Medicines to Prevent Malaria?

by

QUESTION

Which medicines are used to prevent malaria?

ANSWER

There are a number of drugs used to prevent malaria infection, known as malaria prophylactic medication. These vary in terms of how they are taken, how long they are taken for, how much they cost and the typical side effects people experience while they are taking them. In addition, some are recommended more highly for certain types of malaria or certain regions of the world, due primarily to the emergence of resistance in certain areas.

The most common forms of malaria prophylaxis used are doxycycline, atovaquone/proguanil (sold under the brand name Malarone), chloroquine (sold as Aralen) and mefloquine (sold as Lariam). More information on these, on other types of prophylaxis and malaria prevention in general can be found on our Malaria Prevention page.

Drugs for Malaria

by

QUESTION

What drugs are used in the treatment of malaria?

ANSWER

There are a number of medicines used to treat malaria. Traditionally, chloroquine has been the first line drug of choice for uncomplicated, non-resistant malaria. However, several types of malaria, and most notably Plasmodium falciparum, the most severe and deadly kind, has become resistant to chloroquine in many places. In some parts of south-east Asia, Plasmodium vivax has also begun to show worrying signs of chloroquine resistance. In such settings, where resistance to chloroquine is suspected, the first line medications for uncomplicated cases are artemisinin-based combination therapies (ACTs), such as Coartem.

The World Health Organization has recommended that artemisinin only be given in combination with another drug to prevent malaria also becoming resistant to this therapy as well. Cases of malaria which have progressed beyond the grasp of that treatable with oral medication as described above (so-called “complicated” cases, most common with P. falciparum infection) are usually given intravenous quinine as a first-line response.

All of these treatments have been rigorously tested in strictly controlled clinical and field trials, and while they may have side effects, they are generally mild and in most cases, the patient will be given the dose without prior testing for reaction to the drug. One exception is with primaquine, which is sometimes used as a preventative medication against malaria and can also be used to treat the liver stages of P. vivax and P. ovale. Primaquine is known to cause severe haemolysis in people with G6DP deficiency, and so people with a high statistical probability of having this condition (for example due to family history or ethnicity) should be tested prior to being given primaquine.