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Chloroquine and/or Proguanil

This page provides information on the following medications:

Antimalarial tablets must always be used alongside mosquito bite prevention. These two measures together give you the best protection from malaria. However, rarely infection from malaria can still occur.

If you develop symptoms of malaria during your trip, or on return home, you must seek medical attention urgently, even if you have been taking your antimalarial tablets.

Chloroquine preparation

The following preparations of Chloroquine are available and licensed in the UK for malaria chemoprophylaxis:

  • Avloclor® 250mg tablets
  • Malarivon® Syrup 50mg in 5ml (as base) oral solution

Dose

  • The adult dose is 2 tablets taken once a week.
  • The child dose is determined by your child’s weight. This should be discussed with your doctor.

Chloroquine is very toxic in overdose, therefore special care must be taken to store this medication safely and out of the reach of children.

Patient information leaflet (PIL)

You should always read the manufacturer’s patient information leaflet (PIL) before taking any medications. The PIL lists the possible side effects of this medication and also lists any medicines that may be affected by taking it.

If you are regularly taking other medications (even over the counter tablets), you should always discuss this with your doctor or pharmacist to ensure it is safe to take chloroquine.

How to take the medicine

The course should be started one week before entering a country with a risk of malaria; taken weekly for the entire duration of your stay; and continued for 4 weeks after leaving the affected area.

  • Chloroquine should be taken with food and at the same time on the same day of each week.
  • If you miss a dose, you should take the missed dose as soon as you remember and carry on with your schedule. (you may have to get more tablets). However, if it is nearly time for the next dose, then you should skip the missed dose. Never take two doses at the same time.
  • Antacids (used to treat heartburn or indigestion), can reduce the absorption of chloroquine so these medications should be taken at least four hours before or after taking chloroquine.
  • It is very important to complete the course.
  • Chloroquine can safely be taken long term. You might be advised to undergo regular eye examinations and blood tests if you take chloroquine for a very long time as long term use can sometimes affect your vision. Speak to your doctor if you are unsure.

Other considerations

You should check with a doctor if you have kidney or liver disease, psoriasis, epilepsy (or a family history of epilepsy) before taking this medication.

Chloroquine is sometimes recommended for use in pregnancy.

  • If you are pregnant or breast feeding, you should always speak to your midwife or doctor for advice before taking anti-malarial medications or travelling to a malaria-endemic country.

Chloroquine commonly needs to be taken in combination with another antimalarial drug; for example Proguanil.  This is because there is known drug resistance to chloroquine when taken on its own from the most serious type of malaria (P.falciparum) in most regions of the world.

Proguanil preparation

Proguanil commonly needs to be taken in combination with another antimalarial drug; for example chloroquine or atovaquone. There are very few areas in the world where proguanil works effectively on its own.

The following tablets contain 100mg proguanil hydrochloride and are licensed in the UK for malaria chemoprophylaxis:

  • Paludrine® 100mg tablets

Dose

  • The adult dose is two tablets taken once daily at the same time each day.
  • The child dose is determined by your child’s weight. This should be discussed with your doctor.

Patient information leaflet (PIL)

You should always read the manufacturer’s patient information leaflet (PIL) before taking any medications. The PIL lists the possible side effects of this medication and also lists any medicines that may be affected by taking it.

If you are regularly taking other medications (even over the counter tablets), you should always discuss this with your doctor or pharmacist to ensure it is safe to take proguanil.

How to take the medicine

The course of proguanil should be started one week before entering a country with a risk of malaria; taken for the entire duration of your stay; and continued for 4 weeks after leaving the affected area.

  • The tablets should be taken with water after food, and at the same time each day.
    • If you forget to take a dose, you should take it as soon as you remember and carry on with the schedule (you may have to get more tablets). However, if it is nearly time for the next dose, then you should skip the missed dose. Do not take a double dose to make up for the missed dose.
  • Antacids (used to treat heartburn or indigestion), can reduce the absorption of proguanil so they should be taken at least four hours before or after taking proguanil.
  • It is very important to complete the course.
  • Proguanil is considered safe for long term use for up to at least 5 years’ however it may lose its effectiveness if continued long term. Always check with a doctor if you are unsure.

Other considerations

If you suffer from kidney disease, you should be assessed carefully by a doctor before taking this medication.

You should speak to your doctor if you take anticoagulant medications, such as warfarin as using this drug might increase your risk of bleeding.

  • You will need to start your course of proguanil well in advance of your departure date to make sure your clotting level is stabilised before you travel.
  • It may also be necessary to monitor your blood levels whilst you are overseas and again on return once you stop taking the medication.

Proguanil is sometimes recommended for use in pregnancy.

  • If you are pregnant or breast feeding, you should always speak to your midwife or doctor for advice before taking anti-malarial medications or travelling to a malaria-endemic country.

You should try to avoid becoming pregnant (conceiving) for 2 weeks after stopping this medication as the drug might still be in your system.

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