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To pill or not to pill....


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Old Sep 1st, 2007, 15:00   #1
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To pill or not to pill....

Ok so ive been taking malaria pills due to strong advice since i left the UK 6 weeks ago, i havent asked many people along the way if they are but i do feel like the only one taking these horrible chemicals, the chemist in delhi tryed to charged me 50 rupees per proguanil tablet to which i laughed as thats over 1 pound per day in medecine, the chloroquine which im also taking is dirt cheap but he had me to believe that proguanil is that expensive everywhere!

I will be in the south for quite awhile and would like a consensus please, was he taking the piss, and is it wise to just stop them out here as they filled my head full of worry in the UK by saying i had to take them a month after getting back, i just dont know what to do?!?
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Old Sep 1st, 2007, 17:22   #2
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Hi theborg,

Forget about consensus here (maybe on any issue, but certainly on malaria).

I always start with the disclaimer; never give medical advice if you are not a qualified doctor, so this post is just to share our experiences and advice we got. Check with your own doctor (better not your GP, but a specialised travel clinic).

Still, as malaria may kill you we were advised to take 200 milligrams paludrine (proguanilhydrochloride) per person per day. For our kids (then 5 and 3) it is 75 and 50 milligrams each day.

Unless you travel to the far Northeast, proguanilhydrochloride will do the trick. It can be bought in Delhi (and other big cities in India and Nepal).

The information comes from the Dutch ministry of Defence and the company that does preventive health for the Netherlands department of foreign affairs . They base their advise on WHO advice. For more medical travel advice: check www.who.int/ith/en

for information on malaria check: http://whqlibdoc.who.int/publication...0364_chap7.pdf

Have fun,

Hans
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Old Sep 1st, 2007, 18:19   #3
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everyone has their view

I am leaving for two months in India tomorrow and when asking people whether or not I should take Malaria pills, I got tons of different answers.

Most said not to bother, that the side effects and cost are worse than the chance of getting Malaria. Others said not to be stupid and just take them....I was in a dilemma for weeks but decided to take Malaria pills on the recommendation on more than one doctor.

I start my Malarone pills today which are supposed to have the lowest amount of side effects.

I guess the only advice I have for you is go with the medical advice and your gut feeling as everyone will tell you something different.
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Old Sep 1st, 2007, 18:19   #4
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There are 2 schools of thought on this - take them or not take them and get treatment if you get malaria. Given that with the monsoon well entrenched and starting to retreat there will be much water in low lying areas, the perfect breeding ground for mosquitoes. If you are not here for the long haul then maybe you continue but I think the 50r per tab. sounds over the top to me.
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Old Sep 2nd, 2007, 02:02   #5
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Yet another Malaria thread!

But I can contribute this fact: You'll find a Manufacturer's Recommended Price (MRP) on every strip or box or bottle of pills. That is what the pharmacist should be charging you. Easy to check!

Atually, same for most packaged stuff in India: check the MRP.
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Old Sep 2nd, 2007, 02:58   #6
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Hm. A tropical health guide I used to travel with called malaria the "single most contentious topic among travelers."

I'm telling myself again to let this be my last word on the subject. Ever.
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Old Sep 2nd, 2007, 03:01   #7
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Please take this with a grain of salt, but the NHS states that "antimalarials [are] not usually advised" for about half of India. See the NHS FitForTravel India Malaria Map for more information. There is some good literature there about what medication, dosage and what drugs are best. They also give advice on preventative measures you should take. This NHS FitForTravel is a good reference for many things, not just malaria and not just for India.
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Old Sep 2nd, 2007, 08:26   #8
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I had a friend once who didn't take antimalarials and died of it, so I always take them. Malaria stays with you for life; I can think of many other things I'd want with me for the rest of my life!
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Old Sep 2nd, 2007, 08:39   #9
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First off i'm not a doctor just to get that out of the way. When i visited Southern India for four months i was prescibed antimalaria pills but after taking them and experiancing thier horrible side affects (in my case halucinations, cramps, vomiting) i stopped taking them and was fine. Some types are better than others, mefloquine was what i was perscribed which caused me all that pain but doxycycline was ok in my opinion. The only side affects with doxy which i experianced was sensitivity to bright light. Mefloquine made me crazier than a bedbug literally and it was one of the scariest experiances in my life.
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Old Sep 2nd, 2007, 09:03   #10
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Look at http://www.iamat.org/ and click the link for download charts and click on "World Malaria Risk Chart."

Your travel doc/clinic can give you the best advice, but it sounds like you are already on the road long since.

We always take Malarone and have suffered no side effects. You don't want to fool around with malaria.
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Old Sep 2nd, 2007, 10:37   #11
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Quote:
Originally Posted by Nick-H View Post
Manufacturer's Recommended Price (MRP) on every strip or box or bottle of pills.
MRP is Maximum Retail Price. However in case of medicines there's a small problem. For a lot of medicines MRP excludes taxes. Therefore the actual pills may cost slightly more than printed price when things like VAT (Value Added Tax) are included. However, if you check a typical blister strip of tablets, it may say "MRP Rs. XXX, inclusive of taxes", in which case, it shouldn't cost any more than what's printed. In any case, addition of taxes will only increase price by a few rupees, mostly 2 or 3 bucks, not more than that.

Coming back to the topic, I'm not a doctor, but do believe in the "if it ain't broke, don't fix it" philosophy. Malaria medicines are known to be very strong and can have several severe side effects. Tablets like Lariago DS can cause you to lose all apetite, and can actually make you throw up if you have any food at all. So, for anyone coming to India, MEDICINES ARE NOT FOX'S CRYSTAL CANDY. PLEASE ASK YOUR DOCTOR, NOT YOUR NEIGHBOUR, BEFORE YOU START POPPING PILLS.

On the bright side, I'm Indian, I've been in Calcutta all my life, I've never used mosquito nets, mosquito repellents, or had the so called preventive medication for malaria, and I've only had malaria once, and lived to tell the tale!!!
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Old Sep 2nd, 2007, 15:49   #12
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Thank you everbody for your quick and informative replies very helpful, and very sorry to hear about your friend wonderwoman.

I spoke to a guy here in Kerala and said theres no malaria just chikungunya and dengue where we are, so today I cease, Im here for 4 months so Ill worry about starting again when returning north.

Cheers again for the advice on the MRP i usually look on food items but didnt think about it when looking at the medicine, does anyone on the forum have experience buying proguanil and know the cost Im interested in finding out whether he was trying to rip me off...

As for the side effects its hard for me too know whether I am just blaming every bodily function that is slightly abnormal on the tablets or not , I think Ive been losing more hair than usual and have slight stomach cramps every morning but I suppose Ill find out soon...

Again sorry for posting another thread on malaria but I was at loose end and dont spend enough time on the internet to read through all the posts on this site, thanks again!
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Old Sep 2nd, 2007, 16:14   #13
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Just took a quick look through our family medicine box, and the biggest problem as that most of the pills are cut off a bigger strip, according to how many you buy, and so the MRP is not visible! But you can ask the guy to show it to you if you really don't trust him.

We cover this ground so often on the site --- I do wish that people would read the existing threads. I think we'll have to become stricter on the moderating!

But...

It is quite wrong to generalise about the side-effects of anti-malarials, which, when they do exist, vary entirely according to the specific drug. One can cause mental problems; one can cause light sensitivity...

It seems also to be wrong to say that malaria is for life. It used to be: now, it seems, it can be eliminated.

Here is the document giving guidelines to UK doctors on malaria for travellers. A lot of good information there: please check it out.
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Old Sep 2nd, 2007, 17:17   #14
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Quote:
Originally Posted by Nick-H View Post
We cover this ground so often on the site --- I do wish that people would read the existing threads. I think we'll have to become stricter on the moderating!


Here is the document giving guidelines to UK doctors on malaria for travellers. A lot of good information there: please check it out.
I like the document Nick, best one I've seen in english so far. If people don't read it themselves (106 pages) it would be good to take with you to the docter.

It seems the moderation issue pops up more often the last month. If an issue has been discussed to death, the mods might refer to that discussion and close the thread?

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Old Sep 2nd, 2007, 17:20   #15
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Growing up in India with American parents, I don't think we ever bothered with malaria prevention. We got injections appropriate to India, boiled water before we drank it, avoided buying uncooked things from street vendors, but malaria we didn't worry about.
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