Table: Drugs Used to Prevent Malaria-MSD Manual Professional Edition

Drugs Used to Prevent Malaria

Drug^a	Use	Adult Dosage	Pediatric Dosage	Comments
^b	In all areas	1 adult tablet once a day	5–8 kg: one-half pediatric tablet once a day > 8–10 kg: three-fourths pediatric tablet once a day > 10–20 kg: 1 pediatric tablet once a day > 20–30 kg: 2 pediatric tablets once a day > 30–40 kg: 3 pediatric tablets once a day > 40 kg: 1 adult tablet once a day	Begun 1 to 2 days before travel and continued daily during the stay and for 7 days after leaving
	Plasmodium	500 mg once a week	8.3 mg/kg, up to maximum 500 mg once a week	Begun 1–2 weeks before travel and continued weekly during the stay and for 4 weeks after leaving
^c	In all areas	100 mg once a day	≥ 8 years: 2.2 mg/kg (up to 100 mg) once a day	Begun 1–2 days before travel and continued during the stay and for 4 weeks after leaving
^d	Plasmodium	400 mg once a week	6.5 mg/kg, up to 400 mg once a week	Begun 1–2 weeks before travel and continued during the stay and for 4 weeks after leaving
^e	Plasmodium	250 mg once a week	≤ 9 kg: 5 mg once a week > 9–19 kg: one-fourth tablet once a week > 19–30 kg: one-half tablet once a week > 30–45 kg: three-fourths tablet once a week > 45 kg: 1 tablet once a week	Begun ≥ 2 weeks before travel and continued during the stay and for 4 weeks after leaving Contraindicated in patients with a history of depression, other psychologic problems, or seizures; not recommended for patients with cardiac conduction abnormalities
^f	For primary prophylaxis for brief travel in areas known to harbor mainly P. vivax	52.6 mg once a day	0.8 mg/kg up to adult dose once a day	Begun 1 to 2 days before travel and continued daily during the stay and for 7 days after departure Document that the G6PD level is normal before use Contraindicated in people with G6PD deficiency and in pregnant and breastfeeding women unless the breastfed infant has a normal G6PD level
For terminal prophylaxis to prevent relapse of infection in people with substantial exposure to or infection with P. vivax or P. ovale during travel	Dosed as above	Dosed as above	Given daily for 14 days after departure from endemic area. Document that the G6PD level is normal before use Contraindications as above
	For primary prophylaxis in travelers to all areas	200 mg once a day for 3 days before travel as a loading regimen, then 200 mg once weekly for maintenance while in the malaria region starting 7 days after the last loading dose, then a 200 mg final dose after exit 7 days following the last maintenance dose	For patients ≥ 16 years	G6PD deficiency or unknown G6PD status; all patients should be tested for G6PD deficiency prior to use Pregnant and breastfeeding women unless the breastfed infant has a normal G6PD level; known hypersensitivity Psychiatric adverse reactions have been observed Use with caution in patients with a history of psychiatric illness
For terminal prophylaxis in people with substantial exposure to or infection with P. vivax or P. ovale during travel	300 mg single dose	Not for patients < 18 years
^aPreventive drugs are given orally. See table Adverse Reactions and Contraindications of Antimalarial Drugs for adverse reactions and contraindications.
^b
^c Use of tetracyclines is contraindicated during pregnancy and in children < 8 years.
^d
^e
^fchloroquine-resistant malaria as treatment or prophylaxis for prolonged exposure to P. vivax and/or P. ovaleP. vivaxP. vivax
G6PD = glucose-6-phosphate dehydrogenase.
Adapted from the Centers for Disease Control and Prevention Yellow Book: Infectious diseases related to travel: Malaria.

Drug^a

Use

Adult Dosage

Pediatric Dosage

Comments

In all areas

1 adult tablet once a day

5–8 kg: one-half pediatric tablet once a day

> 8–10 kg: three-fourths pediatric tablet once a day

> 10–20 kg: 1 pediatric tablet once a day

> 20–30 kg: 2 pediatric tablets once a day

> 30–40 kg: 3 pediatric tablets once a day

> 40 kg: 1 adult tablet once a day

Begun 1 to 2 days before travel and continued daily during the stay and for 7 days after leaving

Plasmodium

500 mg once a week

8.3 mg/kg, up to maximum 500 mg once a week

Begun 1–2 weeks before travel and continued weekly during the stay and for 4 weeks after leaving

In all areas

100 mg once a day

≥ 8 years: 2.2 mg/kg (up to 100 mg) once a day

Begun 1–2 days before travel and continued during the stay and for 4 weeks after leaving

Plasmodium

400 mg once a week

6.5 mg/kg, up to 400 mg once a week

Begun 1–2 weeks before travel and continued during the stay and for 4 weeks after leaving

Plasmodium

250 mg once a week

≤ 9 kg: 5 mg once a week

> 9–19 kg: one-fourth tablet once a week

> 19–30 kg: one-half tablet once a week

> 30–45 kg: three-fourths tablet once a week

> 45 kg: 1 tablet once a week

Begun ≥ 2 weeks before travel and continued during the stay and for 4 weeks after leaving

Contraindicated in patients with a history of depression, other psychologic problems, or seizures; not recommended for patients with cardiac conduction abnormalities

For primary prophylaxis for brief travel in areas known to harbor mainly P. vivax

52.6 mg once a day

0.8 mg/kg up to adult dose once a day

Begun 1 to 2 days before travel and continued daily during the stay and for 7 days after departure

Document that the G6PD level is normal before use

Contraindicated in people with G6PD deficiency and in pregnant and breastfeeding women unless the breastfed infant has a normal G6PD level

For terminal prophylaxis to prevent relapse of infection in people with substantial exposure to or infection with P. vivax or P. ovale during travel

Dosed as above

Given daily for 14 days after departure from endemic area. Document that the G6PD level is normal before use

Contraindications as above

For primary prophylaxis in travelers to all areas

200 mg once a day for 3 days before travel as a loading regimen, then 200 mg once weekly for maintenance while in the malaria region starting 7 days after the last loading dose, then a 200 mg final dose after exit 7 days following the last maintenance dose

For patients ≥ 16 years

G6PD deficiency or unknown G6PD status; all patients should be tested for G6PD deficiency prior to use

Pregnant and breastfeeding women unless the breastfed infant has a normal G6PD level; known hypersensitivity

Psychiatric adverse reactions have been observed

Use with caution in patients with a history of psychiatric illness

For terminal prophylaxis in people with substantial exposure to or infection with P. vivax or P. ovale during travel

300 mg single dose

Not for patients < 18 years

^aPreventive drugs are given orally. See table Adverse Reactions and Contraindications of Antimalarial Drugs for adverse reactions and contraindications.

^c Use of tetracyclines is contraindicated during pregnancy and in children < 8 years.

^fchloroquine-resistant malaria as treatment or prophylaxis for prolonged exposure to P. vivax and/or P. ovaleP. vivaxP. vivax

G6PD = glucose-6-phosphate dehydrogenase.

Adapted from the Centers for Disease Control and Prevention Yellow Book: Infectious diseases related to travel: Malaria.