Malarone Malaria 250mg Tablets

Malaria Doctor Service

Malaria is one of the world's most lethal diseases and is spread by mosquitoes, present in many tropical and subtropical countries. There is no vaccination, however, malaria tablets are highly effective in preventing malaria.

You can order Malarone or generic Malarone tablets through our registered online doctor service. After completing the online assessment, our doctor will review your assessment and prescribe the selected medication where appropriate. Our pharmacy will then dispense and dispatch your prescription to your door.

Malarone
Malarone belongs to a group of medicines called antimalarials  and it is the original branded version of the combination medication atovaquone and proguanil hydrochloride.

• to prevent malaria
• to treat malaria

Malaria is spread by the bite of an infected mosquito, which passes the malaria parasite (Plasmodium
falciparum) into the bloodstream.

Malarone prevents malaria by killing this parasite. For people who are already infected with malaria, Malarone also kills these parasites.

Protect Yourself From Catching Malaria

People of any age can get malaria. It is a serious disease, but is preventable. As well as taking Malarone, it is very important that you also take steps to avoid being bitten by mosquitoes.

• Use insect repellent on exposed areas of the skin
• Wear light coloured clothing that covers most of the body, especially after sunset as this is the
  time when mosquitoes are most active
• Sleep in a screened room or under a mosquito net impregnated with insecticide
• Close windows and doors at sunset, if they are not screened
• Consider using an insecticide (mats, spray, plug-ins) to clear a room of insects or to deter mosquitoes from entering the room.

It is still possible to get malaria after taking the necessary precautions. Some types of malaria infection take a long time to cause symptoms, so the illness may not start until several days, weeks or even months after returning from abroad.

• See a doctor immediately if you get symptoms such as high temperature, headache, shivering and tiredness after returning home.

Visit the NHS Fit For Travel site before completing the online assessment, and find out if Malarone is the antimalarial you need.

NHS Fit For Travel

How Does Malarone Work?
Malarone works by killing the parasite that causes malaria. As you start taking the medication before you enter the malaria zone, there should be high enough levels of the drugs in your body to kill the parasite in case you are bitten by a carrier mosquito.

How Effective Is Malarone?
It is important to know that no anti-malaria tablet offers 100% protection against Malaria. Although the risk is greatly reduced, you should still take measures to protect against bites, such as covering your skin and applying insect repellent.

How Long Do I Need To Take Malarone Tablets?
You need to take Malarone / Generic Malarone daily for the length of your stay in a malarial zone, as well as 7 days after leaving, and 1-2 days before entering.

What Are The Alternatives To Malarone?
Depending on where you are travelling, you may also be able to take Lariam, Doxycycline, or Lariam. The NHS fit for travel website will give information as to which anti-malarial you need.

NHS Fit For Travel

What is the difference between Malarone and Atovaquone and Proguanil (Generic Malarone)?
Malarone contains the active ingredients Atovaquone 250mg and Proguanil 100mg. Medically there are no differences between Malarone and "Generic Malarone", as they both contain exactly the same amount of active ingredient.

Can I buy Malarone over the counter?
Malarone is a prescription only medication, so cannot be bought over the counter at a pharmacy. A doctor must assess whether it is suitable for you.

How does Malarone work?
Malarone works by killing the parasite (P. falciparum) which causes Malaria.

Is there a generic version of Malarone?
Yes, the generic form of Malarone is Atovaquone and Proguanil. Atovaquone and Proguanil is the name of the drug which is in the brand Malarone. As long as it is purchased from a reliable source (a registered UK pharmacy) then the doses will be bioequivalent with Malarone.

How many Malarone tablets do I need?
To calculate how many Malarone tablets you need, simply add 9 to the number of days you will be spending in the malarial zone. This accounts for the time spent in the area, 2 tablets for before leaving, and 7 for when you arrive back.

Read more about malaria at the NHS website for further information. NHS - Malaria.

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Possible side effects - Side Effects of Malarone / Generic Malarone
Malarone is a well-tolerated medicine, however, as with any medication you take, there is always a risk of side effects occurring. Some are more common than others, and often side effects may subside with the regular usage of the medicine. If the side effects do not subside, you should report them to us, or your GP.

Look out for the following severe reactions. They have occurred in a small number of people, but their exact frequency is unknown.
Severe allergic reactions - signs include:
▪ rash and itching
▪ sudden wheezing, tightness of the chest or throat, or difficulty breathing
▪ swollen eyelids, face, lips, tongue or other part of the body.

Contact a doctor immediately if you get any of these symptoms. Stop taking Malarone.
Severe skin reactions
▪ skin rash, which may blister and looks like small targets (central dark spots, surrounded by paler
area with a dark ring around the edge) (erythema multiforme)
▪ severe widespread rash with blisters and peeling skin, particularly occurring around the mouth, nose, eyes and genitals (Stevens-Johnson syndrome).

If you notice any of these symptoms contact a doctor urgently.

Very common side effects - These may affect more than 1 in 10 people:

Most of the other side effects reported have been mild and have not lasted very long.
▪ headache
▪ feeling sick and being sick (nausea and vomiting)
▪ stomach pain
▪ diarrhoea.
Common side effects - These may affect up to 1 in 10 people:
▪ dizziness
▪ sleeping problems (insomnia)
▪ strange dreams
▪ depression
▪ loss of appetite
▪ fever
▪ rash which may be itchy
▪ cough

Common side effects, which may show up in your blood tests are:
▪ reduced numbers of red blood cells (anaemia) which can cause tiredness, headaches and shortness of breath
▪ reduced numbers of white blood cells (neutropenia) which may make you more likely to catch infections
▪ low levels of sodium in the blood (hyponatraemia)
▪ an increase in liver enzymes.

For a full list of side effects, please read the Patient Information Leaflet.

If you get any side effects, talk to your doctor, our Rightdose pharmacists or nurse. This includes any possible side effects not listed in this leaflet.

You can help to make medicines safer by reporting any side-effects to the Yellow Card Scheme at www.mhra.gov.uk/yellowcard.

Before taking any medication, it is important to read the Patient Information Leaflet. You can find information leaflets for your medicines by typing them into the search bar at medicines.org, or by contacting us.

Patient Information Leaflet Malarone Malaria 250mg Film-coated Tablets (Pack of 12)

Remember to tell your doctor if you start taking any other medicines while you’re taking Malarone.

Other medicines and Malarone
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including medicines you’ve bought without a prescription.

Some medicines can affect the way Malarone works, or Malarone itself can strengthen or weaken the effectiveness of other medicines taken at the same time. These include:
▪ metoclopramide, used to treat nausea and vomiting
▪ the antibiotics, tetracycline, rifampicin and rifabutin
▪ efavirenz or certain highly active protease-inhibitors used to treat HIV
▪ warfarin and other medicines that stop blood clotting
▪ etoposide used to treat cancer.

Tell your doctor if you are taking any of these. Your doctor may decide that Malarone isn’t suitable for you, or that you need extra check ups while you’re taking it.

Malarone with food and drink

Take Malarone with food or a milky drink, where possible. This will increase the amount of Malarone your body can absorb, and make your treatment more effective.

Pregnancy and breastfeeding
If you are pregnant, do not take Malarone unless your doctor recommends it.

Do not breastfeed while taking Malarone, as the ingredients of Malarone may pass into breast milk and may harm your baby.

Driving and using machines
If you feel dizzy, do not drive. Malarone makes some people feel dizzy. If this happens to you, do not drive, use machines or take part in activities where you may put yourself or others at risk.

Malarone contains sodium
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium free’.

How to store Malarone

• Do not use this medicine after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month.
• Malarone does not require any special storage conditions.
• Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. This will help protect the environment.

Keep out of the sight and reach of children.

Before taking any medication, it is important to read the Patient Information Leaflet.

How to take Malarone Tablets

Always take your medicine exactly as your doctor has instructed you. You should check with your doctor or pharmacist, if you are unsure.

Your medicine should be taken by mouth as follows:

• Take Malarone with food or a milky drink, where possible.
• It is best to take Malarone at the same time each day.

Malarone and the generic version should be started 1-2 days before entering a malarial zone.

The adult dose is one tablet taken daily, 1-2 days before travelling to the risk area, taking one each day while in the area, and continuing to take one tablet daily for 7 days after leaving.

For preventing malaria

▪ if you are sick (vomit) within 1 hour of taking your Malarone tablet, take another dose straight away
▪ it is important to take the full course of Malarone. If you have to take extra tablets due to sickness, you may need another prescription.
▪ if you have been vomiting, it is especially important to use extra protection, such as repellents and bednets. Malarone may not be as effective, as the amount absorbed will be reduced.

To prevent malaria the recommended usual dose for adults is 1 tablet once a day, taken as below.

• Not recommended for preventing malaria in children, or in adults who weigh less than 40 kgs.
• Malarone paediatric tablets are recommended for preventing malaria in adults and children who weigh less than 40 kgs.

To prevent malaria in adults:
▪ start taking Malarone 1 to 2 days before travelling to an area which has malaria
▪ continue taking it every day during your stay
▪ continue taking it for another 7 days after your return to a malaria-free area.

For treating malaria

▪ if you have vomiting and diarrhoea, tell your doctor, you will need regular blood tests. Malarone will not be as effective, as the amount absorbed will be reduced. The tests will check whether the malaria parasite is being cleared from your blood.

To treat malaria the recommended dose for adults is 4 tablets once a day for 3 days.

For children the dose depends on their bodyweight:
▪ 11-20 kg – 1 tablet once a day for 3 days
▪ 21-30 kg – 2 tablets once a day for 3 days
▪ 31-40 kg – 3 tablets once a day for 3 days
▪ over 40 kg – dose as for adults.
Not recommended for treating malaria in children who weigh less than 11 kgs. For children who weigh less than 11 kgs talk to your doctor. There may be a different type of

If you forget to take Malarone
It is very important that you take the full course of Malarone.
If you forget to take a dose, don’t worry. Just take your next dose as soon as you remember. Then continue your treatment as before.
Don’t take extra tablets to make up for a missed dose. Just take your next dose at the usual time.

Don’t stop taking Malarone without advice - Stopping early puts you at risk of getting malaria, as it takes 7
days to ensure that any parasites that may be in your blood following a bite from an infected mosquito are killed.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Do not take Malarone:

• if you are allergic to atovaquone, proguanil hydrochloride or any of the ingredients 
• if you have severe kidney disease.

Tell your doctor if either of these apply to you.

Take special care with Malarone and consult with your doctor or pharmacist before taking Malarone if:

• you have severe kidney disease
• your child is being treated for Malaria and weighs less than 11 kg. There is another tablet strength to treat children who weigh less than 11 kg.

Tell your doctor or pharmacist if any of these applies to you.

You should also use bite prevention measures to minimise the risk of bites or contraction of the disease by using insect repellents containing deet, wearing long sleeve clothing and using mosquito nets, are all methods of ensuring you are reducing your risk of contraction of malaria.

What Malarone contains:

The active ingredients are: 250 mg of atovaquone and 100 mg of proguanil hydrochloride in each
tablet.

The other ingredients are:
Tablet core: poloxamer 188, microcrystalline cellulose, hydroxypropyl cellulose, povidone K30, sodium starch glycolate (Type A), magnesium stearate.
Tablet coating: hypromellose, titanium dioxide (E171), iron oxide red (E172), macrogol 400 and polyethylene glycol 8000.

What Malarone looks like and contents of the pack
Malarone tablets are round, pink film-coated tablets engraved ‘GX CM3’ on one side. They are supplied in blister packs containing 12 tablets.