If you are travelling abroad and need to buy malaria tablets, you can order them from us without needing to see a doctor face-to-face.
You can use the Fit for Travel website to check whether you need malaria tablets. To place an order, complete our consultation questionnaire and select your preferred treatment. Our online doctor will review your order and approve an appropriate antimalarial.
Make sure you read our general travel advice before your trip.
How to take
Take one tablet per day starting two days before you enter the malarious area. Every day you are in the area. Continue for 4 weeks after you leave the area.
Always take the tablet with food and avoid lying down for at least 30 minutes. Not recommended for pregnant or breastfeeding women. Not suitable for those who are sensitive to tetracycline antibiotics or who have liver/kidney problems.
Sunburn due to sensitivity to light, stomach upset, heartburn and thrush.
Malarone / Generic Malarone
Both Malarone and generic Malarone work in the same way and contain the same active ingredients, atovaquone and proganil. Generic malarone is a generic (non-branded medication) and it is available at a lower cost.
How to take
Take one tablet per day starting two days before you enter the malarious area. Every day you are in the area. Continue for 1 week after you leave the area.
Not recommended for pregnant or breastfeeding women. People with severe kidney problems are also not advised to take it.
Intestinal upset, headaches, skin rash and mouth ulcers.
Malaria is a serious illness that is caused by a parasite Plasmodium that is carried in a certain type of mosquito, the female Anopheles mosquito, and is transmitted to humans when they bite them infecting the body’s bloodstream in particular the red blood cells. Although malaria can make you very ill with high fevers, muscle ache and flu-like symptoms, and in serious cases can lead to death, in most cases it is treatable and preventable. Therefore it is really important to protect yourself properly against malaria when travelling by taking appropriate antimalarial medication and avoiding being bitten by mosquitos.
Malaria is endemic in more than 100 countries and mainly stretches across the tropical regions of the world. The 2015 World Malaria Report published by the World Health Organisation (WHO) estimated there were 214 million cases of malaria worldwide in 2015, and an estimated 438,000 malaria deaths. In 2014 around 1,586 travellers were diagnosed with malaria after returning to the UK and three people died.
Malaria can be avoided, and Public Health England have published an ABCD approach to prevention:
- Awareness of risk: seek advice to find out whether or not you are at risk of malaria (www.fitfortravel.nhs.uk)
- Bite prevention: avoid getting bitten by mosquitos by using DEET based insect repellents, sleeping nets and clothing that covers your arms and legs, especially between dusk and dawn
- Check to see if you need antimalarial tablets: check the Fit for Travel website, if you do need antimalarials make sure you have the right tables and the correct number to finish the course. Antimalarial tablets are commonly referred to as malaria tablets, but the right term is antimalarial tablets because they are a prevention against malaria, not treatment for it.
- Diagnose quickly and without delay: if you think that you might have malaria even after up to a year from when you returned from travelling, seek immediate medical advice.
If you’re travelling to an area where there’s a high risk of getting malaria you should take a course of antimalarial tablets. It’s important to research where you’re going and to see which tablets are effective in that region. However bear in mind that antimalarial tablets only reduce your risk of infection by around 90% so it’s also really important to take measures to avoid being bitten.
There are different types of antimalarial tablets:
Malarone (Atovaquone-Proguanil): one tablet once a day starting 2 days before you go, during your stay and for 7 days after you return
Doxycycline: one tablet once a day starting 2 days before you go, during your stay and for 4 weeks after you return
Lariam (Mefloquine): one tablet taken once a week starting 3 weeks before you go, during your stay and for 4 weeks after you return
What are the symptoms of malaria?
The symptoms of malaria are
- vomiting and diarrhoea
- flu-like symptoms such as sweats, chills, muscle ache or feeling unwell in general
The time from being bitten to when symptoms of malaria start is called the incubation period. This is normally 7-18 days and depends on the specific parasite that you’re infected with. However in some cases it can take up to a year before symptoms appear. Often the early symptoms of malaria can be quite mild and so it can be hard to diagnose. With some kinds of malaria, you might notice that the chills and fever run in a 48 hour cycle. The pattern is often: cold/shivering followed by fever and severe sweating and fatigue. If you have been to a high malaria risk area and develop these symptoms, see a doctor straight away (even if it was up to a year after you went away). The most serious type of malaria is called Plasmodium falciparum malaria and this can cause life-threatening illness, as you can get very seriously ill, very quickly.
What are the causes of malaria?
Malaria is caused by a parasite called Plasmodium that is carried in the female Anopheles mosquito and transmitted to humans through the mosquito bite. When an infected mosquito bites you, it injects the plasmodium parasite into your bloodstream. If a mosquito bites someone who is infected with malaria, the mosquito can get infected too and pass the parasite on to other people. Malaria is mostly spread by female Anopheles mosquitoes, which bite between dusk and dawn, and are therefore known as night-biting mosquitoes.
When a person is infected with the plasmodium parasite by a mosquito, the parasite travels through the blood to the liver, where it develops. The parasite then travels back through the bloodstream and invades the red blood cells, where it grows and multiplies. At set time intervals (usually every 48-72 hours) the blood cells that are infected burst and spread more parasites into the bloodstream. When the blood cells burst, the person will experience fever, chills and sweating.
There are several different types of plasmodia parasites, but only five of them can cause malaria in humans:
- Plasmodium falciparum: mostly found in Africa, causes the majority of malaria fatalities worldwide.
- Plasmodium vivax: usually found in Asia and Latin America. The symptoms are less severe than those of plasmodium falciparum, however it can remain in the body (the liver) for up to 3 years which can result in a relapse.
- Plasmodium ovale: unusual, normally found in West Africa, and can remain in your liver for years without producing symptoms.
- Plasmodium malariae: quite rare, generally only found in Africa.
- Plasmodium knowlesi: very rare, and found in parts of Southeast Asia.
How is malaria diagnosed?
Visit your doctor/nearest hospital/travel clinic if you develop the symptoms of malaria. They will test for it by looking for the parasite in a blood sample. You can go and get checked whilst you’re away if you start to feel ill before you get home. Don’t wait or leave it too long, as the quicker you start treatment the speedier your recovery.
Some types of malaria can take up to a year to develop, so see your GP and let them know you have been to a malaria endemic area if you start to develop symptoms, even if you’ve been back home for a while.If your GP wants to test for malaria, he will probably send you to your local hospital to have the blood test. You should get the results the same day. If you need treatment, it will start straight away.
Antimalarial tablets are used to treat malaria as well as to prevent it. If someone is very seriously ill with malaria, antimalarial drugs can be given intravenously, through a drip that goes into a vein in their arm.
If you are pregnant or breastfeeding
If you’re pregnant or trying for a baby it’s advisable to avoid travelling to areas that have a high risk of malaria. Pregnant women are at a higher risk of developing severe malaria due to the changes in the body’s physiology, and so could develop dangerous complications.
If you do have to travel to a malaria endemic area, please consult with your doctor about the best antimalarial medication that is safe to take.
Doxycycline is not recommended for pregnant/breastfeeding women because it can harm the baby.
Usually, atovaquone and proguanil (Malarone) are not prescribed during pregnancy or breastfeeding because there isn’t a great deal known about the effects on mother and baby. That said, if there’s a high risk of malaria and there isn’t a good alternative, your doctor might recommend that you take them.
Do I need a prescription?
In Britain, chloroquine and proguanil can be bought over the counter from pharmacies, all other antimalarial medications need a prescription. Talk to your pharmacist, doctor or travel nurse for the best option for you.
Can I get malaria tablets on the NHS?
The Department of Health said in their guidance document FHSL(95)7, that medication for preventing malaria (malaria prophylaxis) should not be reimbursed under the NHS. This means that prescription-only antimalarials will be prescribed to you by your GP on a private prescription.
How does malaria medication work?
Antimalarial medications work by interfering with the malaria parasite’s life cycle in the body. Some antimalarial medications interfere with how the parasite develops within the liver and prevent it from multiplying and invading the red blood cells. This is how malarone works. Other antimalarial medications stop the parasites from multiplying within the red blood cells and prevent illness. This is how doxycycline works, which is why it needs to be taken for four weeks after leaving the malaria area to ensure it effectively kills all the parasites.
When used as an antimalarial the dose is one tablet daily (contains 250mg of atovaquone and 100mg proguanil). You should start taking them 1-2 days before you enter the malarious area and continue to take them after you return for a further 7 days. So if you were going on a 7 day trip you would take 16 tablets (2 before you go, 7 whilst on your travels, and another 7 when you return).
Take the tablet with food, and if you miss a dose or vomit within one hour of taking it, take another dose and carry on with the course.
Side effects include stomach upset, diarrhoea and headaches. It can also interact with certain other medications such as tetracycline antibiotics, rifampicin, rifabutin and metoclopramide.
When used as an antimalarial the dose is one tablet daily (contains 100mg of doxycycline).You should start taking them 1-2 days before you enter the malarious area and continue to take them for 4 weeks after you return. So if you were going on a 7 day trip you would take 37 tablets (2 before you go, 7 whilst on your travels and another 28 when you return).
Take the tablet with food at the same time each day, if you miss a dose take one as soon as remember and then carry on with the course. As it can cause irritation to your food pipe, try to stay sitting or standing for at least 30 minutes after you have taken it.
Side effects include heartburn, nausea, diarrhoea, thrush, headaches. It can also interact with other medications such as retinoids (for psoriasis) or cyclosporin so please let your doctor know which medications you’re currently on.
There isn’t enough known about the effects of atovaquone plus proguanil on mother and baby, so it isn’t recommended for pregnant or breastfeeding women. People with severe kidney problems are also not advised to take it.
Side effects include: intestinal upset, headaches, skin rash and mouth ulcers.
Doxycycline isn’t recommended for pregnant or breastfeeding women, or children younger than 12 (as it can permanently discolour their teeth). It also isn’t suitable for people who are sensitive to tetracycline antibiotics or who have liver problems.
Side effects include: sunburn due to sensitivity to light, stomach upset, heartburn and thrush. Doxycycline reduces the effectiveness of combined hormone contraceptives, such as the contraceptive pill or contraceptive patches.
Lariam isn’t recommended if you have epilepsy, seizures, depression or other mental health problems, or if a close relative has any of these conditions. It is not suitable for people with severe heart or liver problems.
Side effects include: dizziness, headache, sleep disturbances (insomnia and vivid dreams) and psychiatric reactions (anxiety, depression, panic attacks and hallucinations). It is very important to tell your doctor about any previous mental health problems, including mild depression. Do not take this medication if you have a seizure disorder.
Malaria guidelines are regularly updated and countries receive new risk ratings for malaria. As a result, some of the malaria risk advice on our site may be out of date. Before starting your assessment for malaria treatment, please check Fit For Travel guidance on the malaria risk in the country you’re travelling to.
Neither the content on our website, nor our online assessment for malaria treatment are intended as a substitute for a full travel consultation. It is important you discuss all precautions recommended for your trip with your GP or travel specialist - for example you may need vaccines too.