"Do I need malaria tablets for this trip?" is one of the questions we're asked most at our travel clinic. Sometimes the answer is a firm yes, as for a safari in Kenya. Sometimes it's a clear no: Bali, Phuket and Goa usually don't need them. Plenty of trips fall somewhere in between. As pharmacist prescribers at Brookfield Pharmacy in Hucclecote, we've written this destination-by-destination guide to whether you need malaria tablets, which one is likely to suit you, and what it costs. We also cover the malaria prevention methods that matter just as much as the tablets.
Why malaria tablets matter
Malaria is a parasite infection spread by the bite of an infected Anopheles mosquito, which mostly bites between dusk and dawn. Every year, well over a thousand travellers come back to the UK with malaria. The most dangerous form, Plasmodium falciparum, can become life-threatening within a day or two of the first symptoms.
There's no vaccine for adult travellers, so prevention rests on bite avoidance and, where the risk justifies it, antimalarial tablets. Taken correctly, the tablets are highly effective. But they aren't 100% effective, which is why bite avoidance still matters.
People who grew up in a malaria area and now live in the UK are often the most at risk when they go back to visit family. Any immunity you had fades within a few years of leaving, so you need the same protection as any other traveller.
Do I need malaria tablets for my destination?
Malaria risk depends on where you're going within a country, when you're going, how long you'll stay and what you'll be doing. The table below gives the usual UK advice for popular destinations. We always check the latest country-specific guidance for your exact itinerary at the consultation, because risk areas do change.
| Destination | Malaria tablets usually advised? | Notes |
|---|---|---|
| Kenya, Tanzania, Uganda (incl. Zanzibar, safaris) | Yes | High risk in most areas. Nairobi city and the highlands above 2,500m are lower risk, but most itineraries pass through risk areas |
| The Gambia, Ghana, Nigeria, Senegal | Yes | High risk year-round across the country |
| Malawi, Zambia, Mozambique, Zimbabwe | Yes, for most areas | Victoria Falls and safari areas are risk areas |
| South Africa | Depends | Cape Town, the Garden Route and Johannesburg: no. Kruger and the north-east lowveld: risk is seasonal, and tablets may be advised depending on the time of year |
| Egypt, Morocco, Tunisia | No | No malaria risk in tourist areas |
| India | Depends | Goa, Kerala, Rajasthan and the Golden Triangle: usually bite avoidance only. Tablets may be advised for some eastern and north-eastern states |
| Thailand, Vietnam, Cambodia, Laos | Usually no | Cities, beaches and main tourist routes are very low risk. Rural forested border areas carry some risk; tablets are rarely needed for typical trips |
| Indonesia | Depends | Bali, Java and Lombok: no. Papua and West Papua: yes |
| Sri Lanka | No | Declared malaria-free in 2016 |
| Nepal | Usually no | Kathmandu, Pokhara and the main trekking routes: no. Some lowland Terai areas carry low risk |
| Peru, Brazil, Ecuador, Colombia | Depends | Lima, Cusco, Machu Picchu, Rio and the Galápagos: no. Some Amazon basin areas: tablets may be advised |
| Mexico, Costa Rica, Cuba, Dominican Republic | Usually no | Main tourist areas are no or very low risk; bite avoidance is enough for most trips |
"Usually no" doesn't mean "no risk". In very low-risk areas, UK guidance usually says the side effects and cost of tablets outweigh the benefit. Bite avoidance is the main protection there. If you're trekking off-route, working rurally or staying a long time, the answer may change.
The ABCD of malaria prevention methods
UK travel health advice sums up malaria prevention in four letters:
- A — Awareness of risk. Know whether your destination has malaria and when the risk is highest.
- B — Bite prevention. Use an insect repellent containing 30–50% DEET on exposed skin. Wear long sleeves and trousers from dusk, and sleep under an insecticide-treated net if your room isn't screened or air-conditioned.
- C — Chemoprophylaxis. This means taking the right antimalarial tablets, starting on time and finishing the course after you get home.
- D — Diagnosis. Get any fever checked urgently, both during your trip and for up to a year afterwards. Tell the doctor where you've been.
Most travellers who get malaria either took no tablets, took the wrong ones, or stopped them too early. The "C" only works when you finish the course.
Atovaquone/proguanil vs doxycycline vs mefloquine
There are three main antimalarial tablets for travel from the UK. All three work well for most high-risk destinations. The right one depends on your health, the length of your trip, your budget and what you'll find easiest to take.
| Tablet | How often | Start | Continue after leaving | Approx. cost |
|---|---|---|---|---|
| Atovaquone/proguanil (Malarone or generic) | Daily | 1–2 days before | 7 days | £1.50–£2.50 per tablet |
| Doxycycline | Daily | 1–2 days before | 4 weeks | From around 30p per tablet |
| Mefloquine (Lariam) | Weekly | 2–3 weeks before | 4 weeks | £3–£4 per tablet |
Atovaquone/proguanil
This is the most popular choice for short trips. It's well tolerated, and the short course after you return makes it easy to finish. Side effects are usually mild: an upset stomach, headache or mouth ulcers. It costs more per tablet, but for a one- or two-week holiday the total is often similar to the alternatives.
Doxycycline
Doxycycline is the budget option and a good choice for longer trips. It's an antibiotic, so it can cause sun sensitivity, which matters on a beach or safari holiday. It can also cause indigestion (take it upright with plenty of water) and thrush. It isn't suitable for children under 12 or during pregnancy. The four-week course after you return is the part people most often forget to finish.
Mefloquine
The weekly dose suits some long-term travellers. However, mefloquine can cause vivid dreams, low mood and anxiety, so it isn't suitable for anyone with a history of depression, anxiety, other mental health conditions or epilepsy. We start it two to three weeks early so that any side effects show up before you leave.
Chloroquine and proguanil
These older tablets are now rarely recommended, because malaria in most parts of the world has become resistant to them. If you have some left over from a previous trip, please don't rely on them. Ask us first.
How much do malaria tablets cost?
Malaria tablets for travel aren't available on the NHS, so you'll need a private prescription. At Brookfield Pharmacy, we prescribe them after your travel consultation and dispense them at cost. A two-week trip on atovaquone/proguanil typically costs around £40–£65 for the tablets. Doxycycline is usually cheaper, even with the longer course.
Here are some examples from our travel vaccine cost guide:
- Kenya safari, 2 weeks: atovaquone/proguanil, about £55
- Rural India, 3 weeks: about £75 for four weeks' supply
- Peruvian Amazon, 2–3 weeks: about £45
If you're also having travel vaccines with us, your consultation is included. You can find the full vaccine price list on our travel clinic page.
Special situations
- Pregnancy: UK guidance advises avoiding travel to malaria areas while pregnant if possible, because malaria is more severe in pregnancy. If you must travel, speak to us early, as the choice of tablet is limited.
- Children: Children need malaria tablets just as adults do, with the dose based on their weight. Atovaquone/proguanil comes in a paediatric strength, and we can advise on crushing tablets into food.
- Long stays and expats: For trips of several months, cost, side effects and access to healthcare abroad all matter. We'll plan the most practical option with you.
- Medical conditions and other medicines: Epilepsy, kidney problems, mental health conditions and some medicines (including warfarin and some epilepsy treatments) affect which tablet is safe. Bring your repeat prescription list to the consultation.
Getting malaria tablets in Gloucester
You don't need to see your GP. Many surgeries don't prescribe antimalarials for travel. Our pharmacist prescribers handle everything at Brookfield Pharmacy's travel clinic:
- Book a travel consultation online or by phone, ideally 6–8 weeks before you travel. Malaria tablets alone can often be sorted at shorter notice.
- Consultation: we go through your itinerary, dates, health and medicines, and check the current malaria map for each place you're visiting.
- Prescription: if tablets are needed, we'll recommend the best option, explain exactly when to start and stop, and dispense them there and then.
- Everything else: we'll cover any travel vaccines you need in the same appointment. For more pre-trip pitfalls, see 12 common travel health mistakes.
We're a short drive from Gloucester city centre, Brockworth and Churchdown, with parking nearby.
Frequently asked questions
Do I need malaria tablets for Thailand or Bali?
For a typical holiday, no. Bangkok, Phuket, Koh Samui, Chiang Mai, Bali and Lombok are no-risk or very low-risk areas, and bite avoidance is enough. Tablets may be considered for extended trips into rural forested border areas.
Do I need malaria tablets for a Kenya or Tanzania safari?
Yes, for almost all itineraries, including Zanzibar and the Masai Mara. Atovaquone/proguanil is a common choice for a short safari because of its short course after you return.
Can I buy malaria tablets over the counter?
Some antimalarials, including atovaquone/proguanil, can be supplied by a pharmacist after a consultation without a GP prescription. You'll still need a proper risk assessment so the tablet suits your destination, health and other medicines. We do this as part of our travel consultation.
What happens if I miss a dose of malaria tablets?
For daily tablets, take the missed dose as soon as you remember. If it's nearly time for the next one, skip the missed dose and carry on as normal. Don't take a double dose. Keep taking the tablets for the full course after you leave. If you miss several doses, contact a pharmacist or doctor for advice.
How soon after travel can malaria symptoms appear?
Usually within a few weeks of being bitten, but symptoms can take up to a year to appear. Symptoms include fever, sweats, chills, headache, muscle aches and flu-like illness. If you develop a fever after visiting a malaria area, seek medical advice the same day and say where you've travelled.
Book your malaria consultation
Not sure whether you need malaria tablets, or which one to take? A short consultation will give you a clear, honest answer for your exact trip. Book online here or call 01452 618377. Brookfield Pharmacy is at 5 Brookfield Road, Hucclecote, Gloucester GL3 3HA, open Monday to Friday 8:30–18:00 and Saturday 9:00–12:00.
About Ravneet Chahal
Ravneet Chahal is a highly qualified Pharmacist Prescriber at Brookfield Pharmacy with extensive professional credentials and expertise in clinical pharmacy practice.
Qualifications: MPharm, PGDip, PGCert IP, MCMA
With her specialized knowledge and prescribing authority, Ravneet is committed to providing evidence-based health information and personalized pharmaceutical care. She supports our patients in making informed decisions about their health and wellness.
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