Am Fam Physician. 2000;61(1):50-52
| Drug | Areas of effective use | Adult dosage | Pediatric dosage | Use in pregnancy |
|---|---|---|---|---|
| Chloroquine (Aralen) | Middle East, Central America (west of Panama Canal) and Hispaniola (especially Haiti) | 300-mg base (500-mg salt) orally once a week starting one week before travel, once weekly during exposure and once weekly for four weeks after return home | Same weekly regimen as for adults but dosage is as follows: 5 mg per kg base (8.3 mg per kg salt), to a maximum of 300-mg base | Yes |
| Mefloquine (Lariam) | Areas of chloroquine- resistant malaria (South America, Asia, Africa, India and Oceania [Pacific islands and New Guinea]) | 250-mg salt using the same regimen as for chloroquine | Same weekly regimen as for adults but dosages are as follows: | Usually not in first trimester |
| Less than 15 kg (33 lb): 5 mg per kg salt 15 to 19 kg (33 to 42 lb): one fourth of a 250-mg salt tablet per week 20 to 30 kg (44 to 66 lb): one half of a 250-mg salt tablet per week 31 to 45 kg (68 to 99 lb): three fourths of a 250-mg salt tablet per week | May be used in second and third trimesters if use is warranted based on risk and the pregnant woman is unable to postpone travel plans | |||
| More than 45 kg (99 lb): one 500-mg salt tablet per week | ||||
| Proguanil (Paludrine; not available in the United States) | Less effective alternative to mefloquine in sub-Saharan Africa; used with weekly chloroquine dose | 200 mg per day after food | Less than two years: 50 mg per day Two to six years:100 mg per day Seven to 10 years:150 mg per day Older than 10 years: 200 mg per day | Yes, with folate supplementation |
| Doxycycline (Vibramycin) | Reasonable alternative to mefloquine in areas with mefloquine-resistant Plasmodium strains or when mefloquine is contraindicated | 100 mg per day during exposure and for four weeks after return home | Contraindicated in children less than nine years old | No |
| Otherwise, regimen is the same as for adults | ||||
| Primaquine | Terminal prophylaxis if at risk for relapsing type of malaria or for elimination of Plasmodium species in persons who travel for more than two months in a high-risk area | 15-mg base (26.3-mg salt) per day for 14 days before return home | 0.3 mg per kg base (0.5 mg per kg salt) per day for 14 days | No |
| Pyrimethamine-sulfadoxine (Fansidar) | No longer used for prophylaxis | Three tablets as a single dose | 5 to 10 kg (11 to 22 lb): one-half tablet (single dose) 11 to 20 kg (24 to 44 lb): one tablet (single dose) 21 to 30 kg (46 to 66 lb): one and one-half tablets (single dose) 31 to 45 kg (68 to 99 lb): two tablets (single dose) | Not in first or third trimesters |
| Self-treatment if in remote setting or if on inadequate prophylaxis | ||||
| More than 45 kg (99 lb): three tablets (single dose) |