Which anti-malarial for 1 yr?

Rockyp44

I need to start one quickly. Will be in Chennai at least a yr.

1. Malarone
2. Mefloquine (lariam)
3. Doxycycline (act'y an antibiotic)

Thanks!

Nick-H

Best answer would come from a local doctor once you get here.

They will know what the risk is and what the appropriate drug is.

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edwardseco

Malarone costs an arm and a leg. Lariam I suggest only for exceptional postings in the world. You should know the ins and outs of these and especially the how to spot potential side effects and how to take them (especially for Doxy). There will be more threads at the bottom of the page. There is endless discussion on this topic but keep in mind that you have to study the topic as it isn't like quaffing aspiren..

edwardseco

Malarone isn't available in India note and aspirin has an i at the end..

Rockyp44

I have info sheets from my travel clinic that all are effective in Chennai, but a. I need to start this week in the US and b. need to know which will be available in India long term and cost.

Why was it suggested that Lariam is for exceptional postings?

edwardseco

Doxy is cheap in India, Lariam has many, many well documented psychological side effects (as well as satisfied users). There are certain areas that Lariam is specifically prescribed for. To my knowledge Chennai is not one. Nick and I are already tripping so we don't need Lariam..

dhans

Disclaimer: never take medical advice from the net. But for orientation: Forget about Lariam and Doxy unless you are in the north-east. Mefloquine, atovaquone-proguanil or Proguanil hydrochloride (Paludrine) are at the moment the recommended agents for malaria prophylaxis.They are all available in India. Consult a doctor specialised in tropical medicine. Read the India with kids section below for some more info.

Have fun,

Hans

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federica

Nowadays the German Society for Tropical Diseases advises only standby medication for India, except for West Bengal and Assam (there prophylaxis is recommended)....

When you are in India, you will realize that the malaria outbreaks are mostly in certain parts of a city or in a special village, not in the whole area. For staying longterm, the advice of a local doctor would be the best, maybe someone experienced with expats, as their risk is higher.

And remember: all our information here is 2nd hand, so better to talk to an experienced doc or check reputable and trustworthy medical websites!

edwardseco

By whom is relevant..

zoltan

Hi,

Each of these tablets has it's pros and cons.

As Edwardseco points out, (1). Malarone will cost you a fortune. The reason for this is that the drug companies don't want this to become a tablet that becomes resistant to malarial infections as many of the other tablets have in the past.

> 2. Mefloquine (lariam)
This tablet has some *really* nasty side-effects and usually it's the people who are taking it that don't see them.

The most common issues are serious mood-swings; halluncinations; and the like. If you have *any* depression - avoid this tablet like the plague.

> 3. Doxycycline
Reading your profile, you're female and this tablet can have adverse effects on female physiology; including yeast infections.

For both genders; there is also a risks of increased photo-sensitivity and gastic upsets.

I was advised on my last journey to India that paludrine tablets are no longer considered 100% effective as there is a lot of immunity to various malarial infections.

Taking any of the 3 tablets for a 12-month period would also bring into play a host of health issues.

From my perspective, I would be recommending that you do the cover-up (as best as you can (long sleeves & pants) and wear insect repellant when outdoors.

Coming back to what tablet to take, I would suggest that you purchase the malarone tablets because this is actually a cure for malaria once you have the early signs of the infection.

I don't know how many tablets need to be taken or the duration (this is something you need to speak with your GP about). But it would be better for your own body not to be on any form of tablet for an extended period of time.

If you purchaes the Malarone tablets, it may cost you US$100 for a couple of packets but in the bigger picture, it's better for your body & less invasive on many levels.

Cheers
Zoltan

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GerardKelly

If you spend most of your time in Chennai, your risk of malaria is negligible. You could then use occassional Malarone for trips to rural areas for several nights, especially in the middle and northeast of the country.

If you feel more comfortable on an antimalarial drug all the time, you can still start it in Chennai if you aren't leaving the city immediately. Believe it or not, the best choice for longterm use is Larium! It has been tested longer than any other of the antimalarials, and is actually safe if you tolerate it in the first month.

If you haven't had insomnia or strange dreams in the first 3 or 4 weeks, then you are not going to get them later on. If you do have problems with Larium, you can always switch to doxycycline as it is as effective as Malarone but 1/10 the cost. Unfortunately, both Malarone and doxycycline have to be taken daily and most people end up forgetting to take them over time.

I have been on all of them in the past, and for the long haul ... if you can tolerate Larium (and don't have depression or epilepsy) - 80% of people tolerate it fine, then it is the best bet.

Another option is to take Malarone as a self-treatment backup if you get malaria outside of Chennai, and use it for treatment by the local doctor instead of their local medication. Counterfeiting of medication is becoming a several billion dollar industry worldwide, and India is now a major market now that China is trying to clamp down on the industry.

Your best bet is to see a doctor who is an expert in travel medicine for advice on your personal situation. I wouldn't freak out about malaria in Chennai itself, but if there is a chance of travelling to the northeast of India or rural Maharashtra and other central regions, then consider a short course of Malarone for those outings.

Check out the following links which provide good advice:

UK Guidelines have excellent maps of India's malaria risk areas.
http://www.hpa.org.uk/webw/HPAweb&HP...=1191942128258

NaTHNAC has a copy of the malaria risk map of India by severity:
http://www.nathnac.org/ds/images/Ind..._Goa_Final.gif

Nick-H

I have to dispute that Larium has been tested longer than other drugs, simply because it is relatively new, against some drugs that have been around for decades.

When I first came here for six months, my local doctor told me to take chloroquine, once a week. He said that is fine for Chennai, resistant strains of malaria are very rare. That was in early 2005; things do change but it might still be the case. Only a local doc can advise like this.

Now, as an indefinite-termer I take nothing. It does mean having a test for any peculiar fever you may suffer, but that is no great hassle. Last time, malaria was suspected, and chloroquine daily itself made me very sick; weekly I had had no side effects at all.

In three years I've had two malaria blood tests, both negative. The first time was more-or-less self-prescribed; the doc didn't think I had it, and he was right. The second time I had weird symptoms and was tested for several things; if malaria is suspected, anti-malarial treatment should be give until they find out otherwise.

Local doctors know what is going on in your district; doctors, and even travel clinics, abroad, I'd have thought, have to work with far broader statistics. Here we can say that you are at more risk of Malaria in Northern Chennai than you are in the South; can your travel clinic break it down like that?

Victoria

Hi Rocky,

Before going to Uttar Pradesh for a year my doctor advised me NOT to take malaria tablets. Seriously! She said that if i were to take them for such a long period the side effects would be considerable. She didn't want me to be taking them for a year. The adivce was simple, take care, use nets and sprays and if I have been bitten by a mosquito and feel ill to seek medical attention straight away. I had a small batch of pills ready for whenever i went into villages in the middle of nowhere etc but her advice was useful.

Don't know what others think though. I came back without any nasty diseases so all is well!

federica

Exactly... and Malaria deaths in non-Malaria countries happen mostly as the disease is not identified as Malaria. People come back from a holiday, and after months they get symptoms, but the doctors don't consider Malaria.... And after some time it is too late.... at least Malaria is curable when identified. Other diseases like Dengue are more difficult...

bips

i think if you really want to take anti malaria tablets, ayurvedic tablets will be better, i dont know how effective they are but definetely there will be no side effects. one anti malaria ayurvedic tablet i know is called "sudarshan ghanvati" has anyone tried it, pls comment