Doxycycline or Atovaquone/proguanil

Dosage schedule

Antimalarial Dose Schedule Long-term travel
Doxycycline 1 x 100mg Doxycycline tablet/capsule daily. Take one to two days before travel to, throughout stay in and for four weeks after leaving endemic area. Can be taken for up to two years and possibly longer if considered necessary.

Atovaquone/proguanil 1 x (250mg/100mg) Atovaquone/proguanil tablet daily. Take one to two days before travel to, throughout stay in and for seven days after leaving endemic area. Can be taken for up to one year and possibly longer if considered necessary.However, individual SPCs must be checked carefully as licensed treatment periods may vary.

Children’s doses

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 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 Services team for further advice.

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 for ease of administration to young children. Tablets may be cut using tablet cutters where necessary. Crushing, cutting or mixing tablets with foods/drinks may be off-licence, therefore, individual SPCs should be checked and specific manufacturers should be contacted.

Weight Doxycycline
once daily
Under 6.0kg Not recommended
6.0–9.9kg Not recommended
10.0–15.9kg Not recommended
16–24.9kg Not recommended
25.0–44.9kg From 12 years: 1 capsule/tablet
45kg and over 1 capsule/tablet
Weight Atovaquone/proguanil
once daily
5.0 – 7.9kg ½ Malarone paediatric tablet
8.0 – 9.9kg ¾ Malarone paediatric tablet
10.0 – 19.9kg 1 Malarone paediatric tablet
20.0 – 29.0kg 2 Malarone paediatric tabletsc
30.0 – 39.9kg 3 Malarone paediatric tablets
> 40kg 4 Malarone paediatric tablets or 1 adult tablet