Atovaquone with Proguanil

Preventing falciparum malaria while you travel, particularly where the parasite is resistant to other antimalarials.

This page is for prevention only. Treating malaria you already have is not something to order by post.

Atovaquone and proguanil attack the malaria parasite at two different points in its life cycle, including the stage in the liver.

Because it acts on the liver stage, the course only needs to continue for 7 days after you leave the area, rather than the 4 weeks some other malaria tablets need.

Adults, 18 and over, weighing 40kg or more.

Which malaria tablet is right depends on exactly where you are going, so tell us the countries and the regions rather than just the continent.

If you are pregnant, or might be, tell us and a doctor will decide with you: the advice is to avoid these tablets in pregnancy, and there are places where the alternatives are worse.

If you have been told you have kidney disease or reduced kidney function, tell us, because it is avoided where kidney function is significantly reduced.

You tell us where you are going and how long for, we read your answers and decide whether this is the right tablet for that trip, and if it is we dispense it and post it to you.

If we think a different tablet suits your destination better, we will say so rather than send you this one.

Tracked: Tracked delivery, arrives in two working days - Free

When it arrives: Every order is sent tracked. Where this page says in post today, it goes out today. Where it says in post tomorrow, it goes out the next working day. On the rare occasions a medicine is unavailable, we will contact you to talk about timing and alternatives.

We dispense clinically equivalent generic medications where available. Prices shown are for the generic version. If you prefer branded Malarone, let us know in your order form and we will confirm any price difference.

Atovaquone with proguanil from £49.99 per pack.

Common: headache, feeling sick, stomach pain, diarrhoea, cough, dizziness, vivid dreams or trouble sleeping.

Less common: hair thinning, anxiety, low mood, mouth ulcers, palpitations.

Rare: hallucinations, liver problems, seizures, severe skin reactions.

Taking the tablet with food reduces the stomach upset a good deal.

UKHSA advise avoiding these tablets in pregnancy. They may be considered in the second and third trimesters where there is no suitable alternative, so tell us and a doctor will decide with you rather than assume.

Use with care if you are breastfeeding, where specialist sources advise them only if there is no suitable alternative.

Avoid for prevention if your kidney function is significantly reduced.

Rifampicin and rifabutin reduce atovaquone levels substantially and should not be taken alongside. Metoclopramide and tetracycline also reduce the level.

Warfarin and similar anticoagulants may need closer monitoring.

Tell us everything you take, including anything you buy over the counter.

Pregnancy: UKHSA advise avoid, and they may be considered in the second and third trimesters where no suitable alternative is available. Whether there is a suitable alternative depends on exactly where you are going and what the malaria picture is there, so tell us on the order form and a doctor will come back to you. Where a conversation is the better way to do it, we will offer you one.

Breastfeeding: specialist sources advise using these tablets only where there is no suitable alternative, so tell us that too.

How to take it: one tablet once a day, at the same time each day, with food or a milky drink. Start 1 to 2 days before you arrive in the malaria area, keep taking it every day you are there, and carry on for 7 days after you leave.

Tablets are not the whole of it. Avoiding mosquito bites matters at least as much: cover up at dusk and after dark, use a repellent containing DEET, and sleep under a net where one is provided.

If you are unwell with a fever within a year of coming home, and especially within 3 months, tell a doctor where you have been. Malaria can appear after you get back.

If you are being sick or have bad diarrhoea while taking these tablets, less of the medicine is absorbed, so tell a doctor rather than assuming you are still covered.

Malaria tablets for travel are not available on an NHS prescription, so they are paid for privately wherever you get them.