Can I begin taking 1 form of Malaria medication and then switch to another?

Question

I'm going to be travelling through Central America for an as-yet undetermined amount of time. My doctor has prescribed 20 weeks' worth of doxycycline.

My question is - if I end up being there for more than 20 weeks and can't get ahold of doxycycline, can I start taking Larium or Malarone etc?

In other words, can I just swap over from doxycycline?

Answer 1

Yes you probably can, but for safety you should overlap the medication.

Lariam (mefloquine) should be started 1 week before entry into the malaria endemic area, and continued weekly until 4 weeks after exit from the area. If you want to switch from doxycycline to Lariam, a reasonable policy would be to take the first dose of Lariam 1 week before you want to stop doxycycline, and continue doxycycline until you take the second dose of Lariam, and then stop the doxycycline.

Malarone should be started 1-2 days prior to entering the malaria endemic area and continued daily till 7 days after exit, so if you wanted to switch from doxycycline to Malarone, you could just overlap them by 2 days.

Do bear in mind, however, that taking multiple medications like that exposes you to an increased risk of adverse drug reactions, and the possibility of an adverse interaction between the two drugs.

If you are going for a very long period of time, I would actually suggest that you take Lariam instead of doxycycline. It's a weekly dose, which you may find less troublesome. In addition, doxycycline is associated with gastric upset, especially if not taken with a meal, and increases the tendency to get sunburns. On the other hand, Lariam is itself associated with side effects such as vivid dreams and insomnia.

If in doubt, do consult the doctor who prescribed you the medication. The CDC website also has good information on malaria prevention.

Answer 2

Yes, but you really don't want to be taking Malaria medications for more than 20 weeks.
I have heard good things about Malarone.
And, the thing about most Malaria medications is that the prevention is the same as the cure.
So stop taking after 20 weeks, and if you develop symptoms (a rare possibility after 20 weeks on doxycycline) go see a new Dr. and get some new drugs.
Most Dr's in S. America can speak English, and diagnose the symptoms of Malaria. And the treatment won't be all that expensive without health insurance.

Answer 3

There are 3 kinds of Malaria and each required a drug. You will have to take the drug during the trip, a week before another week after the trip. That is a lot of tablets to swallow.