Malaria Tablets Compared: Malarone vs Doxy vs Mefloquine
Malarone, doxycycline, mefloquine — which one's right for your trip? They all prevent malaria but differ on side effects, dosing, cost and who suits them.
Malaria tablets compared — by a pharmacist who prescribes them weekly.
None of these is the 'best' antimalarial in isolation — they're the best for different people on different trips. A backpacker doing 8 weeks across Sub-Saharan Africa has different needs to a businesswoman flying to Mumbai for 4 days. Children, pregnant women, people with epilepsy or depression, and people taking certain other medications all need specific tablet choices.
This guide walks through how each tablet works, who it suits, what to expect, and how we make the choice in clinic. Your travel consultation will personalise the recommendation based on your trip and health.
What antimalarials do
Antimalarial tablets don't make you immune. They suppress malaria parasites if you're bitten by an infected mosquito — so the infection never gets going. None is 100% effective. Pair with bite avoidance: DEET-based repellent, long sleeves at dusk, mosquito nets where available.
Three tablets dominate UK travel clinic prescribing. We'll go through each.
Malarone (atovaquone-proguanil)
Best for
- Short to medium trips (up to several weeks)
- Travellers wanting minimal side effects
- Last-minute departures (start 1–2 days before)
- Children over 11kg
- People who can't tolerate doxycycline or mefloquine
Dosing
One tablet daily, starting 1–2 days before travel, continuing through trip, and for 7 days after returning home. The short post-trip course is one of Malarone's biggest advantages.
Side effects
Generally mild: nausea, headache, vivid dreams, occasional stomach upset. Many patients have no noticeable side effects. Take with food to reduce nausea.
Contraindications and cautions
Severe kidney disease. Caution with warfarin and rifampicin. Not for severe kidney impairment.
Doxycycline
Best for
- Longer trips where Malarone gets expensive
- Backpacking, extended travel
- Adults with no contraindications
- People who tolerate antibiotics well
Dosing
One 100mg capsule daily, starting 1–2 days before travel, continuing through trip, and for 4 weeks after returning home. That post-trip course is the downside.
Take with a full glass of water, sitting upright, and not at bedtime — the capsule can lodge in the oesophagus and cause severe irritation.
Side effects
Most common: photosensitivity (severe sunburn even with brief exposure), stomach upset, nausea. Less common: thrush in women, oesophageal irritation if not taken properly.
Contraindications and cautions
Not for children under 12. Not in pregnancy or breastfeeding. Interacts with antacids, iron, calcium supplements and dairy if taken at the same time. Avoid prolonged sun exposure or use high-SPF sunscreen religiously.
Mefloquine (Lariam)
Best for
- Long trips where weekly dosing is more practical
- People who can't tolerate Malarone or doxycycline
- Travellers without psychiatric history
Dosing
One tablet weekly, starting 2–3 weeks before travel (to identify side effects early), continuing through trip, and for 4 weeks after returning home.
Side effects
Significant for some users: vivid dreams, mood changes, anxiety, insomnia. Rarely: more serious psychiatric effects including depression and psychosis. Most users tolerate it well, but the side effects can be substantial when they happen.
Contraindications and cautions
Not for people with history of depression, anxiety, epilepsy, psychosis or other psychiatric conditions. Not with certain cardiac arrhythmias. Many drug interactions — needs careful review.
Choosing between them
In clinic, the conversation usually goes:
- What's the destination and trip length? Short urban trips might not need tablets at all. Longer rural trips need stronger consideration.
- What can you tolerate? Previous travel experiences with antimalarials matter. If you had mood problems on mefloquine before, we won't repeat it.
- What's your medical history? Psychiatric conditions, epilepsy, pregnancy, kidney function, current medications all narrow the choice.
- What's your budget? For a 2-week trip, costs differ moderately. For a 3-month trip, the difference between Malarone and doxycycline is substantial.
- What's your adherence likely to be? If you might forget daily tablets, weekly mefloquine becomes more appealing — if it's appropriate otherwise.
Special situations
Children
Malarone is licensed for kids over 11kg with weight-based dosing. Doxycycline isn't used under age 12. Mefloquine can be used in younger children with care — we'll work out the right tablet and dose individually.
Pregnancy
Malaria in pregnancy is severe. If travel is essential and destination has malaria risk, mefloquine (in 2nd/3rd trimester) is sometimes preferred. Doxycycline contraindicated. Malarone limited safety data — generally avoided. We refer to specialist UKHSA pregnancy guidance.
People on other medications
Bring a full medication list. Common interactions:
- Warfarin (with Malarone and doxycycline)
- Antiepileptics (with mefloquine)
- Antidepressants (with mefloquine)
- Antacids, iron, calcium (with doxycycline)
- Rifampicin (with Malarone)
Bite avoidance — the other half of malaria prevention
Even on antimalarials, bite avoidance matters:
- DEET-based repellent 30%+ on exposed skin
- Long sleeves and trousers from dusk onwards (mosquitoes that carry malaria bite mostly at night)
- Mosquito nets where accommodation isn't well-sealed
- Air-conditioned, screened rooms where possible
- Permethrin-treated clothing for high-risk trips
What to do if you develop a fever after returning
Any fever within 12 months of returning from a malaria area should be taken seriously. Malaria can present weeks or months after exposure. Symptoms include fever, chills, sweating, headache, body aches, sometimes nausea or diarrhoea.
If you develop a fever:
- Contact your GP, NHS 111, or A&E urgently
- Tell them you've been to a malaria area and when
- Don't wait — falciparum malaria can become severe within hours
Book your travel consultation
Antimalarial choice is part of every Preston Clinic travel consultation. We discuss destination, health, budget and preference — then prescribe and dispense the right tablet same-day. Book online or walk in to Frenchwood Pharmacy on Ruskin Street.
Malaria tablet comparison from Preston's local travel clinic.
Three antimalarial tablets dominate UK travel clinic prescribing: Malarone (atovaquone-proguanil), doxycycline, and mefloquine. All three are highly effective when taken correctly. They differ on dosing schedule, side effect profile, cost, and who they suit best.
Malarone is the most expensive but the most patient-friendly: minimal side effects, short courses, and you can start it just a day or two before travel. Doxycycline is far cheaper, well-tolerated by most, but you need to take it daily for four weeks after returning home. Mefloquine has a once-weekly schedule and very long protection — but it has a side effect profile (vivid dreams, mood changes, occasionally serious psychiatric effects) that means we use it more selectively.
Every appointment is led by Hamza Ali Khan, a registered pharmacist.
Travel vaccinations at Preston Clinic are conducted by a GPhC-registered pharmacist who reviews your itinerary, health background, and vaccine history before anything is prescribed or given.
Hamza Ali Khan
Hamza is the named pharmacist responsible for travel consultations at Preston Clinic. Every appointment is conducted by a registered pharmacist — never delegated to a non-pharmacist — so the person discussing your itinerary is also the person administering the vaccines.
Independent verification: both registrations above can be checked directly on the GPhC public register. Call 01772 491185 with any questions before booking.
NaTHNaC-designated · Yellow Fever CentreEverything you need to stay malaria-free.
Antimalarial prescribing, dispensing and advice — in one visit.
Destination risk assessment
Malaria risk varies by region and season. We check your specific itinerary.
All three tablets stocked
Malarone, doxycycline, mefloquine — all in stock and dispensed same-day.
NaTHNaC-designated
Yellow Fever Centre and pharmacist-led travel clinic following official guidance.
Independent Prescriber on-site
Prescription, dispensing and advice in one visit — no GP referral.
Family travel covered
We see whole families and tailor tablet choice for children where appropriate.
Travel health summary
Written record of antimalarials prescribed, dosing instructions and bite avoidance advice.
Three steps to malaria-protected travel.
Consultation, prescription and dispensing — usually one visit.
Book your travel consultation
Pick a slot. Tell us where you're going and any conditions or medications.
Come to Ruskin Street
1 Ruskin Street, just off Fishergate. We discuss risk and choose the right tablet.
Leave with tablets in hand
Antimalarials dispensed same-day with clear dosing instructions and travel summary.
Malaria tablet questions from Preston travellers.
Still have a question? Call the clinic on 01772 491185 and a pharmacist will get back to you.
- TravelHealthPro — Malaria prevention· accessed 2026-05-18
- PHE/UKHSA — Guidelines for malaria prevention in travellers from the UK· accessed 2026-05-18
- NHS — Malaria — prevention· accessed 2026-05-18
- WHO — World Malaria Report· accessed 2026-05-18
- GPhC — Register entry — Hamza Ali Khan (Reg. 2233681) at Frenchwood Pharmacy· accessed 2026-05-18
General antimalarial guidance only. Tablet choice depends on destination, season, individual health, and other medications. Your travel consultation determines what's right for you.
On Ruskin Street, just off Fishergate. Free patient parking.
Right in the city centre on Ruskin Street, just off Fishergate.
Heading somewhere with malaria? Get tablet advice and prescription in one visit.
Malarone, doxycycline or mefloquine? Pharmacist-led comparison of UK malaria tablets — effectiveness, side effects, cost, who suits each. Preston Clinic.
