I wrapped up my final immunizations this week, knocking out my third Hepatitis B shot, Meningitis (for all those dorm style accommodations), and the Flu.
Malaria doesn’t exist in Tahiti, New Zealand or Australia, so I won’t need to start popping pills until about January 27, 2009 – two days before I fly to Bali. I’ll then be on them until Europe, which is a long time.
After much research online, I settled on Doxycycline (1x/day). It’s side effects are tied to the digestive system, and sun exposure, which I can manage. It also happens to be the cheapest option (judging by costs in the USA, and we all know we’ve got the highest in the world), and most widely available (at least from what I could tell on the BootsnAll forums).
My findings on Lariam (Mefloquin, 1x/week) were startling and quite scary. Side effects include anxiety (I’m already an anxious guy), nightmares, strange, dreams, depression, and many people believe it has lead loved ones to psychotic episodes, and even suicide. The first article/investigation I read was “The Dark Side of Lariam” on CBS’ 60 Minutes website (2003). I continued to read more, and found some scary comments left in the Guestbook of To Lariam or not to Lariam. Below are a few of the more recent ones:
Thanks for the site … been a year since I have taken Lariam and finally am beginning to feel 100% normal; Can’t believe that they prescribe this drug. — Tim 10/20/07
Suffered similar side effects as described here minus the vomiting and diarrhea. Only took three tablets but the severe effects lasted 5 weeks after the last while dizziness, weakness, memory loss, mood swings and delirium seems to have lasted up to 3 months from last tablet. It was very reassuring to read the story and see somebody else had gone through what I’m experiencing. I felt I was going crazy as the side effects are so weird. My advice to anyone, don’t take Lariam when there is safe alternatives such as Malarone or Doxycycline. — Andy 10/16/07
If you’re planning a trip, do a Google search for “lariam” before picking a malaria medication.
Malarone (1x/day) is a newer drug, however it is cost prohibitive for someone like me planning to be away for a long period of time, at least based on US costs.
Chloroquin (1x/week) gave me no side effects when I took it on my past two trips to Central America, however it has been so widely used, the malaria has become resistant to it in much of the world.
Do you have a preference for malaria medication?
Article Series - Pre-trip Immunizations
- Immunizations, Vaccines, and Shots (Oh My!)
- Meet the Needles
- Shot Through the Arm, Yellow Fever to Blame
- Choosing a Malaria Medication
About the Author:
Dave is the author of 1526 posts on Go Backpacking.
Dave (Editor-in-Chief) blogged his way around the world from 2007-2009, and then started Travel Blog Success to teach others how to do the same. When not writing, he can be found salsa dancing in Medellin. Follow him on Twitter @rtwdave or look for him on Google+
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Categories: Planning, Travel Health & Insurance
32 Comments
Hey, Dave.
Not sure if you were planning to buy the doxycycline before leaving the States and then carry it with you the whole time, but if so, I thought I’d mention that Wal-Mart and Sam’s sell doxycycline for only $4. You can get 30 of the 50 mg, or 20 of 100 mg. Of course, you’ll need a prescription before you can get either one.
Yea, I’ve got a prescription for 60 pills, though I’m re-thinking getting it filled now cause I’d just be carrying it around for 2 months. I may as well pick it up as I prepare to leave Australia.
I got a 15 pill prescription to test it out on myself while still in the USA. I feel a bit silly about it, however I think I’m going to get it filled this weekend and make sure I have no ill effects.
I almost believe I use to take this particular antibiotic to treat acne, in which case it’ll have a double benefit!
Hey, Dave.
Not sure if you were planning to buy the doxycycline before leaving the States and then carry it with you the whole time, but if so, I thought I’d mention that Wal-Mart and Sam’s sell doxycycline for only $4. You can get 30 of the 50 mg, or 20 of 100 mg. Of course, you’ll need a prescription before you can get either one.
Yea, I’ve got a prescription for 60 pills, though I’m re-thinking getting it filled now cause I’d just be carrying it around for 2 months. I may as well pick it up as I prepare to leave Australia.
I got a 15 pill prescription to test it out on myself while still in the USA. I feel a bit silly about it, however I think I’m going to get it filled this weekend and make sure I have no ill effects.
I almost believe I use to take this particular antibiotic to treat acne, in which case it’ll have a double benefit!
Hi Dave,
Good post. The question of which Malaria medication to take (or whether to take one or not) is a serious question and one posed my many folk before heading off into the unknown, and for good reason, too. The potential consequences of taking or not taking some form of anti malarial are huge, and I think you’ve indeed been wise to delve deeper into the subject and do your own research.
With so many types on the market, and so much information on the internet about each, you’d have to be crazy not to conduct your own independent study into which (if any) will be best for you and your tailored trip. It’s imperative to get a balanced picture and then, and only then, make your decision.
Before my first trip to Asia I read up and eventually plumped for doxy as I knew some areas I would pass through were resistant to other forms of anti-malarial and some of the anti malarials, as you quite rightly mentioned, potentially had some real nasty side effects. Anyway, I bought loads of doxy in advance (enough for my whole intended trip, which cost a small fortune) only to find that I could have bought them in a Bangkok pharmacy for a fraction of the price. My point is this: during the research stage, it’s also worth checking if you can get them (for certain) in your intended countries. You could save a fair bit of cash this way for a long journey. But obviously it’s not worth chancing it unless your 100% sure you will be able to pick them up!
As it panned out, over time I read more about the anti-malarials and the powerful effect they can have on your body and wound up not taking any at all. I guess it’s just a personal decision and only one that an individual can make, and based on the current risk in whatever area you are in. Essentially, you have to weigh that up and take it from there.
The day I decided to stop taking them I also made a conscious decision to drop everything and get the hell out of an area immediately if there became an increased risk of malaria, and thought a little longer about potential places I would visit. Again, if I felt the risk was too high I would think carefully before going there or wait until the risk had decreased, after all I was away for a long time so this was a valid option.
I didn’t take anti-malarials for years after that, but then decided to take them when I got to the Bay Islands, Honduras. On the way up there we learnt, from locals, that there was an increased risk of malaria at that time. In any event, I got hold of some and started taking them, and my bloody hair began to fall out! Seriously, within two weeks of starting them it was coming out in clumps. I lived on Utila for around 3 months and after a little while there I talked to loads of travellers residing there permanently (such as dive instructors/Divemasters etc) and learnt that many of these folks didn’t take them, the locals didn’t take them, and the risk of Malaria wasn’t as bad as I had thought. I stopped taking them after a few weeks yet my hair continued to fall out for another 3 months afterward. Eventually it stopped but by then my long hair had started to look real bad – really thin and not good at all.
All’s ok now, but I dare say that has put me off anti-malarials for life. I would take them again if the risk was hideously high, but I would also think even more carefully first and only chomp them down if it was deemed absolutely essential. But this is just my experience of them. Everyone has to read up and make a decision based on medical facts and from a wide variety of sources.
Wow, Nathan, thanks for sharing (I’m also glad to know you’re still out there reading!).
Do you recall which drug you took which caused the hair problem? It’s quite alarming, not that I have much hair anymore.
If I did in fact use to take the Doxy for acne (in my early 20′s), then I’ve already experienced taking it for more than a year with no ill effects. It might not be as effective as the other options, however in a way, it’s my closest option to not taking anything at all (which I’m not yet ready to do).
Hi Dave,
Good post. The question of which Malaria medication to take (or whether to take one or not) is a serious question and one posed my many folk before heading off into the unknown, and for good reason, too. The potential consequences of taking or not taking some form of anti malarial are huge, and I think you’ve indeed been wise to delve deeper into the subject and do your own research.
With so many types on the market, and so much information on the internet about each, you’d have to be crazy not to conduct your own independent study into which (if any) will be best for you and your tailored trip. It’s imperative to get a balanced picture and then, and only then, make your decision.
Before my first trip to Asia I read up and eventually plumped for doxy as I knew some areas I would pass through were resistant to other forms of anti-malarial and some of the anti malarials, as you quite rightly mentioned, potentially had some real nasty side effects. Anyway, I bought loads of doxy in advance (enough for my whole intended trip, which cost a small fortune) only to find that I could have bought them in a Bangkok pharmacy for a fraction of the price. My point is this: during the research stage, it’s also worth checking if you can get them (for certain) in your intended countries. You could save a fair bit of cash this way for a long journey. But obviously it’s not worth chancing it unless your 100% sure you will be able to pick them up!
As it panned out, over time I read more about the anti-malarials and the powerful effect they can have on your body and wound up not taking any at all. I guess it’s just a personal decision and only one that an individual can make, and based on the current risk in whatever area you are in. Essentially, you have to weigh that up and take it from there.
The day I decided to stop taking them I also made a conscious decision to drop everything and get the hell out of an area immediately if there became an increased risk of malaria, and thought a little longer about potential places I would visit. Again, if I felt the risk was too high I would think carefully before going there or wait until the risk had decreased, after all I was away for a long time so this was a valid option.
I didn’t take anti-malarials for years after that, but then decided to take them when I got to the Bay Islands, Honduras. On the way up there we learnt, from locals, that there was an increased risk of malaria at that time. In any event, I got hold of some and started taking them, and my bloody hair began to fall out! Seriously, within two weeks of starting them it was coming out in clumps. I lived on Utila for around 3 months and after a little while there I talked to loads of travellers residing there permanently (such as dive instructors/Divemasters etc) and learnt that many of these folks didn’t take them, the locals didn’t take them, and the risk of Malaria wasn’t as bad as I had thought. I stopped taking them after a few weeks yet my hair continued to fall out for another 3 months afterward. Eventually it stopped but by then my long hair had started to look real bad – really thin and not good at all.
All’s ok now, but I dare say that has put me off anti-malarials for life. I would take them again if the risk was hideously high, but I would also think even more carefully first and only chomp them down if it was deemed absolutely essential. But this is just my experience of them. Everyone has to read up and make a decision based on medical facts and from a wide variety of sources.
Wow, Nathan, thanks for sharing (I’m also glad to know you’re still out there reading!).
Do you recall which drug you took which caused the hair problem? It’s quite alarming, not that I have much hair anymore.
If I did in fact use to take the Doxy for acne (in my early 20′s), then I’ve already experienced taking it for more than a year with no ill effects. It might not be as effective as the other options, however in a way, it’s my closest option to not taking anything at all (which I’m not yet ready to do).
malaria tabs really do seem to rip your guts to shreds :( not fun to be on them at all. I think a lot of side-effects on drugs are blown out of proportion. You need to be the rare person to have any. My plain old aspirin bottle carries a “can cause deafness and loss of hearing” warning. Google can be your friend and your foe (I have a female friend who is a hypochondriac). Google is definitely not her friend.
Lariam for sure doesnt have a good rep. Kinda wonder how that passed FDA regs but then the FDA is corrupt as heck anyway.
Stu –
I definitely can be like your friend, and I try to take what I find on the internet with a grain of salt. At the same time, seeing all the drug makers in the US get sued years after they had drugs approved by the FDA gives one pause. I’m going with my gut on this one, and we’ll see how it goes!
malaria tabs really do seem to rip your guts to shreds :( not fun to be on them at all. I think a lot of side-effects on drugs are blown out of proportion. You need to be the rare person to have any. My plain old aspirin bottle carries a “can cause deafness and loss of hearing” warning. Google can be your friend and your foe (I have a female friend who is a hypochondriac). Google is definitely not her friend.
Lariam for sure doesnt have a good rep. Kinda wonder how that passed FDA regs but then the FDA is corrupt as heck anyway.
Stu –
I definitely can be like your friend, and I try to take what I find on the internet with a grain of salt. At the same time, seeing all the drug makers in the US get sued years after they had drugs approved by the FDA gives one pause. I’m going with my gut on this one, and we’ll see how it goes!
I’m at that point as well and I had my little chat with the travel nurse, got stabbed in the arms a couple times, and have info sheets on malaria tablets that I haven’t looked at.
I’ve got to go back for a couple more jabs so have some time to decide which I want to take. She mentioned one tablet that they would prescribe three weeks before and then monitor you. Don’t like the sound of that. I also don’t like the sound of taking a table daily. I’m hopeless.
Thanks for the post and the comments… I’ve got some reading to do!
I’m at that point as well and I had my little chat with the travel nurse, got stabbed in the arms a couple times, and have info sheets on malaria tablets that I haven’t looked at.
I’ve got to go back for a couple more jabs so have some time to decide which I want to take. She mentioned one tablet that they would prescribe three weeks before and then monitor you. Don’t like the sound of that. I also don’t like the sound of taking a table daily. I’m hopeless.
Thanks for the post and the comments… I’ve got some reading to do!
I’ve used Malarone and had no side-effects or at least none I could attribute to the taking them.
And they’re covered under my drug plan so I got them for pennies a pill (or less after the deductible). Because Malarone is used to treat something else, it’s not considered a preventative (and therefore drug plan prohibited) drug. So see if it qualifies under yours and stock up before you go. (buy now store in parents’ fridge for 1-2 years before expiration)
Here’s some stuff I’ve found out in my research.
Things to consider. Malarone is almost impossible to get outside of the Western/northern world. It’s an attempt to stop resistance to it. But often you’ll find travellers with extra that they’d like to dump for free or minimal amounts on the road. You’ll see the messages on TT often
Also, my travel MD mentioned that certain drugs are good for some regions and useless in others. So you might be better off with a mixture of treatments. Ask yours about a mixture – start with Malarone continue with Doxy?? I’m so not a doctor so definitely follow up. And as someone already mentioned you can get Doxy anywhere for a lot less.
I’m with you on Lariam – very scarey.
I’ve used Malarone and had no side-effects or at least none I could attribute to the taking them.
And they’re covered under my drug plan so I got them for pennies a pill (or less after the deductible). Because Malarone is used to treat something else, it’s not considered a preventative (and therefore drug plan prohibited) drug. So see if it qualifies under yours and stock up before you go. (buy now store in parents’ fridge for 1-2 years before expiration)
Here’s some stuff I’ve found out in my research.
Things to consider. Malarone is almost impossible to get outside of the Western/northern world. It’s an attempt to stop resistance to it. But often you’ll find travellers with extra that they’d like to dump for free or minimal amounts on the road. You’ll see the messages on TT often
Also, my travel MD mentioned that certain drugs are good for some regions and useless in others. So you might be better off with a mixture of treatments. Ask yours about a mixture – start with Malarone continue with Doxy?? I’m so not a doctor so definitely follow up. And as someone already mentioned you can get Doxy anywhere for a lot less.
I’m with you on Lariam – very scarey.
Hi dave -
In answer to your question, I can’t remember what it was now. I know it wasn’t Doxy though. I’ll ask my girlfriend, as she was taking them too. I’ll get back to you on that.
cheers
Hi dave -
In answer to your question, I can’t remember what it was now. I know it wasn’t Doxy though. I’ll ask my girlfriend, as she was taking them too. I’ll get back to you on that.
cheers
thanks for the GREAT post! Very useful…
thanks for the GREAT post! Very useful…
A good question to ask when evaluating whether to take malaria medicine is “what happens if I get malaria?”
http://www.malariahotspots.co.uk/beenThere.asp
A good question to ask when evaluating whether to take malaria medicine is “what happens if I get malaria?”
http://www.malariahotspots.co.uk/beenThere.asp
A good question to ask when evaluating whether to take malaria medicine is “what happens if I get malaria?”
http://www.malariahotspots.co.uk/beenThere.asp
If you ever want to see a reader’s feedback :) , I rate this post for 4/5. Detailed info, but I have to go to that damn google to find the missed pieces. Thank you, anyway!
If you ever want to see a reader’s feedback :) , I rate this post for 4/5. Detailed info, but I have to go to that damn google to find the missed pieces. Thank you, anyway!
I did a lot of research on this a few years back when I went to Laos. I heard a lot of arguments against taking anything (including from a very experienced friend), as even if you get malaria, you'll be on the same medication (just in a considerably higher dose). In the end, I settled on Malarone, as in comparison to the others sounded so much better! It was actually fine and I had no reaction to it whatsoever, but on a later trip to Cambodia, I didn't take anything.
I'm about to head to Laos again and got myself a month's worth that was covered by my health insurance (so plenty affordable). The way I see it is that I really have nothing to lose by taking it and it's a bit of added security, but it really is a personal choice.
The important thing to remember that others here have said is that each medication is region-specific. Don't assume just because you took one pill in Central America that it will also work in Southeast Asia. Do some research before you go, and absolutely wear bug repellent!
P.S. This is a really fantastic website Dave!
Hi Aaron,
Thanks for checking out Go Backpacking and sharing your experience with malaria medications.
Hi Aaron,
Thanks for checking out Go Backpacking and sharing your experience with malaria medications.
Great! Thank for information, I'm looking for it for a long time,
I was so frustrated beacuse I couldn`t resolve this issue. Then I found your site in google and problem is solved. Thanks!
I took Lariam on my RTW trip and I was fine. My husband took Malarone, which was super annoying since it’s a daily pill. We backpacked around the Southern Hemisphere through several Malaria zones so we ran out of pills early on and ended up fine by taking non-medical precautions like wearing long sleeve shirts and using mosquito nets. I also slathered on the DEET mosquito repellent. I’ll probably mutate one day from the side effects ;)
It’s good to hear not everyone who takes Lariam has trouble, but I’ve heard enough stories to continue with my old standby, Doxycycline.