What is the best malaria prophylactic to take?

Weighing the pros and cons of lariam and malarone

There is no vaccine for malaria. There are several treatment options if you come down with it, but it's best to avoid it altogether. There are several options for prevention.

Malaria is transmitted via mosquito bites. If you can avoid getting bit, you are in the clear.  But if you are in an area where malaria is endemic, chances are you're going to get bit no matter how much repellent you wear. Your only other option for prevention is to take one of the prophylactics. This article will compare two of the most well known prophylactics, lariam and malarone. 

Lariam (Mefloquine) 

Lariam is widely prescribed as an anti-malarial medication. With a once-a-week dose it has shown to be very effective in preventing cases of malaria. Because it is a once-a-week tablet, it is also relatively cost-effective - you don't have to buy as many pills.

Lariam does have a downside, however. Approximately 25% of people who take Lariam experience some amount of side effects. These side effects range from anxiety, depression, and nightmares - the most common side effects - to seizures and problems with the central nervous system. 

In addition, according to a study from the Walter Reed Army Institute of Research, it takes 7-9 weeks to develop adequate serum levels of mefloquine to prevent malaria. In other words, you need to start taking this medication far in advance of your trip. 


Malarone is also widely prescribed to prevent malaria. It has shown to be effective for both prevention and treatment, and it is officially endorsed by many NGO's as well as the Peace Corps. There are also far fewer side effects and you don't have to take it far in advance. 

The catch is that Malarone is a daily pill and it is very expensive, especially if you are buying it in a first world pharmacy. Generic versions can cost up to $4 for a single tablet. In developing world pharmacies, you will be able to find it cheaper, but it is still more expensive than other options. 

Whether you end up taking Lariam, Malarone, or another option, such as doxycycline, you should visit a travel health clinic first and discuss your options with a doctor. While Malarone may be expensive, it may be a worthy investment considering the possible side effects of other options.