Drug	Dosing		Comments
Atovaquone/proguanil (Malarone)	Begin one or two days before travel and continue for one week after return		Contraindicated in patients with creatinine clearance < 30 mL per minute; best option for short trips, but cost is a limiting factor; best option for patients with a history of seizure
	Adults:
		250 mg atovaquone/100 mg proguanil daily
	Children:
		< 24 lb (11 kg): not recommended
		24 to 44 lb (11 to 20 kg): one children's tablet (62.5 mg atovaquone/25 mg proguanil) daily
		45 to 66 lb (21 to 30 kg): two children's tablets daily
		67 to 88 lb (31 to 40 kg): three children's tablets daily
		> 88 lb (40 kg): one adult tablet daily
Chloroquine (Aralen)	Begin one or two weeks before travel and continue for four weeks after return		Limited use (Central America and Middle East only) because of widespread resistance; safe in pregnant and lactating women; contraindicated in patients with severe hepatic insufficiency; psoriasis is a relative contraindication; therapeutic window is fairly narrow; accurate dosing in young children is critical and may require pharmacy compounding
	Adults:
		500 mg salt (equal to 300 mg base) weekly
	Children:
		8.3 mg salt (equal to 5 mg base) per kg per week, up to adult dosage
Doxycycline	Begin one or two days before travel and continue for four weeks after return		Contraindicated in pregnant and lactating women, and in children eight years and younger; photosensitizing; may cause esophagitis; cheapest but least convenient option
	Adults:
		100 mg daily
	Children (older than eight years):
		2 mg per kg per day, up to adult dosage
Mefloquine (formerly Lariam)	Begin one or two weeks before travel and continue for four weeks after return		Considered safe in second and third trimesters of pregnancy; contraindicated in patients with epilepsy, serious psychiatric illness, or cardiac conduction disturbance (including beta blocker use); reserve for trips longer than three weeks in carefully screened patients without a history of psychiatric illness or seizure
	Adults:
		250 mg weekly
	Children:
		11 to 33 lb (5 to 15 kg): 5 mg per kg weekly (will require pharmacy compounding into liquid form for accurate dosing)
		33 to 42 lb (15 to 19 kg): one fourth tablet weekly
		43 to 66 lb (20 to 30 kg): one half tablet weekly
		67 to 99 lb (31 to 45 kg): three fourths tablet weekly
		> 99 lb (45 kg): adult dosage
Primaquine	Adults:		Contraindicated in pregnant women and in patients with glucose-6-phosphate dehydrogenase deficiency; may be used for primary prophylaxis (off-label) at double the daily dosage, continued for one week after leaving endemic area
		52.6 mg salt (equal to 30 mg base) daily for 14 days after departure from an endemic area in persons with prolonged exposure to Plasmodium vivax and Plasmodium ovale
	Children:
		0.88 mg salt (equal to 0.5 mg base) per kg per day, up to adult dosage, for 14 days