Version June 2024
| Drug | Tablet size | Dose | Frequency* | Initiation (time before first exposure to malaria) | Discontinuation (time after last exposure) |
| Areas with chloroquine-resistant Plasmodium falciparum | |||||
| Atovaquone-proguanil (Malarone) | Pediatric tablet: 62.5 mg atovaquone and 25 mg proguanil Adult tablet: 250 mg atovaquone and 100 mg proguanil | Body weight 5 to 8 kg, 1/2 pediatric tablet daily; Body weight 9 to 10 kg, 3/4 pediatric tablet daily; Body weight 11 to 20 kg, 1 pediatric tablet daily; Body weight 21 to 30 kg, 2 pediatric tablets daily; Body weight 31 to 40 kg, 3 pediatric tablets daily; Body weight ≥41 kg, 1 adult tablet daily | Once daily | 1 to 2 days | 7 days |
| Mefloquine hydrochloride (Lariam and generic agents) | 250 mg salt (228 mg base) | Body weight ≤9 kg, 1/8 tablet or 5 mg salt per kg Body weight 10 to 19 kg, 1/4 tablet Body weight 20 to 30 kg, 1/2 tablet Body weight 31 to 45 kg, 3/4 tablet Body weight ≥46 kg, 1 tablet | Once weekly | 3 weeks preferable; 2 weeks acceptable | 4 weeks |
| Doxycycline hyclate (Vibramycin, Vibra-Tabs, other brands, and generic agents); doxycycline monohydrate (Monodox, Adoxa, and generic agents) | 100 mg | ≥8 years old, 2 mg per kg of body weight orally once daily (maximum dose 100 mg/day) | Once daily | 1 to 2 days | 4 weeks |
| Areas with chloroquine-sensitive P. falciparum | |||||
| Chloroquine phosphate (Aralen and generic agents) | 500 mg salt (300 mg base) | 8.3 mg salt per kg of body weight (5 mg base per kg of body weight) | Once weekly | 1 to 2 weeks | 4 weeks |
| Hydroxychloroquine sulfate (Plaquenil) | 400 mg salt (310 mg base) | 6.5 mg salt per kg of body weight (5 mg base per kg of body weight) | Once weekly | 1 to 2 weeks | 4 weeks |
| Atovaquone-proguanil (Malarone) | (as in 1st row above) | (as in 1st row above) | Once daily | 1 to 2 days | 7 days |
| Mefloquine hydrochloride (Lariam and generic agents) | 250 mg salt (228 mg base) | (as in 2nd row above) | Once weekly | 3 weeks preferable; 2 weeks acceptable | 4 weeks |
| Doxycycline hyclate (Vibramycin, Vibra-Tabs, other brands, and generic agents); doxycycline monohydrate (Monodox, Adoxa, and generic agents) | 100 mg | ≥8 years old, 2 mg per kg of body weight orally once daily (maximum dose 100 mg/day) | Once daily | 1 to 2 days | 4 weeks |
| Areas with Plasmodium vivax | |||||
| Primaquine phosphate for primary prophylaxis (off-label use)¶ | 26.3 mg salt (15 mg base) | 0.8 mg per kg of body weight salt (0.5 mg per kg of body weight base) | Once daily | 1 to 2 days | 7 days |
| Chloroquine phosphate (Aralen and generic agents) | 500 mg salt (300 mg base) | 8.3 mg salt per kg of body weight (5 mg base per kg of body weight) | Once weekly | 1 to 2 weeks | 4 weeks |
| Hydroxychloroquine sulfate (Plaquenil) | 400 mg salt (310 mg base) | 6.5 mg salt per kg of body weight (5 mg base per kg of body weight) | Once weekly | 1 to 2 weeks | 4 weeks |
| Atovaquone-proguanil (Malarone) | (as in 1st row above) | (as in 1st row above) | Once daily | 1 to 2 days | 7 days |
| Mefloquine hydrochloride (Lariam and generic agents) | 250 mg salt (228 mg base) | (as in 2nd row above) | Once weekly | 3 weeks preferable; 2 weeks acceptable | 4 weeks |
| Doxycycline hyclate (Vibramycin, Vibra-Tabs, other brands, and generic agents); doxycycline monohydrate (Monodox, Adoxa, and generic agents) | 100 mg | ≥8 years old, 2 mg per kg of body weight orally once daily (maximum dose 100 mg/day) | Once daily | 1 to 2 days | 4 weeks |
| Presumptive antirelapse therapy (to prevent relapse due to P. vivax or P. ovale) | |||||
| Primaquine phosphate¶ | 26.3 mg salt (15 mg base) | 0.8 mg per kg of body weight salt (0.5 mg per kg of body weight base) | Once daily | As soon as possible following exposure for which another prophylactic drug taken | 14 days |
G6PD: glucose-6-phosphate dehydrogenase.
* Drugs administered once daily should be taken at the same time each day; drugs administered once weekly should be taken on the same day each week.
¶ A quantitative G6PD test must be done to rule out G6PD deficiency prior to the first administration of primaquine or tafenoquine. Note that qualitative G6PD testing can miss those with moderate deficiency and is not sufficient to establish normal G6PD activity. Refer to the UpToDate text for further discussion.
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