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fitfortravel

Travel health information for people travelling abroad from the UK

Chloroquine and/or Proguanil

A - Be Aware When There is a Risk However Small

  • Find out if there is a malaria risk in the area you are visiting.
  • Aspects of travel may increase the risk e.g. rural travel, rainy season or unscreened accommodation.

B - Keep Mosquito Bites to a Minimum

  • Use clothing to protect the skin, particularly between dusk and dawn when mosquitoes feed.
  • Use DEET- based insect repellent on exposed areas of skin.
  • Sleep under a mosquito net that is impregnated with insecticide.
  • Use air conditioning (if available) and plug in vapourisers to protect your room.

C - Use Antimalarials Correctly

  • The antimalarial tablets recommended for you will depend not only on effectiveness but also on suitability, side effects, cost and which regime suits you best.
  • Tablets must be taken regularly according to the manufacturer's instructions.
  • Delayed illnesses - the incubation period of the less severe form of malaria may be greater than 4 weeks (up to a year or more).

D - Report Any Feverish Illness Promptly to a Doctor and Say You Have Been to a Malarious Area

You may need to take a supply of personal emergency treatment abroad with you if you are going to be remote from medical facilities since treatment should always be started promptly. Discuss this option with a Travel Advisor or other healthcare professional.

Chloroquine

Patient Information Leaflet (PIL) for chloroquine

Licensed for prophylaxis in UK.

  • Preparations available: Avloclor® (Zeneca), adult dose is 2 tablets taken once a week.
  • Chloroquine should be started one week before exposure, throughout exposure and for 4 weeks afterwards.
  • Take your tablets with food and at the same time on the same day each week. If you miss a dose, take a dose as soon as you remember. Do not take two doses at the same time. It is very important to complete the course.
  • Antacids used to treat heartburn or indigestion may reduce the absorption of chloroquine and therefore should be taken at least two hours before or after taking chloroquine.
  • Side effects may include: nausea, diarrhoea, headache, rashes, skin itch, blurred vision, hair loss, dizziness, mood change, sun sensitivity or seizures.
  • Long term use of chloroquine can affect the eyes, leading to patchy vision. Eye examinations and blood tests may be necessary for those on very long term chloroquine.
  • Those with kidney or liver disease should be assessed carefully before taking this medication.
  • Can aggravate psoriasis and very occasionally causes convulsions so it should not normally be used in those with epilepsy or when first degree relatives have a history of idiopathic epilepsy.
  • Chloroquine is very toxic in overdose - parents must take special care to store the tablets safely.
  • It is generally accepted, as a result of long usage, to be safe in pregnancy.

Proguanil

Patient Information Leaflet (PIL) for proguanil

Licensed for prophylaxis in UK.

  • Preparations available: Paludrine® (Zeneca). Adult dose is 200mg daily.
  • Can normally be used continuously for a period of at least 5 years.
  • One or two doses should be taken before departure. It should be continued throughout exposure and for 4 weeks afterwards. It is very important to complete the course.
  • Take your tablets with water after food and at the same time each day. If you forget to take a dose take it as soon as you remember. However, if it is nearly time for the next dose, skip the missed dose. Do not take a double dose to make up for the missed dose.
  • Side effects may include: anorexia, nausea, diarrhoea, constipation, skin itch and mouth ulcers.
  • Can delay the metabolism of the anticoagulant, warfarin, and result in bleeding. If it has to be used, restabilising the prothrombin time in advance of departure is advised. It may be necessary to monitor blood levels whilst overseas and on return.
  • Those with kidney disease should be assessed carefully before taking this medication.
  • Safe in pregnancy, but folate supplement is advised.

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