Version June 2024
| Drug | Tablet size | Dose | Frequency* | Initiation (time before first exposure to malaria) | Discontinuation (time after last exposure) | Use in pregnancy |
| Areas with chloroquine-resistant Plasmodium falciparum | ||||||
| Atovaquone-proguanil (Malarone) | 250 mg atovaquone and 100 mg proguanil | 1 tablet orally | Once daily | 1 to 2 days | 7 days | No; insufficient data on use in pregnancy |
| Mefloquine hydrochloride (Lariam and generic agents) | 250 mg salt (228 mg base) | 1 tablet orally | Once weekly | 3 weeks preferable; 2 weeks acceptable | 4 weeks | Yes |
| Doxycycline hyclate (Vibramycin, Vibra-Tabs, other brands, and generic agents); doxycycline monohydrate (Monodox, Adoxa, and generic agents) | 100 mg | 1 tablet orally | Once daily | 1 to 2 days | 4 weeks | No; teratogenic |
| Tafenoquine (Arakoda)¶ | 100 mg | 2 tablets orally | Loading dose once daily for 3 days, then once a week starting 7 days after the last loading dose | Loading dose 3 days prior to trip | 1 week after trip | No; unknown G6PD status of fetus |
| Areas with chloroquine-sensitive P. falciparum | ||||||
| Chloroquine phosphate (Aralen and generic agents) | 500 mg salt (300 mg base) | 1 tablet orally | Once weekly | 1 to two weeks | 4 weeks | Yes |
| Hydroxychloroquine sulfate (Plaquenil) | 400 mg salt (310 mg base) | 1 tablet orally | Once weekly | 1 to 2 weeks | 4 weeks | Yes |
| Atovaquone-proguanil (Malarone) | 250 mg atovaquone and 100 mg proguanil | 1 tablet orally | Once daily | 1 to 2 days | 7 days | No; insufficient data on use in pregnancy |
| Mefloquine hydrochloride (Lariam and generic agents) | 250 mg salt (228 mg base) | 1 tablet orally | Once weekly | 3 weeks preferable; 2 weeks acceptable | 4 weeks | Yes |
| Doxycycline hyclate (Vibramycin, Vibra-Tabs, other brands, and generic agents); doxycycline monohydrate (Monodox, Adoxa, and generic agents) | 100 mg | 1 tablet orally | Once daily | 1 to 2 days | 4 weeks | No; teratogenic |
| Tafenoquine (Arakoda)¶ | 100 mg | 2 tablets orally | Loading dose once daily for 3 days, then once a week starting 7 days after the last loading dose | Loading dose 3 days prior to trip | 1 week after trip | No; unknown G6PD status of fetus |
| Areas with Plasmodium vivax | ||||||
| Primaquine phosphate (appropriate prophylaxis for short duration travel to areas with principally P. vivax)¶ | 26.3 mg salt (15 mg base) | 2 tablets orally | Once daily | 1 to 2 days | 7 days | No; unknown G6PD status of fetus |
| Chloroquine phosphate (Aralen and generic agents) | 500 mg salt (300 mg base) | 1 tablet orally | Once weekly | 1 to 2 weeks | 4 weeks | Yes |
| Hydroxychloroquine sulfate (Plaquenil) | 400 mg salt (310 mg base) | 1 tablet orally | Once weekly | 1 to 2 weeks | 4 weeks | Yes |
| Atovaquone-proguanil (Malarone) | 250 mg atovaquone and 100 mg proguanil | 1 tablet orally | Once daily | 1 to 2 days | 7 days | No; insufficient data on use in pregnancy |
| Mefloquine hydrochloride (Lariam and generic agents) | 250 mg salt (228 mg base) | 1 tablet orally | Once weekly | 3 weeks preferable; 2 weeks acceptable | 4 weeks | Yes |
| Doxycycline hyclate (Vibramycin, Vibra-Tabs, other brands, and generic agents); doxycycline monohydrate (Monodox, Adoxa, and generic agents) | 100 mg | 1 tablet orally | Once daily | 1 to 2 days | 4 weeks | No; teratogenic |
| Tafenoquine (Arakoda)¶ | 100 mg | 2 tablets orally | Loading dose once daily for 3 days, then once a week starting 7 days after the last loading dose | Loading dose 3 days prior to trip | 1 week after trip | No; unknown G6PD status of fetus |
| Presumptive antirelapse therapy (to prevent relapse due to P. vivax or P. ovale)Δ | ||||||
| Primaquine phosphate¶ | 26.3 mg salt (15 mg base) | 2 tablets orally | Once daily | As soon as possible following exposure | 14 days | No; unknown G6PD status of fetus |
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.
Δ Not needed if primaquine or tafenoquine are used as primary prophylaxis.
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