Considerations when choosing a drug for malaria prophylaxis:
• Recommendations for drugs to prevent malaria differ by country of travel and can be found in thecountry-specific tables of the Yellow Book. Recommended drugs for each country are listed in alphabetical order and have comparable efficacy in that country.
• No antimalarial drug is 100% protectiveand must be combined with the use of personal protective measures, (i.e., insect repellent, long sleeves, long pants, sleeping in a mosquito-free setting or using an insecticide-treated bednet).
•For all medicines, also consider the possibility of drug-drug interactions with other medicines that the person might be taking as well as other medical contraindications, such as drug allergies.
•When several different drugs are recommended for an area, the following table might help in the decision process.
Drug Reasons that might make you consider using this drug Reasons that might makeyou avoid using this drug
Atovaquone/Proguanil (Malarone) • Good for last-minute travelers because the drug is started 1-2 days before traveling to an area where malaria transmission occurs
• Somepeople prefer to take a daily medicine
• Good choice for shorter trips because you only have to take the medicine for 7 days after traveling rather than 4 weeks
• Very well tolerated medicine – sideeffects uncommon
• Pediatric tablets are available and may be more convenient • Cannot be used by women who are pregnant or breastfeeding a child less than 5 kg
• Cannot be taken by people with severerenal impairment
• Tends to be more expensive than some of the other options (especially for trips of long duration)
• Some people (including children) would rather not take a medicine every dayChloroquine • Some people would rather take medicine weekly
• Good choice for long trips because it is taken only weekly
• Some people are already taking hydroxychloroquine chronically for...