Sunday, September 15, 2013

Antimalarials

For travel to some posts, the Department of State's medical staff recommend antimalarial medicine.  Malaria prevention is a basic issue for many countries and each medication option has its pros and cons per the CDC.  Recently I looked into the three currently-recommended primary options a little deeper and found some interesting info.

Malarone (atovaquone and proguanil hydrochloride): This is what the State med unit has prescribed for me on two occasions - for reference, I'm not taking any other medication, in good health, and have had no known reactions to it.  The State doctor allowed me to choose my medication, which I thought was good.  A benefit of Malarone over Doxycycline is that Malarone is taken only for one week after returning from the trip.

Larium (mefloquine): This is no longer made under its original brand name, but a generic version is still sold.  In July, the FDA increased its product warning, adding a "black box" warning label requirement because of the danger that the drug could cause serious neurological and psychiatric side effects, some of which can become permanent.  It certainly seems to have its issues to say the least: a 2001 Netherlands study showed 67% of the people who took the drug experienced one or more adverse effects, and 6% had side effects so severe they required medical attention.  Probably not good, but it might be better than contracting malaria.

Doxycycline: While this may have the fewest side effects, you have to take this daily, and you have to continue taking it for four weeks after you've returned from your trip.  Doxycycline also has an added benefit of being an antibiotic prescribed for some infections.

I mention this to help spread the word on these issues, particularly the recent increase in the Larium warning: please check with your doctor for their advice on the most appropriate medication.  It’s also an example of one of the strange issues you might face in the Foreign Service.  Personally, I’ll take the meds and the chance of side effects over contracting malaria.  I think the harder issue is when you have to choose for your child.


(This post written while listening to Give It Away Red Hot Chili Peppers.)

2 comments:

  1. Umm, I think you got the malarone wrong as you have an identical link for both drugs - July 30th NYTimes article on Lariam - Mefloquine.

    Lariam - aka Mefloquine is the one with side-effects and the anti-malarial drug that military invented, back in the 90s?

    Malarone does not have a black box warning and is given to those who can't take doxy, or those who have side effects on mefloquine.

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  2. My mistake – I apologize and thank you for the comment. I corrected the post accordingly. There’s a lot of misinformation on antimalarials and the last thing I want to do is make it worse!

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