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Lariam - any bad experiences?

Travel Forums Central/South America & The Caribbean Lariam - any bad experiences?

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11. Posted by Isadora (Travel Guru 13926 posts) 9y

Quoting samsara2

Hi EdAngeli,

I havent ever taken malaria medication myself. But after seeing how Larium affected a friend I was travelling with in Brazil, I wouldnt touch it. As has been pointed out already, it can affect people differently, but this girl was reeeeeally sick with it. She took it about a week before heading off on a boat down the Amazon

I will have to take malaria medication for Asia and I'm NOT looking forward to it. I've been speaking with a GP who strongly recommended doxycyline over Larium.

What are your opinions about taking malaria medication continuously for a period of 3-4 months?

Thanks,
Evelyn

Though specific causative factors are not known, the adverse physical and psychological affects of Larium (mefloquine) do occur much more frequently in women than in men. It is also not recommended for divers as a reaction to Larium could be confused as nitrogen narcosis or decompression sickness.

Low-dose Doxycycline is used as an anti-malarial and as a long term treatment for acne (same dosages for both). Doxy has been approved for continuous use, up to two years in duration, and studies have shown few adverse reactions. Sensitivity to sun is still the most common and a yellowing of the tooth enamel when given to children does occur. A few cases of esophageal ulcers have been documented in people who took the Doxy at bedtime. (Basically, the Doxy caused an acid reflux type situation.)

Personally, I have no qualms about taking either chloroquine or doxycycline continuously for 6-8 months, twice the period you are inquiring about, Ev. Again, Doxy can interfere with the effectiveness of combination oral contraceptives (those containing estrogen and progestin as it acts upon the estrogen).

Doxy is also the recommended anti-malarial for those traveling through areas where different prophylactics may recommended. Doxy will be effective in areas just requiring chloroquine and in chloroquine-resistant territories. At this time, there are no doxy-resistant strains of the parasite.

12. Posted by Pardus (Respected Member 2356 posts) 9y

I've taken Lariam for about 12 weeks in Africa and I didn't notice any side effects on myself (and on other people I was with). One of the guys who had taken Lariam but then switched to Doxy said it took him about 1 hour in the morning to really wake up and get into gear.
I think whatever you decide - take it for a couple of weeks before you go (recommended anyway) and if you notice any side effects talk to your doctor and switch if they are bad. The side effects normally show up at the start of the program so if you're fine for the first 2 weeks then you're okay.

Just my 2 cents...

13. Posted by samsara_ (Travel Guru 5353 posts) 9y

Thanks Isa. ;)
I had decided I'd take Malarone, but honestly it's sooo expensive, I think it's going to have to be the doxy in the end.

I'll stay tuned to this thread for a bit I think...:)

14. Posted by Isadora (Travel Guru 13926 posts) 9y

Quoting samsara2

Thanks Isa. ;)
I had decided I'd take Malarone, but honestly it's sooo expensive, I think it's going to have to be the doxy in the end.

I'll stay tuned to this thread for a bit I think...:)

Malarone is the most effective prophylatic available because it is a combination drug. This does not mean the others aren't going to be effective, just are single compound meds. The cost is high because it's a combo and the newest on the market. (Both drugs contained in Malarone have been used separately for many years, it's the combined version that is relatively new.)

This is what is said about long term use of Malarone:

Atovaquone/proguanil (Malarone®)
Both components of Malarone® have been used individually on a long term basis, although there is little experience of long-term use of the combination. Many countries do not restrict the length of time atovaquone/proguanil can be taken although the UK product license states it can only be taken for travel up to 28 days. There is a report of atovaquone/proguanil use for periods from 9 to 34 weeks, in which there was no excess of adverse effects and no appearance of unexpected adverse effects. The ACMP (Advisory Committee for Malaria Prevention) concludes that there is no evidence of harm in long-term use and suggests that it can be taken confidently for travel up to one year or longer. Nevertheless, long-term use of atovaquone/proguanil should be prescribed with careful consideration until additional post licensing experience is available.

Source

Making a full assessment of each individual and recommending the right drug for a particular individual traveller is often the difficult part. In the case of Malarone as a general rule it will not be recommended during pregnancy or for those breast-feeding, unless it is the last option and the risk is high. We also have not received any data relating to its long-term use, although at an average cost of £36 for a week's holiday, it is more likely it will only be used for short trips. Malarone is also believed to produce lower blood levels for those taking certain medication and this should be discussed with your doctor prior to using any anti-malarial medication.
Source - Full text

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