Compare Antimalarial Drugs – What You Need to Know Before You Travel

Planning a trip to a malaria‑risk area? Choosing the right antimalarial can feel like a puzzle, but it doesn’t have to be. Below you’ll get a straight‑forward rundown of the main drugs, how fast they kick in, common side effects, and price points. Use this guide to match a medication to your health, itinerary, and budget.

Common Antimalarial Classes and Their Basics

Most antimalarial meds fall into three groups: chloroquine‑based, artemisinin‑combination therapies (ACTs), and proguanil‑based options. Chloroquine works well in places where the parasite hasn’t become resistant, but many regions in Africa and Asia have outgrown it. ACTs—like artemether‑lumefantrine—combine fast‑acting artemisinin with a longer‑lasting partner drug, making them the go‑to for resistant strains. Proguanil (often paired with atovaquone) offers a daily pill that’s easy on the stomach, though it can cost a bit more.

Another popular choice is doxycycline. It doubles as an antibiotic, so it can treat other infections if needed. However, you’ll need to take it with food and avoid sun exposure because it can cause photosensitivity. Mefloquine is a weekly option preferred by travelers who dislike daily dosing, yet it may cause vivid dreams or mood changes in a small subset of users.

How to Choose the Right Drug for You

Start with where you’re going. Check the latest malaria map—countries like Brazil, parts of Central America, and most of sub‑Saharan Africa still report high resistance to chloroquine. Next, look at your health profile. If you have a history of heart problems, mefloquine might be risky. Pregnant women should avoid doxycycline and mefloquine, opting for safer alternatives like chloroquine (if still effective) or ACTs under doctor supervision.

Cost matters too. Generic doxycycline and proguanil are often under $1 per pill, while ACTs can range from $2 to $5 per dose. Insurance may cover some options, but many travelers pay out of pocket. Consider how long you’ll be in the area; a weekly mefloquine regimen could be cheaper than daily pills for a month‑long stay.

Side‑effect tolerance is personal. Mild stomach upset is common with proguanil, while ACTs can cause fleeting headaches or dizziness. If you’ve experienced strong reactions to any antimalarial before, discuss alternatives with a healthcare professional before you book your flight.

Don’t forget the timing. Some drugs, like chloroquine and mefloquine, need to start a week before you arrive and continue for four weeks after you leave. Others, such as doxycycline and atovaquone‑proguanil, are taken one to two days before exposure and kept for a week after returning. Missing doses can lower protection, so set a daily alarm if you’re on a daily schedule.

Finally, pack smart. Keep the medication in its original container, store it at room temperature, and bring a copy of the prescription in case you need a refill abroad. Many travel clinics will give you a printed guide that matches the drug to your destination—use it as a quick reference.

In short, the best antimalarial choice balances effectiveness against local resistance, your health conditions, side‑effect tolerance, cost, and dosing convenience. Talk to a travel health specialist, review the latest resistance data, and pick a regimen you can stick to. Stay safe, stay informed, and enjoy your trip without worrying about malaria.