Malaria · Drug comparison
Both work, and both cover chloroquine-resistant regions, so the choice comes down to cost, side effects, and how long you take it after the trip. Doxycycline is cheap but you continue it for 4 weeks after leaving and it makes your skin sun-sensitive. Malarone costs more but you only take it 7 days after, with fewer side effects. Budget and longer trips lean doxycycline; short trips, last-minute travel, and fewest side effects lean Malarone.
| Doxycycline | Malarone (atovaquone-proguanil) | |
|---|---|---|
| Cost (generic) | Often under $20 | About $40 to $90 |
| Start before travel | 1 to 2 days before | 1 to 2 days before |
| Continue after travel | 4 weeks (longer commitment) | 7 days (short tail) |
| Dosing | Once daily | Once daily, with food |
| Main downsides | Sun sensitivity, stomach upset, take upright with water | Cost; avoid in severe kidney disease |
| Cannot use if | Pregnant, on isotretinoin, allergic to tetracyclines | Severe kidney impairment, pregnant |
| Coverage | Chloroquine-resistant regions | Chloroquine-resistant regions |
The single most common adherence failure with malaria pills is stopping too early. With doxycycline you must keep taking it for a full 4 weeks after you leave the malaria area, because the parasite can still emerge during that window. Malarone's 7-day tail is shorter precisely because it acts at an earlier stage. If you know you will forget a 4-week course once you are home, that alone is a reason to choose Malarone.
Mefloquine is a third option (weekly dosing), but we do not prescribe it online, its neurologic and psychiatric cautions are not something a questionnaire can screen reliably. If a destination or budget points to mefloquine, that is a travel-clinic conversation.
Bidwell Health can review your trip and prescribe doxycycline or Malarone online when it is clinically appropriate, sent to your pharmacy.
A $45 asynchronous visit (no video, no membership) for adults in eligible states. Tell us your destination and dates and we match the pill to your trip. Request it at least two weeks ahead when you can, since you start before you leave.
Both work and both cover chloroquine-resistant regions. Doxycycline is cheaper but you take it for 4 weeks after you leave the malaria area and it causes sun sensitivity. Malarone costs more but you only take it for 7 days after, with fewer side effects. Doxycycline suits budget and longer trips; Malarone suits short trips, last-minute travel, and people who want the fewest side effects.
Doxycycline must be continued for 4 weeks after leaving the malaria area. Malarone is continued for only 7 days after. That shorter tail is one of Malarone's main advantages for short trips.
Doxycycline is cheaper, often under $20 generic. Generic Malarone (atovaquone-proguanil) usually runs about $40 to $90 depending on the pharmacy and trip length. Prices vary, so compare with GoodRx or Cost Plus Drugs.
No. Combining doxycycline with isotretinoin can raise pressure around the brain (pseudotumor cerebri). If you take isotretinoin, you should not use doxycycline for malaria; Malarone is the alternative, or see a travel clinic.