Daily malaria prevention with the shortest post-travel course — and no tablet is a substitute for avoiding bites.
Explained by a GMC-registered GP, not a leaflet
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Atovaquone with proguanil is a combination antimalarial that attacks the parasite at two points in its life cycle — atovaquone disrupts its mitochondria, proguanil blocks folate metabolism. Together they are more effective than either alone.
Its practical advantage is the short tail: it acts against the parasite in the liver, so it only needs continuing for 7 days after leaving a malarial area, rather than the 4 weeks required by doxycycline and mefloquine.
It is generally the best-tolerated option, and correspondingly the most expensive.
Which antimalarial is right depends entirely on where you are going, since resistance patterns differ by region. That is a country-by-country decision, not a general one.
Vomiting within an hour of the dose means taking another one. A dose that did not stay down is a dose not taken.
No antimalarial is fully protective, and bite avoidance is not optional:
Generally the best tolerated of the antimalarials.
Taking it with food substantially reduces the stomach upset, as well as improving absorption.
Uncommon: liver enzyme changes, low blood counts, hair loss.
Unlike mefloquine, it very rarely causes significant neuropsychiatric effects — which is one of the main reasons people choose it.
Caution in severe liver impairment, and in anyone who has had a splenectomy — which markedly increases the severity of malaria.
No routine monitoring for a standard travel course in someone healthy.
Kidney function should be known before prescribing to anyone with kidney disease.
Yes, as part of a travel health consultation — because the choice of antimalarial depends on exactly where you are going, and that has to be assessed rather than assumed.
What the consultation covers:
The most important thing we will tell you: any fever during travel to a malarial area, or within a year of returning, must be treated as possible malaria and assessed urgently. Falciparum malaria can kill within days, and delay is the main reason it does. Tell whoever sees you where you have been.
We do not administer travel vaccinations — those need a travel clinic. A prescription is never guaranteed. This page is information, not an offer to supply.
Malaria prevention is not available on the NHS — it is self-pay in the UK regardless of where you get it.
Generic atovaquone-proguanil costs considerably less than branded Malarone, and is identical. Maloff Protect is available directly from pharmacies without a prescription for adults, after a pharmacist consultation, and for a straightforward trip that is often the cheapest route — we would say so rather than take a fee.
DEET 50% repellent and a treated bed net cost little and prevent more malaria than any tablet.
Complete the full 7 days after leaving the malarial area. Stopping on the plane home is a genuine and dangerous mistake — the parasite can still be developing.
No tapering is needed.
Any fever during or after travel to a malarial area — up to a year afterwards — needs urgent assessment and a malaria test.
Do not assume prophylaxis has protected you. No antimalarial is completely effective, and treating malaria as flu is how people die of it.
Because it acts on the parasite in the liver as well as the blood. Doxycycline and mefloquine do not, which is why they need 4 weeks.
Yes — food or a milky drink roughly doubles absorption. Taking it on an empty stomach genuinely reduces how well it protects you.
For a short trip, often yes — better tolerated, no sun sensitivity, and a much shorter course after returning. For a long trip, doxycycline is considerably cheaper overall.
Yes — Maloff Protect is available from pharmacies for adults after a pharmacist consultation. For a straightforward trip that is often the quickest and cheapest route.
No. No antimalarial is completely protective, which is why bite avoidance matters just as much. Repellent, covered skin after dusk, and a treated net.
Seek urgent medical assessment and say where you have been — any fever up to a year after travel. Falciparum malaria can kill within days, and delayed diagnosis is the usual reason.
It is generally avoided. More importantly, pregnancy is a strong reason to reconsider travelling to a high-risk malarial area at all — malaria in pregnancy is considerably more dangerous.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
September 8, 2026
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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