How To Use Malarone Tablets
Correct administration ensures maximum protection against malaria. Learn more about malaria risks.
Key Takeaways
- Prevention: Start 1-2 days before travel; take daily with food
- Treatment: 4 tablets daily × 3 days (with fatty food)
- Post-travel: Continue 7 days after leaving risk area
- Critical: Never skip post-travel doses—liver-stage parasites may still develop
- Children: Use pediatric tablets (62.5/25mg) for 11-40kg weight range
Malarone provides effective malaria prevention and treatment through a specific dosing regimen that must be followed carefully for optimal protection.
Malaria Prevention with Malarone
- 1-2 days before travel: Take first dose to establish protection.
- Daily during travel: Take at same time each day (e.g., with breakfast).
- 7 days after return: Complete final doses to eradicate liver-stage parasites.
Prevention Dosing Table
| Weight/Group | Tablet Strength | Dose |
|---|---|---|
| Adults & Children ≥40kg | 250/100mg | 1 tablet daily |
| Children 31-40kg | 62.5/25mg | 3 pediatric tablets daily |
| Children 21-30kg | 62.5/25mg | 2 pediatric tablets daily |
| Children 11-20kg | 62.5/25mg | 1 pediatric tablet daily |
Note: Minimum prevention course is 9 doses (2 pre-travel + 7 post-travel). Maximum duration: 1 year continuous use.
Malaria Treatment with Malarone
- Day 1-3: Take 4 standard tablets (or equivalent pediatric doses) daily.
- Timing: All 4 tablets at once with fatty food (e.g., milk, peanut butter).
- Follow-up: Seek medical care even if symptoms improve.
Treatment Dosing for Children
| Weight | Daily Dose (×3 days) |
|---|---|
| 5-8kg | 2 pediatric tablets |
| 9-10kg | 3 pediatric tablets |
| 11-20kg | 1 adult tablet |
| 21-30kg | 2 adult tablets |
| 31-40kg | 3 adult tablets |
| ≥40kg | 4 adult tablets |
How to Take Malarone Tablets
- With food: Essential for absorption—take with milk, yogurt, or fatty meal.
- Swallow whole: Do not crush or chew (bitter taste may cause vomiting).
- Timing: Morning doses reduce insomnia risk vs. evening doses.
- Hydration: Drink plenty of water to minimize stomach upset.
What to Avoid
- Antacids: Separate by ≥2 hours (reduce atovaquone absorption).
- Metoclopramide: Avoid (may decrease Malarone efficacy).
- Excess alcohol: May worsen nausea.
Missed Dose Instructions
| Situation | Action |
|---|---|
| Prevention: ≤24 hours late | Take immediately, then resume schedule |
| Prevention: >24 hours late | Take dose + use mosquito protection for 7 days |
| Treatment: Missed dose | Take ASAP, then continue 3-day course |
| Vomiting: Within 1 hour of dose | Repeat full dose with food |
Special Cases
Children
- Use pediatric tablets for accurate dosing (cutting adult tablets is unsafe).
- Mix crushed tablets with honey or jam if swallowing is difficult (only for pediatric tablets).
Elderly/Kidney Impairment
- Mild-moderate impairment (eGFR 30-90): No adjustment needed.
- Severe impairment (eGFR <30): Contraindicated—choose alternative.
Pregnancy: Avoid unless critical (no folate antagonist alternatives available).
Frequently Asked Questions
Why take Malarone with food?
Fat increases atovaquone absorption by 200%. Without food, efficacy drops significantly.
Can I take Malarone for years?
Yes—approved for up to 1 year continuous use. Monitor kidney function if >3 months.
What if my child spits out the tablet?
Repeat dose with food. For pediatric tablets only: crush and mix with sweet food.
Does Malarone affect birth control pills?
No known interaction. However, vomiting may reduce contraceptive efficacy—use backup method.
Is Malarone safe with warfarin?
Monitor INR—proguanil may increase warfarin effect. Dose adjustment may be needed.
Need Treatment for malaria
If you're experiencing symptoms of a bacterial infection, our UK-registered doctors can help determine if Malarone Tablets is appropriate for your condition through a confidential online consultation.
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Medical Content Manager
Nabeel is a co-founder and medical content manager of Chemist Doctor. He works closely with our medical team to ensure the information is accurate and up-to-date.
Medical Doctor
Dr. Feroz is a GMC-registered doctor and a medical reviewer at Chemist Doctor. He oversees acute condition and urgent care guidance.
Medical Director
Usman is a co-founder and medical director of Chemist Doctor. He leads the organisation's strategic vision, bridging clinical and operational priorities.
Review Date: 03 November 2025
Next Review: 05 May 2026
Published on: 03 November 2025
Last Updated: 04 November 2025
