Last minute travellers
Last minute visits to malarious regions, whether for vacation, business or family reasons, are now commonplace. This may leave the traveller little time to seek and act on travel advice
Mefloquine and doxycycline and for those less than 18 years old atovaquone-proguanil combination preparation, are currently prescription-only medicines (POMs), but some pharmacists are now prescribers and thus able to prescribe these POMs. Some retail pharmacy outlets also supply these POMs under PGDs. If the traveller cannot obtain a GP appointment at short notice, some commercial travel clinics cater for walk-in attendees.
Doxycycline or atovaquone-proguanil combination preparation should be started 2 days before travel to a malarious area. Chloroquine or proguanil or chloroquine plus proguanil 1 week before, and mefloquine 2-3 weeks before (to ensure tolerance).
Nevertheless, it is better to start chemoprophylaxis late than not to take it at all, as suppressive prophylactics will begin to work by the end of the malaria incubation period.
Where the recommended choice for the region to be visited is mefloquine or doxycycline or atovaquone-proguanil combination preparation, it would be sensible to avoid mefloquine for last-minute prophylaxis as it takes time to reach steady state, and especially if the traveller has not taken and tolerated mefloquine in the past. PHE does not recommend loading doses of any prophylactic antimalarial
Check the respective summary of product characteristics (SPC) before prescribing drugs described.
Last edited 12/2019 and last reviewed 12/2019