Take malaria tablets exactly as prescribed, on the same day each week, with food and a full glass of water
Malaria prevention tablets work only if you take them the right way. The most common mistake is skipping doses or taking them at irregular times. Your doctor prescribes a specific tablet, a specific dose, and a specific schedule — usually one tablet on the same day every week, starting one to two weeks before you travel and continuing for four weeks after you leave the malaria zone. Missing even one dose leaves you unprotected.
Take each tablet with food and a full glass of water. Food reduces nausea, which is a common side effect of malaria tablets. Water helps the tablet dissolve and reach your bloodstream. If you vomit within an hour of taking the tablet, contact your doctor or pharmacist to ask whether you need to take another dose.
Set a phone reminder for the same day and time each week. Many people use their travel departure date as a reference point — for example, "every Wednesday at breakfast" — and keep the tablets in a visible place, like next to your toothbrush or coffee maker.
Key Takeaways
- Take your malaria tablet on the same day each week, starting one to two weeks before travel and continuing for four weeks after you return.
- Always take the tablet with food and a full glass of water to reduce nausea and may support proper absorption.
- If you vomit within an hour of taking the tablet, contact your doctor or pharmacist about whether you need a replacement dose.
- Set a weekly phone reminder on the same day and time to avoid missed doses, which leave you unprotected.
- Store your tablets in a cool, dry place away from direct sunlight, and keep them in their original container with the label visible.
What happens if you miss a dose
If you remember within a day or two, take the missed dose as soon as you remember, then resume your regular schedule the following week. Do not double up on doses to make up for a missed one. If you miss more than one dose or realize you missed a dose several days later, contact your doctor or pharmacist when ready — they may recommend additional precautions or a different prevention strategy for the remainder of your trip.
Missing doses is serious because malaria parasites can still infect you even if you have taken most of your tablets correctly. One missed dose does not may provide infection, but it does remove your protection for that week.
Side effects and when to contact your doctor
Common side effects include nausea, dizziness, headache, and vivid dreams. These usually fade after the first few doses. Taking the tablet with food and before bed can help reduce nausea. Drinking extra water throughout the day also helps.
Contact your doctor if you experience severe headache, vision changes, muscle weakness, or signs of an allergic reaction such as rash, swelling, or difficulty breathing. Some people cannot tolerate certain malaria tablets and need to switch to a different type. Your doctor can recommend an alternative if your side effects are severe.
If you are taking other medications, tell your doctor before starting malaria tablets. Some drugs interact with malaria prevention tablets and reduce their effectiveness or increase side effects.
Storage and handling
Store malaria tablets in a cool, dry place away from direct sunlight and heat. Do not leave them in a hot car or bathroom cabinet, where moisture and temperature changes can damage them. Keep them in their original container with the label attached so you can see the expiration date and dosage instructions.
If you are traveling to a hot climate, ask your pharmacist whether your specific tablet can tolerate the heat. Some tablets are more stable than others. If you are unsure whether your tablets have been stored correctly, do not use them — contact your doctor or pharmacist for a replacement.
Different malaria tablets have different schedules
The most common malaria prevention tablets are atovaquone-proguanil (Malarone), doxycycline, mefloquine (Lariam), and primaquine. Each has a different dosing schedule. Atovaquone-proguanil and mefloquine are taken weekly, usually starting one to two weeks before travel. Doxycycline is taken daily, starting one to two days before travel. Primaquine is taken daily for 14 days, usually after you return home.
Your doctor chooses the tablet based on which malaria parasites are present in the region you are visiting, your medical history, and any medications you take. Do not switch tablets or change your schedule without talking to your doctor first. The protection you get depends on taking the exact tablet your doctor prescribed in the exact way they prescribed it.
Keeping track while traveling
Before you leave, write down the name of your tablet, the dose, and the day and time you take it. Keep this information in your phone, your travel documents, and a copy in your luggage. If you lose your tablets or run out while traveling, you can show this information to a local doctor or pharmacy and get a replacement.
If you are crossing time zones, keep taking your tablet on the same calendar day each week, not the same time of day. For example, if you normally take it on Wednesday at 8 a.m. in your home time zone, take it on Wednesday at whatever time it is in your destination time zone. This keeps your protection consistent.
Pack your malaria tablets in your carry-on luggage, not checked baggage. If your luggage is delayed or lost, you will still have your tablets. Keep the original container with the label so customs officials can see what the tablets are.
What malaria tablets do and do not do
Malaria tablets reduce your risk of infection but do not eliminate it completely. They work by killing malaria parasites in your blood before they can cause illness. However, no tablet is 100 percent effective, and protection depends on taking doses on schedule.
Malaria tablets do not protect you from mosquito bites or other mosquito-borne illnesses like dengue or Zika. Use insect repellent containing DEET, wear long sleeves and pants in the evening, and sleep under a mosquito net in areas with high malaria transmission. Combining tablets with these physical barriers gives you the best protection.
Frequently Asked Questions
Can I take malaria tablets without food?
Some tablets can be taken without food, but food significantly reduces nausea and helps your body absorb the tablet. Taking it with a meal or snack is the safest approach. If you have a sensitive stomach, eat a full meal before taking the tablet rather than a light snack.
What if I get malaria even though I took my tablets?
Malaria can still develop despite taking tablets correctly, though it is rare. If you develop fever, chills, headache, or muscle aches during or after travel to a malaria zone, see a doctor when ready and tell them you took malaria prevention tablets. Malaria is treatable if caught early, and your doctor needs to know your prevention history to diagnose and treat you correctly.
Do I need to take malaria tablets if I am only visiting a city?
Malaria transmission varies by region and season. Some cities in malaria zones have little to no transmission, while others have high transmission year-round. Your doctor or a travel medicine clinic can tell you whether tablets are recommended for your specific destination and the time of year you are traveling.
Can I stop taking malaria tablets early if I leave the area before my trip ends?
No. You must continue taking tablets for the full four weeks after you leave the malaria zone, even if you cut your trip short. Malaria parasites can take weeks to show symptoms, and stopping tablets early leaves you unprotected during this window.
Are malaria tablets safe for children?
Most malaria tablets can be given to children, but doses are based on weight and age. Tell your doctor your child's weight and age before traveling. Some tablets are not recommended for very young children or pregnant women, so your doctor needs this information to choose the right prevention strategy.