Malaria Prophylaxis: What Works, What Doesn't, and How to Stay Safe

When you're heading into a malaria-risk area, malaria prophylaxis, preventive medication taken before, during, and after travel to stop malaria infection. Also known as antimalarial prophylaxis, it's not just a pill you pop—it's a decision that can mean the difference between a safe trip and a life-threatening illness. Not all antimalarials are created equal. What worked a decade ago might be useless—or dangerous—today. Drug resistance has changed the game, and side effects can be worse than the disease itself if you pick the wrong one.

Take mefloquine, a once-popular malaria prevention drug now limited due to severe neurological side effects. Also known as Lariam, it's rarely used anymore because of reports of anxiety, hallucinations, and long-term dizziness. Meanwhile, hydroxychloroquine, a drug once widely used for both malaria and autoimmune conditions. Also known as Hsquin, it's no longer recommended for malaria prevention in most places due to resistance and safety concerns. Even though it showed up in early pandemic headlines, its role today is mostly limited to lupus and rheumatoid arthritis. Today, the go-to options are doxycycline, atovaquone-proguanil, and sometimes chloroquine in rare regions where resistance hasn’t taken hold. But none of these are perfect. Doxycycline can make you sun-sensitive. Atovaquone-proguanil is expensive. Chloroquine won’t work in Africa or Southeast Asia anymore.

It’s not just about the drug—it’s about timing, location, and your health history. If you’re pregnant, have a history of depression, or take other meds, your options shrink fast. And no pill replaces mosquito bites prevention: long sleeves, DEET, bed nets. Prophylaxis is a backup, not a shield. You need both.

What you’ll find here aren’t generic lists. These are real stories from travelers, doctors, and patients who’ve been through it. You’ll learn why some drugs got pulled from use, how to spot fake pills online, what the latest research says about resistance patterns, and how to talk to your doctor without sounding like you’re just googling symptoms. This isn’t travel advice from a brochure. It’s what actually works when the stakes are real.