Antimalarial tablets and advice (Antimalarial chemoprophylaxis advice and prescribing)

What is antimalarial advice and prescribing?

Antimalarial advice is a travel health consultation that works out your risk of malaria for a specific trip and how best to reduce it. It covers avoiding mosquito bites and, where appropriate, prescribing antimalarial tablets.

Which tablets are suitable depends on where you are going, the type of malaria there, your health and medicines, how long you are travelling, and any past problems with antimalarials. The main options in the UK are atovaquone with proguanil (often called Malarone), doxycycline and mefloquine.

It is important to understand what these tablets can and cannot do. They greatly reduce your risk but do not remove it completely. No antimalarial is fully protective, and bite avoidance remains the first line of defence.

Because malaria can be life-threatening, this advice also includes recognising fever after travel as an emergency. A fever within about a year of visiting a malaria area needs same-day medical assessment, even if you took your tablets.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Common antimalarial tablets

All are started before travel (mefloquine earliest). The right choice depends on your destination and health, not just convenience. Your prescriber will advise.

Preparing for your treatment

• Book the consultation in good time — ideally several weeks before travel, as some tablets must be started early (mefloquine 2–3 weeks ahead).
• Bring your full travel itinerary, including rural areas, dates and any stopovers.
• List all your medicines and supplements, as some interact with antimalarials.
• Tell the prescriber about your health, including mental health, epilepsy, heart rhythm problems, liver or kidney issues.
• Mention if you are pregnant, planning pregnancy or breastfeeding, as this changes the options.
• Say whether you have taken antimalarials before and how you got on with them.
• Ask about bite-avoidance measures and what to do if you develop a fever after travel.

What happens

The clinician assesses your malaria risk for the specific trip and reviews your health and medicines. They explain bite avoidance and discuss whether tablets are recommended.

If tablets are advised, they explain the suitable options, how and when to take them, the main side effects, and how long to continue them after you return. You will usually be given written instructions.

For some tablets, especially mefloquine, the conversation includes a careful check for reasons to avoid it and a discussion of side effects, so you can make an informed choice. You should leave knowing how to take the tablets correctly and what to do if you become unwell.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The most important point is that tablets reduce risk but do not remove it. Take bite avoidance seriously, take the tablets exactly as prescribed including after you return, and treat any fever after travel as an emergency. If you have mental health concerns, discuss them before being prescribed mefloquine.

Published figures to discuss

The protection antimalarials give is high but not complete, and varies with the drug, the destination's resistance patterns, and how reliably tablets are taken. Side-effect rates differ between drugs and people. Because effectiveness depends so heavily on correct use and local resistance, fixed percentages are not given here; the key message is that no regimen is fully protective.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

This is prevention, not a procedure, so there is nothing to recover from. What matters is taking the tablets correctly and knowing what to do if you become unwell during or after travel.

• Mild stomach upset or headache when starting tablets
• More noticeable sunburn risk on doxycycline
• Vivid dreams or mild sleep changes on mefloquine in some people
• No symptoms at all — tablets are preventive, so feeling normal is expected

Aftercare

• Take every dose exactly as prescribed, including the full course after you return.
• If you miss a dose, follow the advice you were given rather than guessing.
• Keep using insect repellent and a mosquito net throughout your trip.
• On doxycycline, use sun protection and take the tablet with food and water, sitting upright.
• If a tablet causes troubling side effects, contact your prescriber rather than simply stopping.
• Seek urgent medical help for any fever after travel and mention your trip.
• Keep a note of which antimalarial you took, in case you need medical care later.

• Consultation booked several weeks before travel
• Full itinerary and medicines list to bring
• Written instructions on how and when to take the tablets
• Insect repellent and a mosquito net packed
• Plan for what to do if you develop a fever after travel
• Enough tablets to cover the full course after you return

⚠ Get urgent help if…

• Any fever, chills or flu-like illness during or after travel — seek same-day assessment
• Severe or persistent vomiting or diarrhoea while taking tablets
• A severe skin or sun reaction on doxycycline
• Low mood, anxiety, confusion or unusual thoughts on mefloquine — stop and seek advice
• Signs of an allergic reaction such as swelling, widespread rash or breathing difficulty
• Yellow skin or eyes, or very dark urine

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

Because this is prevention, there is no test result. Success means reducing your risk as much as possible and avoiding malaria, but you cannot assume you are fully protected. The tablets work best alongside bite avoidance and taken exactly as prescribed.

The most important outcome is knowing that a fever after travel must be assessed urgently. Most malaria deaths are linked to delay, so acting quickly if you feel unwell matters more than anything else.

Antimalarial advice applies to the trip it was given for. Each new journey needs a fresh assessment, because risk areas, the type of malaria and recommended tablets can change, and your own health may have changed too. Do not reuse old advice or leftover tablets for a different trip without checking.

Related tests, treatments or support

Antimalarial advice is usually part of a wider travel health consultation that may include vaccines such as yellow fever, hepatitis A, typhoid and others, plus advice on food, water and insect-borne illness. Yellow fever vaccine in particular is only available at registered centres.

Follow-up & long-term care

There is no routine follow-up for prevention itself, but you should know how to get help during travel and what to do on return. If you become unwell, the relevant follow-up is urgent assessment for malaria and other travel infections.

• Get a fresh risk assessment for every new trip rather than reusing old advice.
• Replace expired tablets and repellent before travelling again.
• Re-check suitability if your health or medicines have changed since you last travelled.

Repeat, follow-on and what comes next

• It is common to switch antimalarial if the first choice causes side effects or interacts with your medicines.
• Advice should be reviewed for every new trip, as risk areas and recommended drugs change.
• If you develop symptoms despite tablets, the plan shifts immediately to urgent assessment for malaria.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Clear written instructions on dosing and the after-travel period
• A named contact for side effects or questions before and during travel
• Explicit advice that a fever after travel needs same-day assessment
• An offer to reassess for future trips rather than reusing old advice

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The travel clinic or prescriber's consultation fee
• Which antimalarial is prescribed and the length of your trip (more days means more tablets)
• Whether brand or generic tablets are supplied
• Whether the visit is combined with travel vaccines
• Bite-avoidance items such as repellent and mosquito nets
• Any follow-up advice or repeat consultation for future trips

• The consultation fee and what the risk assessment includes
• The cost of the recommended tablets for the full trip plus the after-travel period
• Whether generic options are available
• What is included if a different tablet is needed due to side effects or interactions
• Clear written instructions on how and when to take the tablets
• Advice on what to do if you become unwell during or after travel

On the NHS? Some travel health advice is available through the NHS, but antimalarial tablets for travel are generally private or self-funded; a fever after travel, by contrast, is always urgent NHS care.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Given exactly where I'm going, do I need antimalarial tablets, and which is most suitable for me?
• How and when do I take them, and how long do I continue after I return?
• What are the main side effects, and what should I do if I get them?
• Are these tablets safe with my other medicines and health conditions?
• What bite-avoidance measures do you recommend for my trip?
• What exactly should I do if I develop a fever during or after travel?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for antimalarial tablets and advice

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Malaria prevention NaTHNaC (TravelHealthPro) — Malaria GOV.UK — Guidelines for malaria prevention in travellers from the UK 2024 (UKHSA ACMP) Fit for Travel (NHS Scotland) — Atovaquone/Proguanil (Malarone) GOV.UK (UKHSA) — Malaria: news and updates

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.