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Malaria - Malarone

United Kingdom
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Malaria - Malarone

Hi

I purchased some Malarone tablets last December which we never used. They are unopened and still in their original packaging from the chemist.

There are enough tablets for 3 people spending 6 days in a Malaria zone. Thus 2 days before, 6 days in and 7 days after entering an infected area. A total of 45 tablets.

Anyone interested in making me an offer for these, please send me a private message.

Free State
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1. Re: Malaria - Malarone

Hi Bulalio -

Unfortunately I cannot take the tablets off your hands, but as we will be visiting the Victoria Falls soon and have been advised that the mozzies have become resistant to some of the available meds. Do you have any information?

Thanks

Kate

uk
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2. Re: Malaria - Malarone

im intrested. how much 07738042842 phone me.

Sheffield, United...
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3. Re: Malaria - Malarone

Hi Kate.

According to WHO, Malarone, Larium and Doxycycline are effective in sub saharan Africa, the older type of prophylaxis, Chloroquine and Paludrine are not effective, but in any case they have been out of use in that area for some years now. They are still in use in some North Africa countries, and South America.

Below is all you want to know about Malaria Prophylaxis

"Drugs Recommended in Areas of Chloroquine-Resistant Malaria (All of Sub Saharan Africa)

Atovaquone/Proguanil (Malarone)

Malarone, a combination of atovaquone (250 mg) and proguanil (100 mg), is the newest drug for the prevention and treatment of malaria. Atovaquone/ proguanil has been shown to be 95% to 100% effective in preventing chloroquine-resistant and multi-drug resistant strains of P. falciparum malaria.

Atovaquone/proguanil is active against liver-stage parasites, and requires only a short period of pre-exposure and post exposure dosing. This means the drug may be started 1 day before exposure, continued once daily during exposure, and for 1 week after exposure ceases. The brief post exposure requirement for drug use is ideal for the short-term and frequent traveller, allowing the latter to discontinue medication between trips. In addition, it is an ideal drug for overseas workers who travel into rural malarious areas intermittently, requiring protection for only brief periods. With the exception of primaquine and atovaquone/proguanil, most prophylactic drugs must be taken for 4 weeks after exposure. Mefloquine and chloroquine must be started 1 to 2 weeks before exposure. There is a paediatric formulation of atovaquone/proguanil, making it convenient to prescribe for children, especially those under the age of 8 years who should not take doxycycline.

Atovaquone/proguanil is more expensive than other prophylactic drugs and, therefore, it is less likely to be accepted for long-term prophylaxis. However, because many insurance plans now cover the drug, it is more widely used. Because of its convenient dosing schedule, even in chloroquine-sensitive areas many travellers prefer atovaquone/proguanil to chloroquine.

Adult Dosage: One tablet, started the day before travel, taken daily during exposure, and for 7 days after leaving the malarious region.

Child Dosage: A paediatric-strength tablet (25 mg proguanil with 62.5 mg atovaquone) is available. The dosage is based on weight: 10 kg to 20 kg = one paediatric-strength tablet, 21 to 30 kg = two paediatric-strength tablets, 31 to 40 kg = three paediatric-strength tablets, and more than 40 kg = one adult-strength tablet. Atovaquone/proguanil may now be used for prophylaxis for infants and children weighing at least 5 kg (11lbs).

Side Effects: To date, atovaquone/proguanil (Malarone) has an enviable safety record, with no reports of serious adverse side effects. A recent large-scale trial in travellers from industrialized countries to malarious areas showed that only 1% of users of the drug discontinued it because of side effects, compared with 5% of those using mefloquine (Lariam).

Most complaints include stomach upset, skin rash, mouth ulcers, dizziness, and insomnia in up to 20% of users. Tablets should be taken with food or a milky drink at the same time each day. If vomiting occurs within 1 hour after dosing, a repeat dose should be taken. Atovaquone/proguanil is contraindicated during pregnancy and should not be used by those with severe kidney disease.

Mefloquine (Lariam)

Mefloquine (Lariam) is recommended for both short- and long-term travel to countries where there is chloroquine-resistant P. falciparum. The drug is also highly effective against P. vivax, P. ovale, and P. malariae. In western Cambodia and along the border areas of Thailand, however, the incidence of mefloquine-resistant P. falciparum is as high as 50%. Prophylaxis with atovaquone/proguanil (Malarone) or doxycycline is recommended in these areas.

Adult Dosage: One tablet, 250 mg once weekly during travel in malarious areas and for 4 weeks after leaving such areas. Mefloquine should be started at least 1 week before departure.

Child Dosage: Children: 5 to 14 kg, 1/8 tablet weekly; 15 to 19 kg 1/4 tablet weekly; 20 to 30 kg, 1/2 tablet weekly; 31 to 45 kg, 3/4 tablet weekly; and greater than 45 kg, one tablet weekly. For children weighing less than 5 kg, 5 mg/kg should be given.

Side Effects: Mefloquine (Lariam) in prophylactic doses is generally well tolerated, but about 35% of users report mild-to-moderate side effects—sleep disturbances (strange dreams, insomnia), nausea, dizziness, and weakness. Although the gastrointestinal symptoms are the most frequent, it is the neuropsychological side effects (anxiety, dizziness, depression, agitation, nightmares) that cause about 5% of mefloquine users to discontinue the drug. Studies show that men tolerate mefloquine better than women, and infants appear to tolerate the drug well. More severe neuropsychiatric side effects (psychosis, seizures) are extremely rare. Side effects may be reduced by splitting the weekly dose and taking one half tablet twice weekly. Taking the drug with food lessens stomach upset.

Loading Dose of Mefloquine: Some travel clinics give a loading dose (one tablet daily for 3 days, then once weekly) to achieve therapeutic levels rapidly and to “screen” for side effects. If there are to be significant side effects, they will usually occur within 1 week instead of 3 to 7 weeks when the drug is initiated on a weekly basis. The loading dose should be taken 2 weeks before travel. If bothersome side effects occur, there will be enough time to switch to another antimalarial, such as atovaquone/proguanil or doxycycline (Vibramycin, Doryx). Alternatively, one may start mefloquine 4 weeks before departure (one tablet weekly) because the majority of side effects will occur within the first three doses.

Travellers with a history of epilepsy, psychosis, recent depression or anxiety disorder, or cardiac conduction disturbances with arrhythmia should not use mefloquine (Lariam). The drug should probably not be given to those on mood-altering drugs such as Prozac, Celexa, Paxil, etc. Mefloquine (Lariam) should be administered cautiously when the traveller is receiving quinine, quinidine, procainamide, or other drugs that affect cardiac conduction. In addition, in countries where halofantrine (Halfan) is used to treat malaria, halofantrine should not be given to those using mefloquine for prophylaxis because of the risk of severe heart rhythm disturbances. NOTE. Airline pilots, operators of machinery and heavy equipment, scuba divers, and mountain climbers should be informed that mild dizziness is a possible short-term side effect of mefloquine.

Mefloquine has been shown to be safe for prophylaxis after the first trimester of pregnancy and, by extension, also safe for infants. The drug has not been associated with congenital malformations or adverse postnatal outcomes when used for prophylaxis. There may be a slight trend toward miscarriage when mefloquine is taken during the first trimester, but the data are not firm. Travel medicine physicians will prescribe mefloquine during the first trimester when exposure to chloroquine-resistant falciparum malaria is high and unavoidable. Inadvertent use of mefloquine during the first trimester is not an indication for pregnancy termination.

Doxycycline (Vibramycin, Doryx)

Doxycycline is an inexpensive tetracycline derivative that is more than 90% effective in all chloroquine-resistant areas of the world, including along the borders of Thailand. In addition to its effectiveness and low price, prophylactic doxycycline also prevents other serious diseases such as tick typhus, relapsing fever, plague, Lyme disease, and leptospirosis. A disadvantage is that doxycycline must be taken every day. One or two missed doses may put the traveller at risk for malaria.

Adult Dosage: 100 mg daily. Doxycycline should be started 1 to 2 days before exposure. It must be continued daily during exposure and for 4 weeks after departure from the malarious area. Some recommend taking the pill later in the day, as this is when the mosquito is becoming active, and the drug effect begins to decrease by morning thus any photosensitive effect should reduce.

Child Dosage; (for children older than 8 years of age) 2 mg per kg of body weight per day up to the adult dose of 100 mg daily.

Side Effects: Most travellers tolerate doxycycline well, but nausea, vomiting, and heartburn can occur. Doxycycline should be swallowed in the upright position with sufficient liquid or food to ensure complete passage of the tablet into the stomach. If the tablet or capsule gets stuck in the lower oesophagus it can cause painful mucosal erosions or even oesophageal perforation.

Doxycycline may cause photo toxicity, an exaggerated sunburn-type reaction. Avoiding prolonged, direct exposure to the sun, wearing a hat, and using a broad- spectrum sunscreen can reduce the risk, estimated at 2% to 10%. Women taking doxycycline may develop a vaginal yeast infection and are advised to carry a self-treatment dose (one 150 mg tablet) of the anti fungal drug fluconazole (Diflucan). Doxycycline is contraindicated for pregnant women and children under the age of 8 unless required for the treatment of a serious infection such as falciparum malaria or ehrlichiosis."

I think that just about covers it!

I have taken Doxy with no noticeable side effects, I'm fair skinned and burn easily but by taking the precautions I normally take against sunburn I have no problems. Don’t forget that the sun is MUCH stronger than we are used to in the UK, so unless you have a good tolerance to sun you will need to take precautions anyway, plenty of high SPF sun cream, and a wide brimmed hat especially around mid-day when the sun is at its strongest

Ivan

Victoria Falls...
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for Victoria Falls
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4. Re: Malaria - Malarone

Hi, have a look at www.victoriafalls-guide.net/malaria.html you will find most info that you need on this subject.

5. Re: Malaria - Malarone

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