This is a combination drug used for the treatment and the prevention of falciparum malaria. It contains 2 drugs, atovaquone and proguanil.

It works by killing the parasites in the blood and also in the liver. It is effective against strains of falciparum malaria which may be resistant to other antimalarials and so is especially useful for those travelling to places where there is a high risk of encountering malaria which is resistant to other drugs. It would be particularly useful for those individuals who cannot tolerate, or who are unable to take mefloquine.

It has other advantages; it only has to be taken 24-48 hours before entering a malaria-endemic zone and you only need to take it for 7 days after leaving the area. All other anti-malarials need to be taken for at least one week before entry and for 4 weeks after leaving the malaria zone.

The downside of malarone is its price. It is significantly more expensive than the other antimalarials.

The dose for the prevention of malaria is one tablet daily. It is not recommended for people who weigh less than 40kg (about 6 stone).

The commonest reported side effects are headache abdominal pain, and diarrhoea. It does not have the adverse neuro-psychiatric effects of mefloquine.

If you vomit within 1 hour of taking malarone, you should take another tablet. Take normally if you have diarrhoea. (if for prevention of malaria)

It is not recommended during pregnancy, nor if you are taking certain drugs. In particular, tetracyclines or a certain anti-nausea drug called metoclopramide.

Remember to discuss your itinerary with the nurse and contact MASTA before you start your immunisation schedule. Also please remember that no drug will give you 100% protection against malaria. Cover up from dusk to dawn, and use insect repellant.

Report any feverish illness to your doctor within 12 months of return from a malaria zone.

Further information

This article published on
08 February 2006

Next review date 2/1/2013


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