Malaria drugs

Question 1

Prevention of malaria

Answer 1

• Chloroquine sensitive areas: chloroquine, atovaquone-proguanil (malarone), doxycycline or mefloquine
• Chloroquine resistant areas: atovaquone-proguanil (malarone), doxycycline or mefloquine
• Mefloquine (multidrug) resistant areas: atovaquone-proguanil (malarone) or doxycycline
• Areas w/ mainly P vivax: Primaquine for primary and terminal prophylaxis for travelers who are not G6PD deficient

Question 2

Considerations for malaria prohpylaxis

Answer 2

• Chloroquine and mefloquine taken once a week, but must be started 1-2 weeks before travel
• Mefloquine cannot be used in people w/ seizure or psychiatric disorders, or cardiac conduction abnormalities
• Malarone and primaquine only needs to be taken 1-2 days before travel
• Malarone not for people w/ severe renal impairment
• Primaquine not for people w/ G6PD deficiency

Question 3

Contraindications in pregnant women

Answer 3

• Prophylaxis: chloroquine for sensitive malaria, mefloquine for resistant malaria
• Contraindicated: primaquine (may cause hemolysis), doxycycline (prevents bone development in newborn), malarone (not enough data)

Question 4

Contraindications in children

Answer 4

• Chloroquine for sensitive areas, otherwise mefloquine (>5kg body weigh) or malarone (>11kg)
• Contraindicated: doxycycline (<4 yrs may cause hemolysis)