Choosing an anti-malarial drug

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#1 Fri, 02/25/2011 - 17:04

Choosing an anti-malarial drug

We've evaluated these five options:

  1. Doxycycline (not acceptable for South America)
  2. Fansidar/Bimalar (affordable, serious side effects, not as effective as other drugs)
  3. Malarone (very expensive, few side effects)
  4. Mefloquine (very expensive, very serious and permanent side effects)
  5. No pills, only DEET and mosquito net (if you get malaria you're screwed)

After months of deliberation and consultation with our doctor in the US who merely said "pick any" before we departed, we finally decided on Bimalar and purchased two months worth in Guatemala (stationed in El Salvador now). Wanting to be extra sure we used the drug correctly we started searching the web for more info since the included instructions were in Spanish. Somehow we failed to realize one of us is extremely allergic to one of the main ingredients (sulfa) in Bimalar (epic frustration ensued).

So now it appears we need to get our hands on Doxy but have read it's not effective in South America. We're looking for advice on how to proceed. It seems like the best course of action is Doxy while we're in Central America and then we probably need to switch but the two recommended SA drugs (#3, #4) are fairly expensive and seem to have some nasty side effects. At this point we're extremely frustrated and #5 is looking like a pretty good option. Any info on availability, info concerning reactions to the drugs, and effectiveness in central/south american countries is greatly appreciated. Most importantly, we want to know what YOU did on your trip.


Sat, 02/26/2011 - 11:51

anti-malarial meds

Based on the research I've done (WHO, CDC, and traveldoctor websites), Doxycycline is fine for South America (it's Chloroquine that there's resistance to). So, you should be fine with Doxy the whole way through if that's the way you want to go. In addition, Chloroquine should be fine for Central America (as far as Panama City) and is much cheaper.

Fortunately, we have encountered hardly any mosquitoes throughout Colombia (including the Amazon Basin) and have decided not to start taking anything for the time being. We have a little bit of Doxycycline we bought in Cartagena (very expensive!), but our drug of choice in Chloroquine-resistant areas has always been Mefloquine. Neither of us has suffered any side effects in the 3 times we've used it, and it's convenient in only needing to take it once a week. We consulted with several doctors before we left about potential long-term problems with taking it for an extended period and they indicated we shouldn't be concerned...whatever that's worth. But I know some people can react poorly to it, so you may not want to risk trying it for the first time after you're already on the road.

Based on folks we know and have met while traveling, a common approach is not to take anything in prevention but be sure to have treatment meds on hand in case you develop symptoms and cannot get to a place for treatment right away.

Good luck!  Anne

Mon, 02/28/2011 - 06:16

malaria meds

We decided to take mefloquine for the choloroquine resistant areas, and didn't have any problems.  The nice thing about that is that you only need to take it once a week (as opposed to doxy, which you take every day).  Also, doxy makes you very sensitive to the sun, not good for pale gringas like me who are already sun-sensitive.  But like everything, you need to weigh the pros and cons for your own self and make a personalized decision.  We also stopped taking any malaria meds after we left Ecuador since we were sticking to the Pacific side of South America and didn't need to worry much about mosquitos since we were not rarely in the jungle.