4 months in East and Southern Africa: which malaria pills?
Replies: 7 - Last Post: Sep 28, 2013 10:50 AM Last Post By: marijne
Jul 14, 2013 12:39 PM
4 months in East and Southern Africa: which malaria pills?We're going to spend 4 months in Africa, starting in Kenya and making our way down to South Africa. A friend that joins us for 3 weeks just got his Malerone tablets (3 euro each in Holland), and I read here that you can't get Malerone for longer than 28 days in the EU. Does anyone have advice about which pills are good and safe to use for 4 months, and how much do they cost? And does anyone have experience with being on them for this long? We're travelling at the moment and will pass through mexico, Holland and the UK before Africa, so we have a few options of getting them there. Thanks for the info!
Jul 14, 2013 4:54 PM
1Hi Marijine - your question about long term use of any medication is valid. There have been questions from previous posters about the problem of getting a prescription for Malerone in the EU for periods greater than 28 days and I think the answer(s) included - getting two different prescriptions via different doctors/clinics; getting a new supply of Malerone in-country once you have arrived in East Africa (it is available in Nairobi - not sure of costs etc). I am aware of mining companies providing Malerone to their European employees for periods in excess of one year with no apparent side affects.
My understanding is that the 28 day restriction in the EU was as a result of the testing program that only anticipated people requiring short-term use. The cost factor is usually the major drawback with Malerone - the last time I check in Sydney (Australia) they were around $8.00 AUD each (about the same as the Euro cost).
Your other choices for long term use are Lariam (Mefloquine) which does have some psychotic side effects. I have been using it since 2007, including a three month continuous use period (in fact when I add in the before and after periods it was closer to 4 months) without any major problems. The other product is Doxycycline which I can no longer use due to the issue of significantly increased sun sensitivity. I recommend that you find a major health clinic that has experience with anti-malarial products and be guided by their recommendations.
Jul 14, 2013 5:40 PM
Jul 15, 2013 2:25 AM
I live in east africa. you can buy malaria tablets over the counter here without a perscription and its super cheap instead of what you pay back home. Actually even your needles and other medicine is all over the counter here and cheap. Yellow fever you can get at the airport for $50 when you arrive.
I have always used Doxy but tried Malarone in west africa last year and its thought to have triggered allergies in me but not proven. Here its usually Doxy or Malarone over the counter that everyone takes.
feel free to message me with any other East african questions you may have.
Jul 15, 2013 6:37 AM
Jul 15, 2013 7:04 AM
5Malarone is licensed for sale in Kenya and South Africa, where it is sold under the brand name Malanil. In theory, it requires a prescription, but I have seen reports of people who found obliging pharmacists. Reports are the prices are no different than elsewhere. The Surgery, a clinic in Kampala, Uganda, also has it and you may find it at other specific clinics. Not available in Mexico.
If you find Malarone elsewhere, I'd be concerned that it is either counterfeit or black market. Black market is more likely as Malarone is not really a target for counterfeiting.
Fake, understrength. and out-of-date doxycycline is unfortunately common. Fake or understrength stuff may not be effective; seriously deteriorated or out-of-date doxy can actually be toxic. Be sure to buy from a reliable pharmacy, perhaps one associated with a hospital or one recommended by your embassy. If you are offered pills in bulk, ask to see the original container with the expiration date.
Mefloquine may be sold under the brand names Lariam, Mefliam, Mephaquin or many other brands.
One consideration you need to make is which one is best for you, individually. You have to consider your health history, your allergies, your age, your gender, and, sometimes your pocketbook. This is best done in consultation with a health care person.
Mefloquine and doxycycline have a lot of history of long-term use, as in years. In general, if you tolerate a drug in the short term, you are OK for the long term. (There have been studies in Peace Corps workers, military personnel, embassy workers, and others.) There is less data on Malarone, but studies so far indicate that long term use may be OK. The EU limit of enough pills for a 28-day trip is not found in most other countries where MAlarone is licensed. (I say "most" because I have not looked up every single country. I can say that in the US, Canada, Australia, New Zealand & South Africa, there is no limit.) Current UK opinion is
The most common reason antimalarials fail is that users get careless about taking them or stop altogether because it's a pain to have to remember. Doxy and Malarone must be taken daily, at the same time each day, to keep a steady level in the blood. That can be difficult, given the hassles of travel. Malarone needs to be taken with food or drink that has fat in it, in order to be better absorbed.
The plural of anecdote is not data.
Jul 16, 2013 5:09 PM
Sep 28, 2013 10:50 AM
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