which antimalarial?

[scottishscuba]

I was aware that Lariam can give people bad dreams and wierd behaviour (in fact when I went to Indonesia and learned to dive, we were told not to take Lariam). So, like DocVikingo, wondered if people were getting mixed up?

Chloroquine resistance is so high that his only options are Malarone or Doxy. Given the virulence of the Plasmodium parasite out there, Malarone has a better protection profile. He has taken Malarone before with no problems, I just wondered if there were any info on taking it whilst diving. When diving in the Philippines I took doxy as an antimalarial which was fine for me, but if I were going to West Africa I wouldnt risk taking doxycycline. So I've narrowed the choice down to one!

He is going to be doing the open water course out there so no deep diving for him, hopefully he'll be fine. His GP has given him the once over and signed him off for diving too.

Thanks for all your input

 

[Malpaso]

Chloroquine resistance is so high that his only options are Malarone or Doxy.

Good to know. I've never ventured outside of North/Central America where it is the recommended option.

 

[chillyinCanada]

I'm reasonably sure Mossman has used Malarone. I'll invite him in here.

 

[Mossman]

Never heard anything about Malarone and bad dreams, just a potential tummyache which neither I nor my buddy suffered on any of three dive trips where I've used it. The main "side effect" is the cost IMO. We paid $6/pill and you have take it daily and for a week after IIRC.

---------- Post added May 15th, 2014 at 11:30 AM ----------

Chloroquine resistance is so high that his only options are Malarone or Doxy. Given the virulence of the Plasmodium parasite out there, Malarone has a better protection profile. He has taken Malarone before with no problems, I just wondered if there were any info on taking it whilst diving. When diving in the Philippines I took doxy as an antimalarial which was fine for me, but if I were going to West Africa I wouldnt risk taking doxycycline. So I've narrowed the choice down to one!

An issue with doxy is a reaction to sun exposure. If you're only planning on night dives, no problem, but it can often be difficult for daytime divers to avoid direct sun.

 

[Malpaso]

An issue with doxy is a reaction to sun exposure. If you're only planning on night dives, no problem, but it can often be difficult for daytime divers to avoid direct sun.

The doxy/sun issue is a decreased effectiveness of the doxy, not a (otherwise) negative side affect to the Pt, correct?

 

[scottishscuba]

Doxycycline does cause photosensitisation and thus, sunburn is a much more significant problem. Am I understanding you correctly Malpaso, in that exposure to the sun will cause reduced efficacy of the drug? That is not something I'm aware of.

Doxycycline is not as effective an antimalarial as the actual marketed antimalarials, but depending on the particular area the effectiveness may be sufficient (therefore I took it in the Philippines where my risk of exposure was low). In Western Africa IMO doxy is unable to provide a level of protection I'd be comfortable with. When I took doxy, I made extra sure I was on top of my sun protection and didn't allow myself to be burned.

Mossman I'm glad to hear that your only negative side effect was the cost! Dads company will be paying for the Malarone so its not an issue for him.

 

[DocVikingo]

The doxy/sun issue is a decreased effectiveness of the doxy, not a (otherwise) negative side effect to the Pt, correct?

Hi Malpaso,

Sun exposure while taking doxycycline is problematic as it causes over-reactivity of the skin to u/v rays, a condition known as photosensitivity. However, sunlight does not reduce the efficacy of the drug.

Regards,

DocVikingo

 

[Malpaso]

Am I understanding you correctly Malpaso, in that exposure to the sun will cause reduced efficacy of the drug? That is not something I'm aware of.

Hi Malpaso,
However, sunlight does not reduce the efficacy of the drug.

Thank you both for that clarification. Not sure where I picked up that mis-information. Maybe the internet, if that's possible

 

[Ricky B]

An issue with doxy is a reaction to sun exposure. If you're only planning on night dives, no problem, but it can often be difficult for daytime divers to avoid direct sun.

A Lycra dive skin is cheap, doesn't add buoyancy, and makes a wetsuit easier to don. If I had concern about sun exposure, that would be my first choice. Given that Egypt is generally pretty hot, evaporative cooling would probably not be much of a problem.