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What is generic Malarone?

Malarone is an antimalarial drug that is used to prevent and treat malaria. Malarone is a combination of two medicines in one tablet. These two medicines are Atovaquone and Proguanil. Malarone is the GSK brand name, but generic versions are available and will only state Atovaquone and Proguanil as the active ingredients. Take an antimalarial like Malarone (generic version) before travelling to malarial areas in Africa, South America and South Asia.

How does Malarone work?

Malarone is a combination of two drugs, Atovaquone and Proguanil, in each tablet. Both drugs work to prevent malarial parasites from surviving and reproducing in the body. Parasites of the Plasmodium family cause malaria and may rapidly reproduce in the body after a mosquito bite. The symptoms of malaria include a high fever, chills, headaches and nausea. If left untreated, malaria can be fatal. 

The Atovaquone and Proguanil combination offers adequate protection and treatment of malaria for most people. It is particularly effective against Plasmodium falciparum (the most deadly malaria strain) while there is resistance to other antimalarials such as Chloroquine. Atovaquone stops respiration in parasite cells, and Proguanil works to prevent parasite DNA synthesis. Through both mechanisms, the parasite will die.

Is this drug suitable for the country I am visiting?

For most countries where malaria is prevalent, generic Malarone tablets are a suitable medicine. It is particularly useful in regions where there is resistance to other antimalarial drugs. Read our article on ‘Which malarial medicine do I need?’ for further information.

How effective is Malarone?

Generic Malarone and GSK-branded Malarone are equally effective. Malarone is the most effective medicine for prevention and treatment in a wide range of countries. However, when travelling to a malarial area, it is best to use additional protection against mosquito bites as no medicine is 100% effective.

Malarone summary

Active ingredients

The active ingredients in Malarone are atovaquone and proguanil.

Inactive ingredients

The inactive ingredients in generic Malarone tablets can vary between different manufacturers. In GSK's Malarone, the inactive ingredients are low-substituted hydroxypropyl cellulose, magnesium stearate, microcrystalline cellulose, poloxamer 188, povidone K30, and sodium starch glycolate. The tablet coating contains hypromellose, polyethylene glycol 400, polyethylene glycol 8000, red iron oxide, and titanium dioxide.

What should I do if I miss a dose of Malarone?

If you forget to take a dose, take your next dose as soon as you remember. Do not take a double dose if you have missed a dose. If you vomit within one hour of taking a tablet, take another tablet straight away. Losing a tablet may mean that you need to purchase further tablets to complete a full course of the medicine to remain protected.

Do I need to take my tablets with food?

You should take Malarone with food or a milky drink as this will allow the body to absorb it better, and help you avoid side effects such as nausea.

How do I take Malarone and when should I begin and finish a course of tablets?

Take Malarone as instructed by your doctor or pharmacist. Take one tablet each day with food. Tablets should be started two days before travel to a malarial area, taken during your stay and continued for seven days after leaving the malarial area.

Malarone side effects

As with all medicines, there is a risk of unwanted effects. Common side effects affecting around one in ten people include headaches, abdominal pain, nausea, vomiting and diarrhoea. More severe side effects tend to be rarer. For full information regarding side effects refer to the UK patient information leaflet.

How can I handle the side effects of Malarone?

If you experience troublesome side effects, it is worth speaking to a doctor regarding these and whether you can use an alternative antimalarial. Remember to take your tablets with food as this reduces the chance of getting gastrointestinal side effects and helps with the medicine’s absorption. Pain relief medicines can help with headaches. 

However, if you have severe side effects, including an allergic reaction, stop taking the tablets and immediately seek emergency medical help. An allergic reaction may appear as:

• Rashes and itching
• Blistering
• Skin peeling
• Wheezing
• Chest tightness
• Shortness of breath
• Swelling of the face

Are there any contraindications, drug interactions and other points of caution?

Do not take Atovaquone/Proguanil if you have severe kidney disease or are allergic to any ingredients. 

Certain drugs can interfere with the effectiveness of this medicine, such as:

• Metoclopramide 
• Antibiotics including tetracycline, rifampicin, rifabutin
• HIV medicines including Efavirenz or other highly active protease-inhibitors 
• Warfarin
• Etoposide

Other conditions of note are: 

• If you are pregnant, you should not take Malarone without your doctor’s approval.
• Malarone should not be used if you are breastfeeding.
• Avoid alcohol when taking this medicine as it can cause dizziness.
• There is no evidence that the medicine affects menstruation (periods) or interacts with the contraceptive pill.

What other antimalarial drugs are available?

If Malarone is not suitable for your travel destination, other antimalarials may be.

While Malarone is more expensive than other antimalarials, it has fewer side effects and can be started only two days before a trip, making it ideal for short trips. 

Chloroquine and Mefloquine are more suitable for trips of a longer duration as they are taken only once a week but need to be started two weeks before travel, taken during your trip and continued for four weeks after leaving a malarial area.

Malarone vs Doxycycline: Another alternative is Doxycycline which is effective in some parts of the world. While it is cheaper, it does have more side effects than Malarone, including sensitivity to sunlight.

What else can I do to protect myself from malaria?

You should remember to protect yourself using other measures to avoid being bitten by mosquitoes. Use an insect repellent such as 50% DEET or higher, sleep under a mosquito net treated with insect repellent and wear long-sleeved clothing and trousers in the evening to help prevent contracting malaria. You should avoid damp areas and stagnant water sources like ponds or lakes. Insect repellents for your accommodation are also possible options. Check out our guide on preventing mosquito bites.

What is the difference between generic Malarone and Malarone (GSK)?

Malarone is the brand-name for this drug, manufactured by GSK. The active ingredients - Atovaquone and Proguanil - are the same in all Malarone tablets, so you are not compromising quality by buying generic Malarone. The only difference is that GSK no longer owns the patent to manufacture Malarone exclusively so other manufacturers can now make it too.

Can I get Malarone on the NHS?

It is rare for the NHS to prescribe Malarone, as travel medicines are not usually available on the NHS. As Malarone is not available for travel purposes, you can buy it from an online pharmacy or a doctor with a private prescription.

Can Malarone cure malaria?

Malarone can be used to treat malaria; however, treatment would need to be monitored in a hospital. The dose is usually higher; for example, four tablets to be taken once a day for three days. You must inform doctors of any antimalarials you were taking so that they can treat you appropriately.

Is generic Malarone suitable for children?

Malarone can be used in children and adults that weigh over 40kg. Paediatric Malarone is for children and adults that weigh between 40kg and 11kg. However, Paediatric Malarone is currently not available at Dr Felix. You should speak to your doctor about getting a private prescription for this medicine if required.