Hi Trys, and welcome to the HUBB!
There isn't a lot of information on the topic of long-term use of malaria prophylaxis, but there have been some studies on expats. Health Canada's advice
"At present, there is no evidence that long-term use of therapies currently recommended for short-stay travellers have significant adverse reactions. Doxycycline may be an exception, as studies have been confined to short-term travellers and persons using tetracyclines (at lower dosage) for skin therapy.
In general, guidelines for the prevention of malaria in long-term travellers or expatriates should not deviate significantly from standard recommendations for the short-term traveller."
Worth noting is that long-term would be considered 6-12 months or more. For up to 6 months, the suggestion is to follow the same regimen which you would follow for short-term use.
When you start and stop the pills dependson the actual drug you are taking. The following guidelines
are from the US Center for Disease Control website. Starting prophylaxis:
<font face="" size="2">"Malaria chemoprophylaxis with mefloquine or chloroquine should begin 1–2 weeks before travel to malarious areas; prophylaxis with doxycycline and atovaquone/proguanil can begin 1–2 days before travel. Beginning the drug before travel allows the antimalarial to be in the blood before exposure to the malaria parasite. Chemoprophylaxis can be started earlier if there are particular concerns about tolerating one of the medications. Starting the medication 3–4 weeks in advance allows potential adverse events to occur prior to travel. Should unacceptable side effects develop, there would be a greater window of opportunity to change the medication before the traveler’s departure."</font>
<font face="" size="2">"Chemoprophylaxis should continue during travel in the malarious areas and after leaving the malarious areas (4 weeks after travel for chloroquine, mefloquine, and doxycycline, and 7 days after travel for atovaquone/proguanil). "</font>
Hope this helps. Of course you know that avoiding being bitten is the best prevention, and you shouldn't rely on the malaria prophylaxis. So don't forget your mosquito repellent and long sleeves whenever the mossies are biting.
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