Buying Malarone in Morocco or other west african country
 

I've planned to use Doxycycline against malaria when driving through africa, but I'm a bit worried about the "sun sensitivity" side affect. Malarone is my only alternative, since Lariam gives me dizzy spells. Malarone is VERY expensive here in Norway (about US$2000 per year), but I'm wondering if it can be bought in Morocco or other places in west africa cheaper.
Does anyone know? Can it be bought without a perscription?

Erik D.

www.dunia.no

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I'm a bit confused. Do you intend taking anti-malaria drugs for an entire year?

You can only take Doxycycline for six months. Malarone has a dosage limit of 37 days which will only give you 28 days protection (2 before, 28 in situ, and 7 after).

Terry,

According to the info I've recieved from several doctors (who don't know each other) using Doxy for a year is not a major problem.
I also personally know people who have used Malarone for nearly a year (the government payed the bill...) with no problems.
I think there was even a "public anouncment" regarding Malarone and that the FDA (or whatever it's called) in the US has given the green light for prolonged use.

Erik D.

www.dunia.no

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I would seriously check that you really need to take any anti-malarial for a year - exactly how long are you going to be in malarial regions?

Sam.

Sam,

As far as I've understood, from southern Mauritania and until we reach southern africa, we will be in potential malaria areas. This will take about a year...
Any thoughts?

Erik D.

www.dunia.no

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Sorry! Just thought I'd check - quite often people calculate their requirements on the length of the whole trip, not the malarial part of it!

Have a good one!

Sam.

Malarone is a drug manufactured by the UK company GlaxoSmithKline.

I have just talked by phone to their head of licensing. Malarone is still only licensed for 37 days continual use in the UK. He is not aware of any country, including Norway and the US that allows it to be used for longer periods. He was very concerned to hear that people are suggesting that it can be taken for a year.

There was a recent announcement by the US Food and Drug Administration (FDA) stating that Malarone has a better safety profile than the older antimalarial drugs.

Terry,

You are correct with the licensing for 37 days. But it seems that some people have "over looked" that rule and used it for longer instead of using Lariam.
Perhaps the 37 day limit is simple because GlaxoSmithKline haven't yet gone through the time consuming prosess of getting it cleared for longer(with the FDA etc.)? Hopefully this will eventually happen, since it seems to have less side affects than the other drugs.
Re. the FDA, it was probably your statement that I vagely ( and a bit incorrectly)remembered.

Bottom line: Malaria sucks...

Erik D.

www.dunia.no

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We are from the Netherlands and have the same issue. We'll be in Malaria territory for more than 4 weeks (probably much much longer) and my wife has so much side effects from Lariam that she is no longer allowed to use it. We went to the best hospital for tropical diseases in the Netherlands (the Harbour Hospital in Rotterdam). It is indeed true that doctors are only allowed to prescribe malarone for 35 days (which is effectively 4 weeks) BUT there are numerous research projects around the world for longer use of malarone. A research for use of 6 months has already been finalised and results were very positive. They are now doing research into more than 6 months use and my wife will participate in this research (and thus get a prescription for 1 year). The doctor at the hospital told us the only reason the official period is 4 weeks is that they have the legal obligation to prove by using several hundred 'human case studies' that there are no dangerous side effects from loger use (or less effectiveness).

Is it really wise to subject yourself to the known side affects for that long?
We're heading off next month for the standard trans-Africa over eleven months. Despite explaining that my wife is a total mossie magnet, the tropical desease specialist where we went for our jabs has very very strongly recommended against anti malaria drugs for such a long time.
He prefers to supply us with malaria treatment, with repeated prescription, that we take at the slightest onset of a symptom.
Added to that the copious use of DEET and Permethrin should (apparantly) do the job.
After all, it's better not to get bitten.
We'll let you know
Luke

There's pro's and cons.

I heard people being in favor of using malarone as cure rather then profylax. Taking the 'small' doses for longer periods as profylax encourages the developpment of resistent bugs, while taking it as a cure doesn't bother you to much (as long as you're early with it).

It seems that especially Benin is bad for Lariam resistent Malaria.