Planning a trip to Africa, Asia or South America? Alongside your passport and travel insurance, malaria prevention belongs on your checklist. Malaria is a serious and sometimes life-threatening illness, but it is largely preventable. For many destinations, UK health experts recommend anti-malaria tablets together with careful mosquito bite prevention.

This guide explains what malaria is, how malaria tablets in the UK work, how the main antimalarial tablets compare, and what else you can do to protect yourself. If you are looking for malaria tablets in Manchester, it also explains what to expect at a consultation. If you would like advice tailored to your trip, our travel clinic in Manchester in Altrincham can review your itinerary and talk through your options.

What Is Malaria?

Malaria is a serious illness caused by a parasite called Plasmodium. It spreads to people through the bite of an infected female Anopheles mosquito, which usually bites between dusk and dawn. It is not normally passed from one person to another in the way a cold or flu is.

Several types of the parasite infect humans. Plasmodium falciparum is the type most often linked with severe illness, and it can become life-threatening quickly if it is not treated.

Early symptoms often look like flu: fever, chills, sweats, headache, muscle aches, tiredness, nausea and vomiting. Symptoms can begin about a week or more after a bite, and in some cases they appear months after you return home. Any fever while you are in a malaria area, or after you come back, should be treated as urgent. Always tell the doctor where you have travelled.

Who Is at Risk of Malaria, and Where?

Malaria occurs in parts of sub-Saharan Africa, South Asia, South-East Asia, Central and South America and some other regions. Risk varies a great deal by country, region, season, altitude and the type of trip, so a simple list of countries is not reliable. The UK Health Security Agency (UKHSA) publishes country-by-country recommendations for UK travellers every year, and the TravelHealthPro website explains them in plain language.

Travellers visiting friends and relatives (VFR) are an especially important group. UK data show that VFR travellers, particularly those travelling to West Africa, account for a large share of the malaria cases brought back to the UK. Any immunity you built up while growing up in a malaria country fades quickly after you move to the UK, and UK-born children have no natural protection at all. This is why people who think of their destination as home still need to take malaria precautions.

Prevention of Malaria Disease: The ABCD Approach

UK guidance sums up malaria prevention in four steps, known as ABCD.

• A: Awareness of risk. Find out whether your destination, and the region and season you are visiting, carry a malaria risk.
• B: Bite prevention. Use an effective insect repellent, such as one containing DEET, cover your arms and legs at dusk and dawn, sleep under an insecticide-treated net or in a screened or air-conditioned room, and consider plug-in vaporisers. If you do get bitten, our guide to the best antihistamine for insect bites can help with itching and swelling.
• C: Chemoprophylaxis. This is the medical term for taking anti-malaria tablets where they are recommended. No tablet gives 100% protection, so tablets should never replace bite prevention.
• D: Diagnosis. Get urgent medical help for any fever, during your trip or after you return, even if you have taken your tablets correctly.

Do You Need Malaria Tablets When Travelling from Manchester?

Whether you need malaria tablets UK guidance recommends depends on your destination, the region and time of year, how long you will stay, your health and other medicines, and whether you are pregnant, breastfeeding or travelling with children. For some places, only bite avoidance and awareness are advised. That does not mean there is no risk, so bite prevention matters just as much. For other destinations, tablets are recommended.

It is best to ask for advice at least four to six weeks before you travel, because some tablets need to be started well in advance and it is sensible to check how you tolerate them. Last-minute travellers can still get advice, so do not skip it. Malaria prevention is also only one part of pre-travel health. You may need vaccines too, so take a look at our page on travel vaccinations in Manchester and our travel health checklist.

Types of Antimalarial Tablets Available in the UK

The main anti malarial drugs used to prevent malaria in UK travellers are atovaquone/proguanil, doxycycline and mefloquine. All three are prescription-only medicines, so you need an assessment and a prescription from an appropriate prescriber. The notes below are general information, not a prescription. Always follow the advice of your prescriber and the patient information leaflet.

Malarone (atovaquone/proguanil) malaria tablets

• Taken once a day. It is usually started one to two days before you enter a malaria area, continued while you are there, and taken for seven days after you leave.
• The shorter course after travel makes it a popular choice for short trips.
• It is generally well tolerated. Possible side effects include nausea, stomach upset and headache.
• Generic atovaquone/proguanil contains the same active ingredients as the Malarone brand.
• It is not suitable for everyone, for example people with severe kidney problems, and pregnancy or breastfeeding needs specific advice.

Doxycycline

• Taken once a day. It usually starts one to two days before travel and continued for four weeks after you leave the malaria area.
• It is often a cost-effective option for longer trips.
• It can make your skin more sensitive to the sun, so use sun protection, and it can upset the stomach. Take it as directed, usually with food and a full glass of water.
• It is not suitable for pregnancy or for young children.

Mefloquine

• Taken once a week. It normally starts two to three weeks before travel, so any side effects show up early, and it continues for four weeks after you return.
• The weekly dose is convenient for long trips, but side effects can include vivid dreams and changes in mood.
• It is not suitable for people with certain mental health conditions or a history of seizures.
• TravelHealthPro has reported an ongoing UK shortage of 250 mg mefloquine tablets, so it may not always be available.

Chloroquine-based options are now rarely used for UK travellers, and Avloclor chloroquine tablets have been discontinued.

How to Choose the Right Anti-Malaria Tablets

There is no single best antimalarial for everyone. A prescriber will usually consider:

• Your destination, including any local drug resistance
• How long you will be away, and whether you will make repeated trips
• How much time you have before departure
• Your medical history and any other medicines you take
• Pregnancy, breastfeeding, and the age and weight of children
• Side effects you have had with antimalarials before
• Cost, because prices differ between medicines and trip lengths

Tips for Taking Malaria Tablets Safely

• Start on time. Begin before you enter the malaria area, exactly as your prescriber advises.
• Take them at the same time each day, or on the same day each week if your tablet is weekly.
• Finish the whole course after you return. Stopping early is a common mistake, and most malaria cases in UK travellers are linked to tablets not being taken as advised.
• Follow the leaflet if you miss a dose, and never double up without advice.
• Ask for advice if you are sick or have diarrhoea soon after a dose, because the tablet may not have been absorbed. Our advice on traveller’s diarrhoea may help.
• Keep tablets in their original packaging and carry them in your hand luggage. See our guide to travelling with prescription medicines.
• Keep using repellent and covering up. Tablets are only one layer of protection.

Malaria Treatment: What If You Get Malaria?

Malaria treatment is different from prevention. Tablets taken to prevent malaria are not a treatment, and you should never try to treat suspected malaria yourself.

If you develop a fever or flu-like symptoms during your trip or after you return, get medical help urgently. Call NHS 111 or go to A&E, and call 999 if you are very unwell, confused, having seizures or struggling to breathe. Tell staff you have travelled to a malaria area. Malaria is diagnosed with a blood test, and treatment uses prescription antimalarial drugs chosen according to the type of malaria and how severe it is. Treatment is often given in hospital. The sooner it starts, the better the outcome.

Malaria Tablets and Prevention Advice at Oldfield Pharmacy Travel Clinic, Manchester

At Oldfield Pharmacy, our travel clinic serves Manchester and Altrincham. Our pharmacist can review your destination, itinerary and medical history, explain your malaria risk, talk you through bite prevention, and advise whether antimalarial tablets are recommended for your trip. Our superintendent pharmacist is a qualified Independent Prescriber, so where it is clinically appropriate, we can discuss treatment options as part of a private prescribing consultation.

Malaria tablets are often just one part of your travel health plan. We can also advise on the typhoid vaccine, the hepatitis A vaccine and the yellow fever vaccine, and we offer same day travel vaccines in Manchester where suitable. For everyday healthcare, you can also rely on us as your pharmacy in Manchester.

Ready to plan your trip? Book your travel health consultation or call us on 0161 942 9701.

This article is for general information and is not a substitute for personal medical advice. Malaria advice changes, so check the latest UKHSA malaria prevention guidelines for travellers and NHS information on malaria before you travel.