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Long term malaria meds?

South Florida...
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Long term malaria meds?

Hello. Will be in East Africa for approximately 9 months starting in September 2013.

Regarding malaria meds: I have a problem with Doxycycline. After about 2 weeks on 100 mg I start to experience nerve problems, pins & needles beginning in my hands and increasing up my arms. I've always had to stop the meds.

That leaves me with Lariam, which is hard on the system, or Malarone, which is extremely expensive, @ 250 USD for a 30 day supply! !!! I'm not sure either can be taken for such an extended amount of time. If I can't take them non-stop then in December I'll take a break, fly to Europe for a few weeks, and then return to EA/Nairobi in January and start the course again.

Does anyone have any suggestions from their own personal experience?

Edited: 01 March 2013, 17:59
Ottawa, Canada
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1. Re: Long term malaria meds?

you may find a number of people who stay a long period of time in a country actually give up on the malaria meds. They may get complacent, or just work harder with the local bug cream and long sleeves.

I took it the month I was in Tanzania, but I know I wasn't paranoid about any few bites that I got. I am not particularly attractive to mosquito, but did get a few bites. Other volunteers traded the expensive meds, for more protective clothing and bug cream.

How and what to take for this length of time is best discussed with a travel physician - not your family physician, but a specialist in travel medicine.

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2. Re: Long term malaria meds?

Likewise not sure just how long Malarone can be taken when considering long-term, so should be discussed with a Tropical Diseases specialist.

However, the military gives Malarone* to the soldiers for their extended tours of duty whether in Iraq and/or Afghanistan.

*the military had been using Lariam for years even after Malarone became available, till they woke up and realized the psych damage this was doing to the guys/gals, besides the many who had PTSD. I always wonder what took them so long to changeover, as they no doubt get these meds at discount prices.

kimanjo - if you have a drug plan, check to see if you can obtain at a discount... my plan does discount these. There's also a generic for Malarone (now available about a year) which price is about half that of the 'branded' tabs. $45/generic vs $95/branded... for a 30/day supply

Over the years, I've used both Malarone and Lariam with no side-effects from either; friends who had been in the Peace Corp years back before Malarone became available did take Lariam for 2/yrs with no side-effects.

All though must be discussed with a professional. Good luck!

Edited: 01 March 2013, 22:36
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3. Re: Long term malaria meds?

I agree . Talk to your Doctor to prescribe for you the best medication for you.

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4. Re: Long term malaria meds?

I spent 10 months in Africa in 2010, although not all of it was in malarial areas, and some was in low risk areas where I chose not to take anti-malarials. I did, however, take Larium for 5 months when in Tanzania and Zambia. When I saw my doctor about it, which was back in 2009, she said malarone hadn't really been tested for long term use and, at least in the UK, it wasn't recommended that doctors prescribe it for more than 8 weeks. Things may have changed since then though. Larium, however, is fine for long term use.

I had taken Larium in the past for holidays (before malarone was available) and remembered having very weird dreams as side effects. However, this time I had no noticeable side effects at all- possibly some slight hair loss. Plenty of people take it with no problems- all you can do is try.

Bungoma, Kenya
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5. Re: Long term malaria meds?

It might also be worth looking at posts for expectant mothers!! The reason I suggest this is because there is a lot of information about how to cope without taking any prophylaxis. (Which are not advised in early pregnancy).

What is important is WHERE you will be in East Africa. Some areas are much more malarial than others.

As you have been advised here, get advice from your travel clinic - you GP may not know the answer to this one!!

Global African
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6. Re: Long term malaria meds?


Malaria meds are a complex and personal choice, especially for long term use. I lived in a Malaria area for 18months and did not take meds. And manged to avoid it. You will find that people who live in Malaria areas do not gobble meds, they try to avoid being bitten and know the symptoms and go to be checked out if they think they have Malaria. Good thing about being in a Malaria area is the medical staff will recognise it much more easily than your doctor back home and will be efficient in treating it.

The most important thing is to avoid getting bitten - you can still get Malaria even if you are taking the meds, they just mask the symptoms. Also know the symptoms.

Avoiding being bitten is not as easy as it sounds. Do some research on the internet (and the tip above about how pregnant women cope is a good one). I'll give some of the things that are not always said. AVOID perfumes - in everything. So this means non-scented deodorant, bosy cream etc etc, not always that easy. Mossies are attracted to perfumes.

One perfume they do not like is Lavender. I used this as a perfume - few drops of aromatherapy grade lavender in non-scented bosy cream, and always kept a bottle next to my bed.

Use repellants rigourously (throughout the day), and long sleeves, trousers and SOCKS after dusk and before dawn.

Spray clothes, especially socks with a repellant that lasts over multiple washes. They can zap you through thick jeans so treatment of your clothes is a good protection. Mozzies are attracted to foot smell so sprayed socks are important!

Get one of those rechargeable mozzie bats that look like a tennis racket and keep it charged around your lodgings to zap em. Mosquito nets over the bed, preferably treated ones.

Light coloured clothing - they are attracted to dark colours and you cant see them as easily.

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7. Re: Long term malaria meds?

It also depends on where in East Africa you are staying. Not all spots are Malaria zones. We were in Kenya and did not need it. Only when going to Maasai Mara. Check with the CDC before you leave. They can advise. Good luck!

Ballarat, Australia
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8. Re: Long term malaria meds?

Doxycyclad allergy triggered a whole lot of subsequent allergies for me. It is an antibiotic and I don't believe should be used to prevent malaria.

My problem started with nerve endings getting sore, then I just swelled to the point my gums were so enormous I could not chew. I lost almost a third of my bodyweight and recovery took over 6 months!

If worried about long term use of any anti malarial, do your homework on ensuring high levels of vitamin B in your system.

The smell repells insects.

It is a naturopathic alternative, but you need to weigh up the benefits and risks for yourself. Too much for too long can muck up your other hormones!

I have a script for anti malarials, but am thinking of sticking to vitamin B supps from my naturopath and being vigilant with repellent and sensible clothing!

Such bad experience once has made me very cautious and suspicious.

Malaria is actually harder to treat if you do acquire it and you are on any form of anti malarials. None are 100% effective.

Then again malaria is a horrendous disease to contract and can remanifest in your system once you have contracted it, especially if you get a raging temperature from something else.

My brother survived black water fever, but still has problems occasionally.

Prevention is everything!

Thankfully The Gates Foundation is willing to pour money into much needed research!

The lives that could be saved with a truly safe and effective preventative!

Mtwapa, Kenya
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9. Re: Long term malaria meds?

Side effects with doxycycline are rare, it is approved in the UK for use of periods up to two years. It is frequently prescribed to teenagers for long term treatment of acne.

Mtwapa, Kenya
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10. Re: Long term malaria meds?

plus if you want your life by relying on a myth that there is no scientific evidence to support, that is your right, but could you please stop giving people the dangerous advice to do the same