Malarone is an antimalarial drug that can be used to prevent and treat malaria. Taking an antimalarial like generic Malarone before travelling to a malaria-endemic area (Africa, South America, South Asia) is highly advised to stop the spread of the disease. Malarone is also known as Atovaquone-Proguanil, Malarone is the GSK brand name, but generic versions are available.
Generic Malarone is a combination of the drugs atovaquone and proguanil. Both drugs work synergistically to prevent malarial parasites from surviving and reproducing in the body. Parasites of the Plasmodium family cause malaria and may reproduce in the body rapidly after a mosquito bite. The symptoms of malaria include a high fever, chills, headaches and nausea. If left untreated the sufferer can deteriorate and die.
The atovaquone/proguanil combination offers good protection and treatment of malaria for most people. It is particularly effective against plasmodium falciparum (the most deadly malaria strain) with resistance to other antimalarials such as Chloroquine. Atovaquone halts the respiration or energy utilization of parasite cells and proguanil works to stop the synthesis of parasite DNA. Through both mechanisms, the parasite can be eliminated.
For most countries that malaria is prevalent, generic Malarone is a suitable medication. It is useful in places in the world where there is resistance to other antimalarial drugs. Read our article on ‘Which malarial medication do I need?’ for further information.
Generic Malarone is a largely effective medication for both prevention and treatment in a wide range of countries. However, when travelling to a malaria zone it is best to use additional protection against mosquito bites as no drug is 100% effective.
The active ingredients in Malarone are atovaquone and proguanil hydrochloride.
The inactive ingredients in Malarone can vary between generic 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.
Take your medication as instructed by your doctor or pharmacist. One tablet per day should be taken with food. Tablets should be started 2 days before travel to a malaria zone, during your stay and continued for 7 days after your return from the region.
You should take your Malarone with food or a milky drink as this will allow the body to absorb the drug better and it will help you to avoid side effects such as sickness or nausea.
If you forget to take your dose of the medication, 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 the medication take another tablet straight away. This may mean that you need to purchase further tablets to complete a full course of the medication to remain protected.
As with all medications, there is a risk of unwanted effects. Common side effects affecting around 1/10 people can include headaches, abdominal pain, nausea, vomiting and diarrhoea. More serious side effects tend to be rarer. For full information regarding side effects refer to the UK patient information leaflet.
If you experience side effects that are troublesome 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 largely reduces the incidence of getting gastrointestinal side effects and also helps with the absorption of the medication. Over the counter, pain relief medications such as Paracetamol or Ibuprofen can help with headaches.
However, if you have severe side effects including an allergic reaction stop taking the tablets and contact a doctor immediately. This includes:
Do not take generic Malarone if you have severe kidney disease or if you are allergic to any ingredients.
Certain drugs can interfere with the effectiveness of this medicine such as:
Other conditions of note are:
If Atovaquone/Proguanil is not suitable for your travel destination other antimalarials may be.
The advantage of Malarone, while it is more expensive than other antimalarials, is that it has fewer side effects and can be started only 2 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 2 weeks prior to travel and continued until 4 weeks after return. Chloroquine and Mefloquine, in contrast to other antimalarial drugs, are suitable for pregnant women.
Another alternative is the antibiotic Doxycycline that is effective in some parts of the world. While it is cheaper it does have more side effects including sensitivity to sunlight which may be troublesome.
You should remember to protect yourself using other measures to avoid being bitten by mosquitoes. An insect repellent such as 50% DEET or higher, sleeping under a mosquito net treated with insecticide and wearing long-sleeved clothing and trousers in the evening can help to prevent contracting malaria. You can also avoid damp, dark places and stay away from stagnant sources of water like ponds or lakes. Repellents for your home are also possible options. Check out our guide on avoiding mosquitoes.
Malarone is the brand-name for this drug, manufactured by GSK. The active ingredients (atovaquone/proguanil) are exactly the same in generic Malarone, so by buying generic Malarone, you are not compromising quality. The only difference is that the drug is no longer under patented to GSK alone, sometime after they originally developed it.
It is very rare for the NHS to prescribe Malarone, as travel medications are not usually available on the NHS. As Malarone is not available for travel purposes, it should be bought from an online pharmacy or a doctor with a private prescription.
Generic Malarone can be used to treat malaria however treatment would need to be monitored in a hospital. In order to treat malaria, the dose of the medication is usually higher, for example, 4 tablets to be taken once a day for 3 days. If you were taking Malarone as a precaution for malaria and subsequently contract malaria, treatment with Malarone will not work. You must inform doctors of the prior antimalarials you were taking so that they can treat you as appropriate.
Generic Malarone is not recommended to prevent malaria in children. A lower dose, pediatric formulation of the medication exists but is currently not available at Dr Felix. You should speak to your doctor about getting a private prescription for this medication if required.