Anti Malaria Drugs

[crudy21]

Wasn't sure where to post this as it covers quite few questions.

Heading to Saigon/Mekong Delta/Phnom Penh in a few weeks and was wondering about malaria protection.

Last time in Cambodia i bought some pills in Pattaya, the name of them escapes me but they were green and black capsules. This time we are heading to SGN from BKK and wanted to know where to buy some protection in lower Sukhumvit area but don't send me to that small pharmacy opposite NEP as they ripped me off last time i used them!!.

Also i read on some website that you need different medication for different areas?

Any help would be great

[crudy21]

Anyone?

[PST]

I'm no expert,but i would personally go to a local doctors surgery on sukhumvit, and get a prescription,as i am under the impression that very few pharmacies sell these OTC.

PST.

Edited July 4, 2009 by PST

[noahvail]

I'm no expert,but i would personally go to a local doctors surgery on sukhumvit, and get a prescription,as i am under the impression that very few pharmacies sell these OTC.

PST.

Very good advice. There are two common anti-malarial meds, neither of which I can name anymore (CRS syndrome lol). My doc back in NZ put me on a course of one when he found out I was moving here, but there's no malaria in this area, just dengue fever.

So a doc who knows the area would be the way to go.

[llso]

Try Doxycycline 100 mg per day for each day exposed to Malaria. It is widely available and dirt cheap (Thai brand). Continue for 7 days after leving malarial area. May cause hypersensitivity to sunlight but rare . And don't take if you have liver problems otherwise very safe and been around for ages antibiotic. I lived here for more than 7 years and never took anything and never caught anything. But I might have just been lucky.

LL

[jackdanielsesq]

Yeah - you and Jacko!!

Google it and get with a decent MD. It is not pleasant.

BR>Jack

Try Doxycycline 100 mg per day

[Maizefarmer]

Source from a hospital (versus a chemist on Soi whatever - and that includes Boots!) - the Doxycycline retail market in Thailand, along with anti-malarial meds is flooded with counterfeit (the figure in some areas is 80% plus counterfiet - the more out of town you are the greater the chance of been sold counterfeit). Oddly, some of these dodgy meds do have the requird active ingredient, but many don't and you just never know what you're getting - and don't let genuine looking packaging convince you.

[sunholidaysun1]

Source from a hospital (versus a chemist on Soi whatever - and that includes Boots!) - the Doxycycline retail market in Thailand, along with anti-malarial meds is flooded with counterfeit (the figure in some areas is 80% plus counterfiet - the more out of town you are the greater the chance of been sold counterfeit). Oddly, some of these dodgy meds do have the requird active ingredient, but many don't and you just never know what you're getting - and don't let genuine looking packaging convince you.

Good advice . Tons of fake medicines now and the packaging is very very hard to tell if at all against the real thing. God knows what is in these fake medicines, it wont be long before there are muliple deaths due to the fakes.

[Rinrada]

First came across Doxy when in PP in 1993 ..German Army Doc used to hand them out like sweets ...nice chap.....also handy for other little ailments like ...Gonni etc...Bit of info....amazing little things...

Doxycycline kills certain bacteria that cause infection, or stops their growth. It treats many kinds of infections of the skin, bone, stomach, respiratory tract, sinuses, ear, and urinary tract.

It also treats certain sexually transmitted diseases.

It is a broad-spectrum antibiotic, and not particular to one type of STD.

Doxycycline treats Chlamydia and Syphilis.

[kubota]

Wasn't sure where to post this as it covers quite few questions.

Heading to Saigon/Mekong Delta/Phnom Penh in a few weeks and was wondering about malaria protection.

Last time in Cambodia i bought some pills in Pattaya, the name of them escapes me but they were green and black capsules. This time we are heading to SGN from BKK and wanted to know where to buy some protection in lower Sukhumvit area but don't send me to that small pharmacy opposite NEP as they ripped me off last time i used them!!.

Also i read on some website that you need different medication for different areas?

Any help would be great

I'm working offshore around the world, and when we are in Malaria infected areas we always use Malarone, start the treatment few days before travel to the area.

I bought "malaria tablets" in Pattaya Memorial Hospital a few years ago, but when i came on board and showed this to the Medic, he said that we stopped using this 30 years ago, and i might as well be chewing candy

Malarone is the most common nowadays, but they are quite expensive, some of the drug they used 10-20 years ago gave serious side effects. but this one should be fine.

[Harcourt]

I don't know much about it, but I DO know that Indian Tonic Water (Schweppes) still has quinine in it.

Drink about 20 Gin and tonics per day, starting at breakfast

[Rinrada]

I don't know much about it, but I DO know that Indian Tonic Water (Schweppes) still has quinine in it.

Drink about 20 Gin and tonics per day, starting at breakfast

Agree absolutely.........but dont forget the Lime....or if English....Lemon.....

on the other hand bit more info...from wiki...

I tried MALOPRIM many years ago when in the M.Navy (on the Hanoi run) and had really yucky side effects that I have never taken any since but as the Thais say...up 2 you.

The following regimens however are recommended by the WHO, UK HPA and CDC for adults and children aged 12 and over:

* chloroquine 300 to 310 mg once weekly, and proguanil 200 mg once daily (started one week before travel, and continued for four weeks after returning);

* doxycycline 100 mg once daily (started one day before travel, and continued for four weeks after returning);

* mefloquine 228 to 250 mg once weekly (started two-and-a-half weeks before travel, and continued for four weeks after returning);

* Malarone 1 tablet daily (started one day before travel, and continued for 1 week after returning).

Other chemoprophylactic regimens that are available:

* Dapsone 100 mg and pyrimethamine 12.5 mg once weekly (available as a combination tablet called Maloprim or Deltaprim): this combination is not routinely recommended because of the risk of agranulocytosis;

* Primaquine 30 mg once daily (started the day before travel, and continuing for seven days after returning): this regimen is not routinely recommended because of the need for G-6-PD testing prior to starting primaquine (see the article on primaquine for more information).

* Quinine sulphate 300 to 325 mg once daily: this regimen is effective but not routinely used because of the unpleasant side effects of quinine.

[Rinrada]

I don't know much about it, but I DO know that Indian Tonic Water (Schweppes) still has quinine in it.

Drink about 20 Gin and tonics per day, starting at breakfast

Agree absolutely.........but dont forget the Lime....or if English....Lemon.....

on the other hand bit more info...from wiki...

I tried MALOPRIM many years ago when in the M.Navy (on the Hanoi run) and had really yucky side effects that I have never taken any since but as the Thais say...up 2 you.

The following regimens however are recommended by the WHO, UK HPA and CDC for adults and children aged 12 and over:

* chloroquine 300 to 310 mg once weekly, and proguanil 200 mg once daily (started one week before travel, and continued for four weeks after returning);

* doxycycline 100 mg once daily (started one day before travel, and continued for four weeks after returning);

* mefloquine 228 to 250 mg once weekly (started two-and-a-half weeks before travel, and continued for four weeks after returning);

* Malarone 1 tablet daily (started one day before travel, and continued for 1 week after returning).

Other chemoprophylactic regimens that are available:

* Dapsone 100 mg and pyrimethamine 12.5 mg once weekly (available as a combination tablet called Maloprim or Deltaprim): this combination is not routinely recommended because of the risk of agranulocytosis;

* Primaquine 30 mg once daily (started the day before travel, and continuing for seven days after returning): this regimen is not routinely recommended because of the need for G-6-PD testing prior to starting primaquine (see the article on primaquine for more information).

* Quinine sulphate 300 to 325 mg once daily: this regimen is effective but not routinely used because of the unpleasant side effects of quinine.

[Rinrada]

Sorry double post...firefox playing up...

[henryalleman]

Yeah - you and Jacko!!

Google it and get with a decent MD. It is not pleasant.

BR>Jack

Try Doxycycline 100 mg per day

You don't have to take it before hand, when you get Malaria you take 4 tablets a day for 4 following day's and you will get over it. Not any malaria vaccin give 100 % protection.

For all correct information

website of the world famous tropical institute in Antwerp

http://www.itg.be/itg/

have in English language

[Tim207]

Wasn't sure where to post this as it covers quite few questions.

Heading to Saigon/Mekong Delta/Phnom Penh in a few weeks and was wondering about malaria protection.

Last time in Cambodia i bought some pills in Pattaya, the name of them escapes me but they were green and black capsules. This time we are heading to SGN from BKK and wanted to know where to buy some protection in lower Sukhumvit area but don't send me to that small pharmacy opposite NEP as they ripped me off last time i used them!!.

Also i read on some website that you need different medication for different areas?

Any help would be great

I would be more concerned about Dengue, also born by mosquitoes. No medicine prevents it so mosquito avoidance is the prevention which incidentally works for malaria also.

[astral]

The local advice, practiced by the Thai military is do not take anything.

However, any fever get yourself to a doctor immediately.

[Rionoir]

If you are really concerned about this, why don't you talk to a doctor at BNH or some other decent hospital. The consultation fees are cheap and generally better than getting ur medical advice off of the general forum on thaivisa... lol

[soundman]

Moved to medical forum.

[shubh]

These drugs are usually available in pill form and are often required to be taken with a glass of milk. Milk coats your stomach and helps treat nausea from the medication, although taking the medication with food is also an option. There is a typical loading period of one to two weeks while your body adjusts to the medicine. Fake anti-malaria drugs have been the most noticeable among such illicit drugs.

[Gaccha]

This is not something to mess around with, falciparum malaria is fatal in 20% of cases when not immediately treated.

You need to see if any of the regions you are going to are resistant to chloroquine (this is mostly sub-saharan Africa). Check this:

"Thailand

Malaria risk exists throughout the year in rural, especially forested and hilly, areas of the whole country, mainly towards the international borders. There is no risk in cities and the main tourist resorts (e.g. Bangkok, Chiangmai, Pattaya, Phuket, Samui). P. falciparum resistant to chloroquine and sulfadoxine–pyrimethamine reported. Resistance to mefloquine and to quinine reported from areas near the borders with Cambodia and Myanmar. "

etc. (see http://www.directchemist.com/malarone_ht_58.html)

Then the treatment can be determined:

http://www.merck.com/mmpe/sec14/ch186/ch18...#S14_CH186_T002

(this is the internationally famous Merck Manual online)

Malarone is the brand name for a drug that contains both atovaquone and proguanil, both mentioned in the very detailed chart in the link above. Follow the link and you won't end up dead.

There. Have a good trip.

[walterego]

Try Doxycycline 100 mg per day for each day exposed to Malaria. It is widely available and dirt cheap (Thai brand). Continue for 7 days after leving malarial area. May cause hypersensitivity to sunlight but rare . And don't take if you have liver problems otherwise very safe and been around for ages antibiotic. I lived here for more than 7 years and never took anything and never caught anything. But I might have just been lucky.

LL

Spot on! Doxy is also recomended treatment (in large doses) for Pneumonic Plague which keeps dangerously appearing not far away. (a very very nasty disease) It will clean up that Syphilis also.

Such a good all rounder. I keep a good stock.

[Colour]

Ah well!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[PeaceBlondie]

When I moved to the beach in southernmost Mexico 1/1/2000, a recent Ph.D. graduate in tropical diseases (earned in London) advised me to take quinine. The US Army expert MD in tropical diseases agreed it wasn't harming me,

[FBN]

Both Quinine and Chloroquin is not used any more; Quinine only with certain indications as treatment in combination with other drugs.

Multiple drug resistant strains are common in the malaria affected areas of Thailand and Doxicycline is the current prophylaxis.

[Sheryl]

Should note though that malaria transmission is limited to specific, fotreasted areas in SE Asia. There is NO malaria transmission in the cities nor in most rural towns and villages. You pretty well have to spend the night in the jungle to be exposed, not something most people do. Unless your itinerary is quite unusual, you are unlikely to be in an endemic area, and prophylaxis is thus probably not needed.

If for some reason you are going to be after dark in remote forests, then as FBN said, doxycline.

And for treatment of malaria, if falciparum malaria, it is currently artemisine or an artemisinin/mefloquine combo.

[Chaimai]

I have been recommended LARIAM as a Malaria preventative and also as a deterrent to mozzies.

Whilst I do not feel particularly exposed to Malaria (living in a town 50km from Cambodia) the little buggers do seem to take a liking to me. I am just seeking to prevent this discomfort.

The friend who had a similar problem now claims to be bite-free.

I am concerned by some reports of extreme side-effects.

Is the risk of side effects worth taking for the benefit of perhaps deterring the mosquitos ?

[bumrungrad]

To the OP:

We have launched a new Travel Medicine Center here at the hospital which is specifically geared to give you the right medicines and advice for the right locations.

Unfortunately, the Center is so new that we don't have the page up - it should be posted by middle of next week.

Contact details:

Location

Bumrungrad International Clinic building, 15 Floor, station A, C

Contact Us

Phone 66 (0) 2667-1555

[Sheryl]

I have been recommended LARIAM as a Malaria preventative and also as a deterrent to mozzies.

Whilst I do not feel particularly exposed to Malaria (living in a town 50km from Cambodia) the little buggers do seem to take a liking to me. I am just seeking to prevent this discomfort.

The friend who had a similar problem now claims to be bite-free.

I am concerned by some reports of extreme side-effects.

Is the risk of side effects worth taking for the benefit of perhaps deterring the mosquitos ?

Lariam does not work by reducing ir discouraging mosquito bites. Its action is on the replication of the malaria parasite within the body after being bitten by a mosquito carrying the parasite. So it will have no effect at all on the problem of being bitten. And as noted earlier in this thread, (1) malaria prophylaxis not indicated for most people living or traveling in Thailand and (2) when prophylaxis is used, lariam not the best choice.

So as we say in my home town, fuhggedaboutit.

For the annoying mosquitos, lots of topical repellents available including some natural products, the latter being citronella based.

And some people report that B6 supplements seem to help

Frequent bathing helps a lot, to reduce scent which attracts them.

[Chaimai]

I have been recommended LARIAM as a Malaria preventative and also as a deterrent to mozzies.

Whilst I do not feel particularly exposed to Malaria (living in a town 50km from Cambodia) the little buggers do seem to take a liking to me. I am just seeking to prevent this discomfort.

The friend who had a similar problem now claims to be bite-free.

I am concerned by some reports of extreme side-effects.

Is the risk of side effects worth taking for the benefit of perhaps deterring the mosquitos ?

Lariam does not work by reducing ir discouraging mosquito bites. Its action is on the replication of the malaria parasite within the body after being bitten by a mosquito carrying the parasite. So it will have no effect at all on the problem of being bitten. And as noted earlier in this thread, (1) malaria prophylaxis not indicated for most people living or traveling in Thailand and (2) when prophylaxis is used, lariam not the best choice.

So as we say in my home town, fuhggedaboutit.

For the annoying mosquitos, lots of topical repellents available including some natural products, the latter being citronella based.

And some people report that B6 supplements seem to help

Frequent bathing helps a lot, to reduce scent which attracts them.

Thanks Sheryl.

We are coming up to the 4 showers a day season so that should help with odours. I usually carry a lemongrass spray but I think I may have a try at the B6 supplements.