Reviewed by a GPhC-registered Pharmacist at Newdays Pharmacy
Quick Answer: The most commonly prescribed antimalarial tablets for UK travellers are atovaquone/proguanil (Malarone), doxycycline, and mefloquine (Lariam). The right choice depends on your destination, the type of malaria parasite present, the length of your trip, your medical history, and personal preferences. A travel health pharmacist can advise on the best option for your itinerary.
Why Do I Need Antimalarial Tablets?
Malaria is a life threatening parasitic infection spread by the bite of infected Anopheles mosquitoes. It is caused by Plasmodium parasites, of which Plasmodium falciparum is the most dangerous species, prevalent in sub-Saharan Africa and parts of Southeast Asia. No antimalarial tablet provides 100% protection: they significantly reduce risk but must always be used alongside mosquito bite avoidance measures (DEET repellent, permethrin treated clothing, bed nets).
Types of Antimalarial Tablets
Atovaquone/Proguanil (Malarone)
Malarone is generally the most popular antimalarial for UK travellers to high risk destinations, including most of sub-Saharan Africa.
- How to take: Start one to two days before travel; continue during travel and for seven days after leaving the malaria zone
- Suitable for: Most destinations; effective against Plasmodium falciparum including chloroquine resistant strains
- Common side effects: Nausea, abdominal pain, headache (take with food to reduce gut side effects)
- Not suitable for: Severe renal impairment; children under five kg; pregnancy or breastfeeding (specialist advice required)
- Cost: More expensive than alternatives, particularly relevant for long trips
Doxycycline
Doxycycline is an antibiotic with antimalarial properties and is a cost effective alternative to Malarone, particularly for longer trips.
- How to take: Start one to two days before travel; continue during travel and for 28 days after leaving the malaria zone
- Suitable for: Most high risk destinations; effective against Plasmodium falciparum including chloroquine resistant strains; also protects against some other infections (for example leptospirosis)
- Common side effects: Photosensitivity (increased risk of sunburn, use SPF 50+), nausea (take with food and a full glass of water; do not lie down for 30 minutes after taking), vaginal thrush, oesophageal irritation
- Not suitable for: Children under twelve; pregnancy; those on certain other medications
Mefloquine (Lariam)
Mefloquine is taken once weekly, which some travellers find convenient for long trips.
- How to take: Start two to three weeks before travel (to allow time for side effects to manifest before departure); continue during travel and for four weeks after leaving the malaria zone
- Suitable for: Some destinations where atovaquone/proguanil and doxycycline are unsuitable
- Side effects: Neuropsychiatric side effects are the most significant concern, including vivid dreams, insomnia, dizziness, anxiety, depression, and in rare cases severe neuropsychiatric reactions. It is contraindicated in those with a history of depression, anxiety disorders, psychosis, or epilepsy
- Not recommended as a first line choice: Due to neuropsychiatric risk, mefloquine is typically used only where other options are unsuitable
Chloroquine and Proguanil (Paludrine/Avloclor)
Chloroquine and proguanil are older antimalarials now rarely recommended for most high risk destinations due to widespread chloroquine resistant malaria. They may still be used in specific low risk areas (for example some parts of Central America, parts of the Middle East). Always seek up to date destination specific advice.
Do I Need Antimalarials for All International Travel?
No. Malaria is not present in all countries and malaria risk varies enormously within countries. Antimalarials are not needed for travel to most of Europe, North America, Australia, Japan, parts of Southeast Asia (for example main tourist areas of Thailand), or most popular tourist destinations in North Africa and the Middle East.
They are strongly recommended for travel to most of sub-Saharan Africa and are destination and itinerary specific for South and Southeast Asia, Central America, and South America. Always seek personalised advice for your specific destination and itinerary.
Book Antimalarial Tablets in Windsor, Twyford, or Reading
Newdays Pharmacy’s travel clinic pharmacists provide destination specific malaria risk assessments and can prescribe and supply all commonly used antimalarial tablets as part of a comprehensive travel health consultation.
Book Now: Book a Travel Clinic Consultation
Clinical Disclaimer: This article is intended for general information only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any treatment or medication. Information is accurate as of the date of publication and reviewed by a GPhC-registered pharmacist. Newdays Pharmacy is registered with the General Pharmaceutical Council (GPhC). Branch registration numbers: Eton/Windsor 1029048 | Twyford 1028983 | Coley Park Reading 1029008.
Frequently Asked Questions
Some antimalarials (chloroquine and proguanil) are available over the counter, but most clinically recommended options for high-risk destinations (Malarone and doxycycline) are prescription only in the UK. A travel health consultation and prescription are required. Our pharmacist prescribers can provide this.
Follow the instructions for your specific medicine. For Malarone (daily), take it as soon as you remember and continue at the usual time. If more than 24 hours has passed, take the missed dose and continue as normal; do not double up. If you have persistent concerns, seek advice from a pharmacist or doctor.
The main antimalarials prescribed for UK travellers are effective against Plasmodium falciparum, the most dangerous malaria species. They also protect against some other species. However, protection is not 100% effective, so mosquito bite avoidance measures such as DEET, insecticide-treated nets and covering exposed skin should always be used alongside tablets.