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Old 02-28-2015, 06:10 PM
 
Location: Idaho
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Quote:
Originally Posted by Tiger Beer View Post

Did you have to take well beforehand as well?
Yes, but not too far in advance.

MD Travel Health

"The usual dosage of doxycycline is 100 mg daily starting one or two days before arrival in the malarious area and continuing through the trip and for four weeks after departure"
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Old 02-28-2015, 06:53 PM
AFP
 
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Take the medication I rarely see people complaining of side effects from Doxycycline it's not worth risking it.
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Old 02-28-2015, 09:07 PM
 
Location: Canada
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Quote:
Originally Posted by Tiger Beer View Post
I think that's the big issue, that I've read. Starting medication weeks before, will some real nasty side effects.

Which are some of the better ones without so much side effects?




Did you have to take well beforehand as well?
Oh yeah, then you've what you've heard about is Mefloquine (Lariam), that's the one that has the most side effects, although in my experience it's often because people mix it with drugs or alcohol. It's a problem in people with epilepsy, heart rhythm problems, and a number psychological disorders. It can cause nightmares. People like it because you only need to take the pill once a week, so in that sense it's more convenient, but the other options are great and have very few side effects.

Doxycycline you only need to start the day before you go, although you need to continue it for 4 weeks after you come back. The main thing is that it can irritate the esophagus and give you heartburn if you don't take it right, but it's fine if you do take it right, which is with lots of water and some food, and you don't lie down right after you take it (ie, you wait until it's in your stomach). It can also make some people (not everyone) more sensitive to sun, so you'd want to wear sunscreen as a precaution.

Malarone is awesome, very few side effects, but it's a little more pricey then some of the other options. You start a day before going and continue a week after returning. Only side effect really is some people are more likely to get canker sore like mouth sores, but in practice that's mostly just kids with braces. If you've got good insurance and it's a short trip this is an awesome choice.

Primiquine is great and cheap, no side effects. What's the catch? Only one, you need to get a blood test to make sure you don't have a rare deficiency in a certain metabolic protein because if you're deficient it's going to mean you get a sort of anemia from taking it. Start a day before you go and only 3 days after coming back, dosed 2 tablets taken once daily. Great choice if you know you can take it.

All said, I'd encourage you to take something. It's rational to worry about side effects, but we need to balance the risk of side effects against he risks of getting the disease and experiencing those symptoms. With the low risk of serious side effects from some of these great options and often the main trade off from malarone being you just to take a pill a little more often I'd definitely suggest going with a drug versus risking malaria, especially in areas that might not have great medical infrastructure if you become seriously ill.
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Old 02-28-2015, 09:56 PM
 
Location: Macao
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Quote:
Originally Posted by BIMBAM View Post
Oh yeah, then you've what you've heard about is Mefloquine (Lariam), that's the one that has the most side effects, although in my experience it's often because people mix it with drugs or alcohol. It's a problem in people with epilepsy, heart rhythm problems, and a number psychological disorders. It can cause nightmares. People like it because you only need to take the pill once a week, so in that sense it's more convenient, but the other options are great and have very few side effects.

Doxycycline you only need to start the day before you go, although you need to continue it for 4 weeks after you come back. The main thing is that it can irritate the esophagus and give you heartburn if you don't take it right, but it's fine if you do take it right, which is with lots of water and some food, and you don't lie down right after you take it (ie, you wait until it's in your stomach). It can also make some people (not everyone) more sensitive to sun, so you'd want to wear sunscreen as a precaution.

Malarone is awesome, very few side effects, but it's a little more pricey then some of the other options. You start a day before going and continue a week after returning. Only side effect really is some people are more likely to get canker sore like mouth sores, but in practice that's mostly just kids with braces. If you've got good insurance and it's a short trip this is an awesome choice.

Primiquine is great and cheap, no side effects. What's the catch? Only one, you need to get a blood test to make sure you don't have a rare deficiency in a certain metabolic protein because if you're deficient it's going to mean you get a sort of anemia from taking it. Start a day before you go and only 3 days after coming back, dosed 2 tablets taken once daily. Great choice if you know you can take it.

All said, I'd encourage you to take something. It's rational to worry about side effects, but we need to balance the risk of side effects against he risks of getting the disease and experiencing those symptoms. With the low risk of serious side effects from some of these great options and often the main trade off from malarone being you just to take a pill a little more often I'd definitely suggest going with a drug versus risking malaria, especially in areas that might not have great medical infrastructure if you become seriously ill.
This is good stuff! Yeah, Mefloquine, that seems to be the one that I keep hearing about! Thats the one I"d like to avoid.

Doxycycline seems to be the clear WINNER here. ALthough, the sunburn thing. I am hoping to tie in Mt. Kilimanjaro with any Africa trip, which would include at least 4 days of being out in the sun, probably covered up as much as possible though. I am very light-skinned already, and easily burnable. So, not sure what the ramifications of that combination might be.

Malarone might be good. How expensive is expensive?

If I do this particular trip, it will be about 15 days which will include Mt. Kilimanjaro. I'm also a beer drinker.
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Old 02-28-2015, 10:57 PM
 
Location: Canada
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Quote:
Originally Posted by Tiger Beer View Post
This is good stuff! Yeah, Mefloquine, that seems to be the one that I keep hearing about! Thats the one I"d like to avoid.

Doxycycline seems to be the clear WINNER here. ALthough, the sunburn thing. I am hoping to tie in Mt. Kilimanjaro with any Africa trip, which would include at least 4 days of being out in the sun, probably covered up as much as possible though. I am very light-skinned already, and easily burnable. So, not sure what the ramifications of that combination might be.

Malarone might be good. How expensive is expensive?

If I do this particular trip, it will be about 15 days which will include Mt. Kilimanjaro. I'm also a beer drinker.
It's probably cheaper for you since you're in China, and if you've got some insurance that could help. It's about 5$ a pill here in Canada where I practice (I'm an upper year pharmacy student, so you can ask me anything about drugs).
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Old 02-28-2015, 11:03 PM
 
Location: Macao
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Quote:
Originally Posted by BIMBAM View Post
It's probably cheaper for you since you're in China, and if you've got some insurance that could help. It's about 5$ a pill here in Canada where I practice (I'm an upper year pharmacy student, so you can ask me anything about drugs).
Malarone. $5/pill. Is that one pill a day?

If so, than 15 days in Africa, plus a day before, and 7 days after. 23 days of Malarone. At about US$115 total. That is reasonable cost-wise to prevent Malaria. Particularly if it doesn't have the other side effects of the other ones. It is once a day, right?

Well, Macau/Hong Kong, I wouldn't have insurance for that, but if that's just the rate for uninsured, it is doable. I wouldn't cross the border into China though, even it might be cheaper, I don't really trust any of the pharmaceuticals or doctors over there.
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Old 02-28-2015, 11:45 PM
 
Location: Canada
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Quote:
Originally Posted by Tiger Beer View Post
Malarone. $5/pill. Is that one pill a day?

If so, than 15 days in Africa, plus a day before, and 7 days after. 23 days of Malarone. At about US$115 total. That is reasonable cost-wise to prevent Malaria. Particularly if it doesn't have the other side effects of the other ones. It is once a day, right?

Well, Macau/Hong Kong, I wouldn't have insurance for that, but if that's just the rate for uninsured, it is doable. I wouldn't cross the border into China though, even it might be cheaper, I don't really trust any of the pharmaceuticals or doctors over there.
Fair enough on quality concerns. Yeah, it's dosed once a day. If you're only going for 15 days I think Malarone is probably the best choice as long as you're fine with the price. Call your local pharmacy to get a price quote on about how much it'd be in your locale. If it ends up being way more for some reason, another strategy to try is to get your doctor to prescribe you doxycycline (if you need an Rx over there) and start it 3-4 weeks in advance to see how you tolerate it and whether or not it makes you more sensitive to the sun then usual. That way, you have lots of time to switch to something else if you don't like it. But you could just go straight for the Malarone which is a great drug.
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Old 03-01-2015, 06:59 PM
 
Location: Idaho
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Quote:
Originally Posted by Tiger Beer View Post
Doxycycline seems to be the clear WINNER here. ALthough, the sunburn thing. I am hoping to tie in Mt. Kilimanjaro with any Africa trip, which would include at least 4 days of being out in the sun, probably covered up as much as possible though. I am very light-skinned already, and easily burnable. So, not sure what the ramifications of that combination might be.
My husband is half Irish and half British so he is very fair skin and gets sunburn easily. We were on a self-fly safari/diving trip which meant we were mostly outdoor. The sun can be quite intense through the plexiglass of a small plane while flying. We were in mostly open Land Rover while on land, mostly open boat while on river and completely open Zodiac during diving trips & protected only by wide-brim hats while hiking. We put on sunscreen in the morning before heading out and didn't even bother to reapply it during the day. There were absolutely no problems with sunburn while we were taking Doxycycline.
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Old 03-01-2015, 07:01 PM
 
Location: Texas
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Malaria = worse than possibly getting a side effect.

The only side effect I have ever had was weird dreams.
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Old 03-02-2015, 09:04 AM
 
Location: Hougary, Texberta
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If you're only going for a couple weeks, take the pills. Lariam was fine. Really vivid dreams though. No other side effects for me.
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