Why "The Best" Antimalarial Doesn't Exist
One of the most common questions our pharmacists hear is: "Which antimalarial is best?" It's a fair question — but the honest answer is that there is no single best antimalarial medication. The right tablet for you depends on where you're going, how long you'll be away, your medical history, your tolerance for side effects, and your budget.
Three antimalarials are prescribed in the UK for most travellers: Malarone (atovaquone/proguanil), Doxycycline, and Mefloquine (Lariam). Each is highly effective when taken correctly, but they differ enormously in dosing schedule, cost, and side-effect profile. A two-week safari honeymoon, a six-month backpacking trip, and a fortnight's business travel may each suit a different tablet.
This guide compares all three so you understand the trade-offs before your consultation. If you need malaria tablets in Gloucester, our pharmacists will match the right one to your trip — but knowing the basics first helps you ask better questions.
Malarone (Atovaquone/Proguanil)
Malarone is the most commonly prescribed antimalarial in the UK, largely because it is the best tolerated. It combines two drugs — atovaquone and proguanil — in a single daily tablet.
Dosing: One tablet a day, taken with food or a milky drink. You start just 1–2 days before entering a malarial area, continue every day while you're there, and take it for only 7 days after you leave. This short tail makes it convenient and easy to remember.
Side effects: Malarone has the fewest side effects of the three. Some people experience mild stomach upset, headache, or vivid dreams, but serious reactions are rare.
Best for: Shorter trips, last-minute travellers (because of the short pre-trip start), and anyone who has struggled with side effects from other antimalarials.
The catch: Cost. Malarone is the most expensive option, and because you take it every single day, the price adds up quickly on longer trips. A generic version (atovaquone/proguanil) is available and brings the cost down considerably, which we'll always consider for you.
Doxycycline
Doxycycline is an antibiotic that doubles as an effective and very affordable antimalarial. It's a popular choice for longer trips and budget-conscious travellers such as backpackers and gap-year students.
Dosing: One capsule a day, started 1–2 days before travel, continued daily throughout, and taken for a full 4 weeks after leaving the malarial area. That four-week tail is longer than Malarone's and is a common reason people stop too early — so it requires discipline.
Side effects: The two to watch are sun sensitivity (your skin burns more easily, so high-factor sunscreen is essential) and stomach irritation. Taking the capsule with plenty of water, with food, and not lying down straight afterwards reduces the risk of heartburn. It can also reduce the effectiveness of some oral contraceptives in the first weeks and may cause thrush in some women.
Best for: Long trips where Malarone would be cost-prohibitive, and travellers who don't mind a daily tablet. As an antibiotic, it also offers some incidental protection against other travel infections.
Not suitable for: Pregnant or breastfeeding women, and children under 12.
Mefloquine (Lariam)
Mefloquine, still widely known by its brand name Lariam, is the only one of the three taken just once a week, which makes it appealing for very long trips.
Dosing: One tablet weekly, but you must start 2–3 weeks before travel. This longer lead-in is deliberate — it lets us check that you tolerate the drug before you depend on it abroad, and it gets the medicine to a steady level in your system. You continue weekly throughout and for 4 weeks after you leave.
Side effects: Mefloquine is effective and cheap for long trips, but it carries the most significant neuropsychiatric side effects of the three — including anxiety, depression, vivid dreams, sleep disturbance, and dizziness. Because of this, it is not suitable for anyone with a history of depression, anxiety, psychiatric illness, or epilepsy, and a careful screening conversation is required before we prescribe it.
Best for: Long-duration trips where weekly dosing is a genuine advantage and where the traveller has no relevant mental-health history.
Side-by-Side Comparison
Here's how the three compare at a glance:
Malarone (Atovaquone/Proguanil)
- How often: Daily
- Start before travel: 1–2 days
- Continue after travel: 7 days
- Cost: Highest (generic cheaper)
- Main drawback: Price on long trips
- Side effects: Fewest
Doxycycline
- How often: Daily
- Start before travel: 1–2 days
- Continue after travel: 4 weeks
- Cost: Lowest
- Main drawback: Sun sensitivity, stomach upset
- Side effects: Moderate
Mefloquine (Lariam)
- How often: Weekly
- Start before travel: 2–3 weeks
- Continue after travel: 4 weeks
- Cost: Low for long trips
- Main drawback: Neuropsychiatric effects; screening required
- Side effects: Most significant
Remember, the cheapest tablet isn't a bargain if its side effects ruin your trip, and the best-tolerated tablet isn't worth it if the daily cost is unaffordable over six months. The "right" choice balances all of these factors against your specific itinerary.
How We Choose For You
No antimalarial replaces good bite avoidance — insect repellent containing at least 50% DEET, covering up at dusk and dawn, and sleeping under a treated net where appropriate all remain essential, whichever tablet you take.
At your consultation, our pharmacists carry out a full risk assessment using the latest NaTHNaC and TravelHealthPro guidance. We look at your exact destinations (malaria risk varies enormously even within a single country), the time of year, the length and style of your trip, your full medical history and current medications, and any previous experience you've had with antimalarials. From there we recommend — and prescribe — the most suitable option.
Because Mefloquine needs a 2–3 week head start and some travellers need time to weigh up the choice, we always recommend booking your consultation at least 4–6 weeks before you travel.
Book a Consultation Before You Travel
Getting your antimalarial right is one of the most important parts of preparing for a trip to a malaria-risk area. Our pharmacist-led travel health consultations are available at both our Hucclecote locations in Gloucester:
- Brookfield Pharmacy, 5 Brookfield Road, Hucclecote, GL3 3HA
- Hucclecote Pharmacy, 7 Glenville Parade, Hucclecote, GL3 3ES
Book your appointment today and we'll make sure you travel with the right protection — and real peace of mind.