? Only then, of course, there wouldn't have been any point in my posting a reply at all!

Crossposted...

Yes, a doctor's advice is the necessary thing here. Entirely agree!