Proguanil for malaria prevention Paludrine
Proguanil tablets help to protect against malaria when travelling to a country where malaria occurs.
It is important that you take the tablets for one week before you travel, during the whole of your stay, and for four weeks after you return.
Proguanil is only one of a number of measures that you need to take to reduce your risk of malaria. Others include wearing suitable clothing, using insect repellents and sleeping in screened rooms or beds.
|Type of medicine||An antimalarial medicine|
|Used for||To prevent malaria|
|Also called||Paludrine® (proguanil hydrochloride)|
Combination brands: MaloffProtect®, Malarone® (proguanil with atovaquone)
Proguanil tablets help to protect you from malaria when you travel to areas where this can be a problem. It is usually used in combination with another antimalarial medicine to increase its effectiveness. Malaria is a serious infection. It is common in tropical countries such as parts of Africa, Asia, South and Central America, and the Middle East. Malaria is a disease which is passed on to humans by infected mosquitoes. A parasite called plasmodium lives inside the stomachs of infected female mosquitoes and is passed on to humans by a bite.
Because the pattern of malaria varies with the part of the world you are travelling to, as well as the season and the type of activity you have planned, you should always obtain the latest advice about malaria prevention from your doctor, pharmacist or travel organiser. A backpacking trip may well require different preventative measures against malaria to those needed for a business trip to a city.
Proguanil tablets are not available on the NHS, but you are able to buy the tablets without a prescription at a pharmacy.
Proguanil is also available as a combination tablet with atovaquone for malaria prevention. See the separate medicine leaflet for more information.
Before taking proguanil
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking proguanil it is important that your doctor or pharmacist knows:
- If you are pregnant or trying for a baby. Travel to areas with malaria is best avoided during pregnancy. If the travel is unavoidable, you will still be advised to take proguanil even if you are pregnant, but you will also be advised to take a supplement of folic acid.
- If you have any problems with the way your kidneys work.
- If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take proguanil
- Before you take proguanil, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about the tablets, and will also provide you with a full list of the side-effects which you could experience from taking them.
- Proguanil should be taken for a week before entering an area where malaria occurs. This is to ensure there is sufficient medicine in your bloodstream to give you the required protection. You should continue to take proguanil throughout your stay and for a further four weeks after you have left the area.
- Take the tablets exactly as your doctor or pharmacist tells you to. You will be given tablets containing 100 mg of proguanil. Adults should take 200 mg daily, so this means taking two tablets every day. Take the two tablets at the same time. If the proguanil is for a child, read the directions on the label carefully, as their dose will depend upon their age and weight.
- Take the tablets with a snack or just after a meal, and try to take your doses at about the same time of day, each day. The tablets can be crushed and mixed into milk, jam or honey to make them easier for children to swallow.
- If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, do not take two doses together to make up for the forgotten dose. You should complete the full course of tablets (unless you are told otherwise by a doctor). Make sure you continue to take the tablets for four weeks after returning from your visit.
Getting the most from your treatment
- Proguanil tablets will help reduce the risk of you getting malaria, but it is also important that you take the following precautions against being bitten by mosquitoes:
- Cover up bare areas of your arms and legs with long-sleeved, loose-fitting clothing, long trousers and socks. This is especially important if you are outside after sunset, as this is when mosquitoes feed.
- Use an effective insect repellant spray on your clothing and any area of your skin which is bare. If you are also using a sunscreen, apply the sunscreen first and the insect repellant afterwards.
- Spray the room with an insecticide each evening a couple of hours before you go to bed. Check your sleeping areas for mosquitoes - pay particular attention to furniture and areas under your bed where insects can hide.
- If you are sleeping in an unscreened room, use a mosquito net impregnated with an insecticide.
- If you have been advised to have an oral vaccine to protect you against typhoid, you should arrange to have this so your course is finished at least three days before you start taking proguanil. This is because proguanil tablets can stop the vaccine from working properly.
- If you take a medicine for indigestion (such as an antacid), do not take it within 2-3 hours before or after taking proguanil tablets. This is because some magnesium-containing antacids interfere with the way proguanil is absorbed by your body, making it less effective.
- If you feel ill or develop a high temperature (fever) or flu-like symptoms while you are travelling or within one year (especially if it is within three months) of returning home, you should see your doctor straightaway. This is important, even if you have taken your antimalarial tablets correctly.
Can proguanil cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with proguanil. You will find a full list in the manufacturer's information leaflet supplied with your medicine. Speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common proguanil side-effects||What can I do if I experience this?|
|Stomach upset, such as mild diarrhoea||Drink plenty of water to replace any lost fluids|
|Constipation||Try to eat a well-balanced diet and drink plenty of water each day|
|Sore mouth and mouth ulcers||If troublesome, ask a pharmacist to recommend a suitable mouth gel|
If you experience any other symptoms which you think may be due to the tablets, discuss them with your doctor or pharmacist who will be able to advise you further.
How to store proguanil
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Paludrine® 100 mg tablets; Alliance Pharmaceuticals, The electronic Medicines Compendium. Dated March 2015.
Medicines Complete BNF 85th Edition; British Medical Association and Royal Pharmaceutical Society of Great Britain, London.