What alternative malaria prevention tablets can be used for India (and Sri Lanka) if chloroquine and proguanil are unsuitable for a traveller?
A. Chloroquine plus proguanil are the recommended malaria prevention tablets for India (apart from Assam state in Northern India where either mefloquine, doxycycline or atovaquone/proguanil (Malarone®) are the drugs of choice) and Sri Lanka. If a traveller is unable to take the combination of chloroquine plus proguanil, the alternative is a choice between one of three prescription drugs available: mefloquine, doxycycline or atovaquone/proguanil. It depends on the reason why chloroquine and proguanil are not suitable as to which alternative is considered (e.g. those unable to take chloroquine due to epilepsy should not take mefloquine; if a traveller does not tolerate proguanil, then they should avoid Malarone® as this also contains proguanil). For advice on malaria prevention in pregnant women, see above. Chloroquine plus proguanil remain the first choice agents in India and Sri Lanka because for most areas in these countries, Plasmodium vivax is the most prevalent species of malaria a
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