||Long term travel
||2 x 250mg Avloclor® tablets once weekly.
||Take one week before travel to, throughout stay in and for four weeks after leaving endemic area.
||Can be taken continuously for three years. Beyond this, regular ophthalmic examinations are recommended every three to six months.
Calculate the dose by weight in kilograms (kg) rather than by the age for infants and children. The following doses are based on guidelines from the Public Health England Advisory Committee on Malaria Prevention (ACMP) and may differ from doses in patient information leaflets (PILs)/SPCs (off-licence doses should not be sold, but must be prescribed). Contact the NPA Pharmacy team for further advice.
- The dose steps for chloroquine syrup are not the same as for chloroquine tablets, because the tablets differ from the syrup in chloroquine base content
- It is preferable to avoid crushing tablets; however, chloroquine, proguanil, mefloquine and atovaquone/proguanil tablets may be crushed and mixed with jam, honey, pasteurised yoghurt, or similar foods for ease of administration to young children
||Chloroquine base (155mg)
||1 and 1/2 tablets
|45kg and over
||Chloroquine syrup (50mcg/5ml base)
|4.5 – 7.9kg
|8.0 – 10.9kg
|11.0 – 14.9kg
|15.0 – 16.5kg
- Tablets may be cut using tablet cutters where necessary
- Crushing, cutting and/or mixing tablets with foods/drinks may be off-licence therefore, individual SPCs should be consulted
- An antimalarial medicine must not be sold over the counter if it is to be administered outside of the terms of the manufacturers’ product licence
- If chloroquine is unsuitable/unavailable, proguanil is not recommended to be used alone as an alternative to chloroquine for malaria chemoprophylaxis; Public Health England guidance, “Guidelines for malaria prevention in travellers from the UK,” states “there are very few regions in the world where the local P. falciparum strains are fully sensitive to proguanil.“ so prophylaxis with proguanil as a single agent is rarely appropriate”
- The choice of an alternative will depend on the reason why chloroquine is unsuitable, for example, due to the travellers’ medical history or potential interactions with other medicines
- If chloroquine is unsuitable or unavailable, alternatives to be considered are a choice between mefloquine, doxycycline or atovaquone/proguanil.
- Pharmacists should ensure that malaria chemoprophylaxis is sold over the counter in-line with manufacturers’ licensing guidance or, when supplied under a Patient Group Direction (PGD), in accordance with the terms of the PGD
- Travellers should be advised that no prophylaxis regimen is 100 per cent effective and they should take adequate measures to avoid being bitten; pharmacy contractors can refer to the NPA Malaria prophylaxis information leaflet for further information on bite avoidance measures and malaria prophylaxis.