Travel Medicine · Methodology

How we decide whether you need malaria pills

By Bidwell Cranage, APRN, FNP-C, Member, International Society of Travel Medicine · Clinically reviewed by Ashley Cranage, APRN, FNP-C · Reviewed June 19, 2026

We follow the CDC's destination guidance for your exact itinerary, prescribe only the two drugs we can manage safely online (doxycycline and Malarone), refer out anything that needs more, and tell you honestly when you need no pill at all. Here is the full method, so you can see the reasoning behind every recommendation.

The steps we follow

  1. Start with the CDC. We use the CDC Yellow Book and the CDC's destination-specific Travelers' Health guidance for each country on your trip. That is the authoritative source for where malaria is and is not, and which drugs are appropriate.
  2. Check region and elevation, not just the country. Malaria risk usually depends on where in a country you go and how high. Many capitals, resorts, and high-altitude areas have no malaria, while a jungle or coastal leg of the same trip does. We map your specific stops, which is why our destination pages answer by region (for example, Peru's Amazon yes, Machu Picchu no).
  3. Match the right drug. The CDC lists the options for each country. We prescribe doxycycline or atovaquone-proguanil (Malarone), which are appropriate for most tourist destinations, and we help you choose between them based on cost and dosing schedule.
  4. Apply the safety screens. We check for the things that change the answer: drug allergies, isotretinoin or severe kidney disease for the routing between doxycycline and Malarone, and pregnancy or breastfeeding.
  5. Refer out what needs more. If your itinerary needs mefloquine, primaquine, or tafenoquine, or if you are pregnant, we refer you to an in-person travel clinic rather than work around the screening those drugs require.
  6. Say so when no pill is needed. When the CDC does not recommend a pill for your itinerary, we tell you, rather than sell you one. Many trips need only mosquito precautions.
  7. Date it and review it. Every destination page carries a "CDC checked on" date, and we log changes in our data changelog when guidance changes.

What we prescribe, and what we refer

Why we keep the line where we do. An online visit is the right tool when the decision is clear from your itinerary and the drug is one we can manage safely. When a trip needs lab testing, a neuropsychiatric review, a vaccine, or an exam, the honest answer is a travel clinic, and we will tell you that even though it means sending you elsewhere.

Who reviews this

These decisions are made and reviewed by Bidwell Cranage, APRN, FNP-C, an AANP board-certified Family Nurse Practitioner and a Member of the International Society of Travel Medicine, with clinical review by Ashley Cranage, APRN, FNP-C. The same boundaries are published in machine-readable form at /data/travel-medicine-scope.json.

FAQ

How do you know if I need malaria pills?

We follow the CDC's destination guidance for your exact itinerary, not just the country. Malaria risk often depends on the region and elevation, so a trip to a capital city or a high-altitude area can need no pills while a jungle or coastal leg of the same trip does. We map your specific stops against the CDC's malaria map and tell you what is recommended.

Why do you only prescribe doxycycline and Malarone?

Doxycycline and atovaquone-proguanil (Malarone) are appropriate for most tourist destinations and can be prescribed and managed safely through an online visit. The other options, mefloquine, primaquine, and tafenoquine, need extra screening: mefloquine needs neuropsychiatric and cardiac review, and primaquine and tafenoquine need a G6PD blood test first. Those are not safe to do online, so we refer you to a travel clinic for them.

What if the CDC recommends a drug you do not prescribe?

If your itinerary needs mefloquine, primaquine, or tafenoquine, or if you are pregnant, we refer you to an in-person travel clinic rather than work around the safety screening. We will tell you plainly that your trip needs more than an online visit, even though it means sending you elsewhere.

Do you ever tell people they do not need malaria pills?

Yes, often. Many popular trips, like Cancun, a Bali beach holiday, or Cusco and Machu Picchu, have no malaria, and many low-risk destinations need only mosquito precautions. When the CDC does not recommend a pill for your itinerary, we say so rather than sell you one you do not need.

Malaria pills online, $45 visit ›

Related

Reviewed by Bidwell Cranage, APRN, FNP-C, AANP board-certified Family Nurse Practitioner and Member, International Society of Travel Medicine, with clinical review by Ashley Cranage, APRN, FNP-C.
Last reviewed: June 19, 2026. Sources: CDC Yellow Book and CDC Travelers' Health. See our editorial policy and medical review policy.