I’m going to Tanzania for 4 weeks in July and need to sort out my meds.

There seems to be a few options, but having had no experience of any of them before, I don’t know where to begin. I asked the nurse when getting my Yellow Fever jabs and she didn’t really help at all, just presented me with options.

Malarone looks to be the best option so far, but is very expensive. I heard there are generic versions available though?

Although never diagnosed, I don’t think I’d feel comfortable with Larium due to its potential side effects for those with mental health issues. I’ll leave it at that.

Doxycycline seems cheap, but the idea that it could cause sensitivity to the sun while visiting Africa is a bit of a turn off.

All advice welcome, thanks in advance.

presented me with options

That’s neither a bad thing nor a sign of weakness

Tanzania has chloroquine resistance, so those 3 (non-chloroquine) options sound feasible, though this does not constitute professional advice

Your local travel clinic, or many pharmacies, will be able to advise if you want another point of view

(They will ask how long for, when and exactly where you’re going – most particularly if you’re exclusively spending time in highish mountainous regions)

I take malarone for periods of upto 7 weeks so far. Or rather the generic one. Never been bitten though so don’t continue for the 7 days when I get home. I do find I don’t sleep well with it all and have lots of crazy dreams but that might just be me or the nature of my work.

I’ve taken them all and survived (I think). If it’s only 4 weeks I’d be comfortable with larium but would probably just go for malarone unless I couldn’t afford it. Way more important though is sorting out your clothing, sprays and nets as none of them are 100pct effective

Whatever you chose, I’d suggest you try it early enough that, if it doesn’t suit you, you have time to get established on another before you go. I had unpleasant reactions quite quickly to both Chloroquine and Lariam, bad enough with the latter that I stopped taking it while abroad. But it was regarded locally as useless anyway, and had fallen from favour elsewhere.

I’ve had a lot of doxycycline, with the reaction to sunlight happening after two and a half years.

YMMV.

To buy Malarone cheaply

Get a cosultation with pharmasist at Asda (free) and buy tablets from them… half the price of my GP.

Oh God… not Larium – NEVER LARIUM… or Mefloquine as it is sometimes labelled.

Bad ass hallucinations (particularly lucid dreams) and destabilising for even pretty mentally robust people.

Plus I got malaria whilst taking it. Twice.

If I had any inkling of the side effects of Larium I would have stopped, during the prescribed taking it before you go period I was absolutely fine. Got into the jungle and it all went very, very odd pretty quickly – and then I was on it for a good couple of months. Got the souvenirs though (Vivax & Falciparum) to enjoy anwyay….

Thanks all, very helpful!

I think I’ll try and get an appointment at Asda then and find some generic Malarone.

You’ve sparked my interest now Kronos, are we talking full on fear and loathing? 😯

It gets well freaky, and I wasn’t the only one “enjoying” it.

But yes, never described it as full on fear and loathing, but that would be a pretty damn accurate description… particularly of the really odd stuff that happened whilst asleep and having really, really lucid/visual/messed up/trippy dreams.

I will never, ever touch the stuff again.

To the extent when I was told the cure would be yet more Larium – and a higher dosage – I decided to take my chances with the plasmodia instead.

The recurrences are now very, very rare – I think the last one was around the Swine Flu outbreak. I had that first then hit by the malaria the week after… fun times… and they are certainly getting less severe too, so I think I made the right choice!

Far better than being institutionalised in the name of being “cured” anyway!

i take doxycycline whenever I’m in malaria problem areas in asia.
I never had a problem with sensitivity to daylight from them, although I had major light sensitivity problems with a different kind of drug in europe a long timeago

When I last got Malarone on a private prescription it was around 3 quid a pill. So for 4 weeks plus the extras for either end you would not be looking at so much cash in the grand scheme of things.

Plenty of people are OK with Larium and Doxy but why would you risk it?

Went the Malarone way last time, seemed to work fine but it was coupled with lots of repellant and being sensible – don’t hang around at dusk etc.
Did get the very vivid dreams part to the end of the week – and I mean felt like real dreams jumping out of bed looking for the mice that had been crawling around… anyway that is down at the less likely end of things

I never got any reaction to Larium at all. Took it for three months I think.

*shrugs*

I’ve used doxy three times on trips to Indonesia (2 months straight, 1 month straight, 1 month straight) it was only after all that when I was prescribed it for something else in the uk that I got the sun sensitivity so it definately seems a gradual build up.

No medical fact to this but I never got a bad stomach either while over there either and I wondered if the doxy was protecting me from that too

I always take Larium, doesn’t affect me at all, the advantage is you only need to take it once a week and it’s cheap. It sent my wife loopy though. You can always switch if you get weird symptoms.

Generic malarone from Tesco or Asda is the way to go.

When there buy some Coartem to have as an emergency treatment (bring back with you).

I have taken Malarone and Doxy whilst in Africa. I found with the doxy I had to take the tablet directly after eating as I would throw it up otherwise it also made me quite constipated. Malarone on the other hand made feel a little vague and fuzzy, nothing major but just irritating. A guy I used to work with couldn’t take Malarone as it gave him insomnia.

We had one guy on site sent home as he had a Larium induced breakdown, but I also know a lot of people who take it with no real effects.

But remember kids, prevention is better than cure.

Malarone (tradename) / Atovaquone-Proguanil (generic) does not list mental health issues, vivid dreams etc as side effects. That’s Larium/mefloquine.

The advice you were given is correct, in that you should avoid chloroquine prophylaxis but the other 3 varieties will be fine. You can find up-to-date information from the NHS here: fit for travel

Malarone used to be expensive as its tradename was protected and produced under license. The generic, Atovaquone-Proguanil, is relatively cheap. You can get it for 2 quid a pill from the internet, so for 4 weeks away plus 1 week on return plus prescription fee it will cost you about 80 quid. Doxycycline will be cheaper but is an antibiotic with its own possible side effects. Your choice.

Enjoy Tanzania btw.

We did a consultation with a Superdrug pharmacist before going away for 6 months. Ended up paying £150 for everything (all jabs + 2x 6 months-worth of malaria tabs).

The reason I’m telling you this is that our £150 counted towards around £50 of points in Superdrug’s loyalty scheme so we got all our sun lotion for free. If you’re going to have to spend money on malaria prophylaxis, you may as well benefit from it.

I once mistakenly took 14 weeks worth of lariam in 14 days. The doc shat a brick. I got really, really lucky by the sound of it.

Probably not if you stay on the mainland but if you are thinking of doing some scuba diving, possibly on Zanzibar, then lariam is definitely out.

Dunno if it’s a another direct side-effect or (quite possibly) booze/de-hydration/diet related – a group of us went to Tanzania years ago & one guy taking larium had wild constipation for about a week, he was not pleasant to be around during this time… it ended with him suddenly sprinting down the road, frantically undressing Tom Dumoulin-style as he went, in search of the nearest hole in the ground.

konagirl – Member
Malarone (tradename) / Atovaquone-Proguanil (generic) does not list mental health issues, vivid dreams etc as side effects. That’s Larium/mefloquine.

It does under the professional section, I was warned about it by the GP who suggested it.

Psychiatric
Psychiatric side effects including strange or vivid dreams (7%), insomnia (3%), anxiety (less than 1%), and depression (less than 1%) have been reported.[Ref]

https://www.drugs.com/sfx/malarone-side-effects.html

I took Doxy for nearly thee years with no problems.

Never been bitten though

How do you know? Just because you it doesn’t come out in a lump doesn’t mean you haven’t been bitten.

OP, take some repellent too. Cover up in the evenings.

I do find I don’t sleep well with it all and have lots of crazy dreams but that might just be me or the nature of my work.

I found the same when I took it so switched to taking it in the morning rather than evening and the weird dreams and restlessness stopped.

I do find I don’t sleep well with it all and have lots of crazy dreams but that might just be me or the nature of my work.

I found the same when I took it so switched to taking it in the morning rather than evening and the weird dreams and restlessness stopped.

I’ve been travelling on business in tropical Africa (including Tanzania) for 35 years and my British colleague in Lagos has lived there for 15 years. Neither of us takes anti-malaria drugs and neither of us has ever had malaria. When I first started travelling I took the Boots Chloroquine and (I think) Proguanil tabs but stopped when I realised they were useless. Later I tried something more heavy-duty like Fansidar but it messed up my vision so I stopped.

The “accepted wisdom” amongst older expats who live in Africa is that it’s better to know you’ve got malaria then go and get it treated but I’d rather not get it at all. This means not getting bitten; stay in air-conditioned hotels and don’t open the window. Spray the room before going to bed. Wear long sleeves (a smart long-sleeved shirt is now the standard “uniform” for business people in Africa) and put a DEET insect repellent on your ankles because mozzies like to cruise around in the footwells of cars and will bite through socks. Wear long trousers and long sleeves outdoors at night and rub DEET on exposed skin.

If you take these precautions are you are in a city you will have to be extremely unlucky to get malaria. You have to be bitten by the female of one of five different species of mosquito and she has to have bitten somebody else with malaria, which in a city environment is less likely than in the country where people live in huts. The WHO tells us that malaria is on the retreat anyway.

However if you are doing a job out in the bush and living in places with louvre windows or straw roof, going out at night and wearing shorts and T shirts you must ignore all the stuff above and think seriously about a powerful anti-malarial drug. The best advice is from BA travel clinics or the tropical medicine hospital clinics in Liverpool and London.

PS: DO get your yellow fever jab and certificate because in common with almost every other African airport, the airport manager’s family and pals when they need to earn a bit of cash will put on a white coat, set up a desk and demand to see arriving visitors’ certificates, taking bribes off them if they haven’t got one or if, more commonly, they are carrying a fake certificate. No doubt the airport manager gets a cut of the takings.

Maybe Larium did have an effect, now I’m seeing double 😛

EDIT:dagnammit

We took larium when we spent 2 weeks in tanzania, the technicolour dreams were very trippy, but no other side effects. My son was 4 years old and he used to call them his ‘shouty dreams’.

Was in Indonesia for a few months back in the 90s and took larium. Given the kind of jaunt it was the trippiness was quite fun, until I got the paranoia and lucid dreaming that scared the bejeesus out of everyone else. Screaming girls in the middle of the night is bad form in a hippy retreat.

As globalti said about yellow fever, plus for me the reaction after the injections was the worst of any, so arrange it in advance of leaving.

I’ve always taken Larium, once for 3 months. Liked the convenience of once a week. You get very vivid dreams particularly on the 2 nights after the tablet. It does depend what sort of dreams you get I guess. I quite looked forward to them. If you take it in the morning it can make you dizzy that day. As above not getting bitten is very important and taking the tablets when you get home. Have fun

Lots of great advice, thanks everyone.

I’m actually out there with 30 kids from our school doing a trip with Camps International. I’m one of 3 school staff going, so it’s probably not ideal for me to be tripping balls in my tent every night. We’re out in the bush and, I suspect, sleeping in tents, so I’m planning on dipping myself in DEET every few hours 🙄

Rockhopper – Member
I took Doxy for nearly thee years with no problems.

This.

Two years of doxy in Malawi, ending in January this year. No sun problems, cheap as out there (less than a pound for a month supply) and had the other positive/negative of seeming to help keep low level GI issues at bay compared to friends who stopped taking it for periods of time.

As above, deet laden spray, covering up and being careful all help though I also slept without a net for six months and was fine.

Obviously YMMV, many expats had malaria and simply dealt with it when it happend. For short trips prevention seems like a better technique than cure in my mind.

If you’re in big tents, the camp operator should provide nets and mozzie coils, which work pretty well. I would still take my own supply of mozzie coils though, a couple for each night.