Travel Medicine · Tool
Malaria pills start before you arrive and continue after you leave, and the after part is where people slip up. Doxycycline continues for 4 weeks after you leave the malaria area; atovaquone-proguanil (Malarone) for only 7 days. Enter your dates below to get the exact start day, last dose, and how many tablets to fill.
| Medication | Start | Stop | Daily dose |
|---|---|---|---|
| Doxycycline (malaria) | 1 to 2 days before entering the area | 4 weeks (28 days) after you leave | 100 mg once a day |
| Atovaquone-proguanil / Malarone (malaria) | 1 to 2 days before entering the area | 7 days after you leave | One adult tablet (250/100 mg) once a day with food |
| Acetazolamide / Diamox (altitude) | The day before you ascend | After the first couple of days at altitude, once acclimatized | 125 mg twice a day |
The big takeaway: Malarone has a short 7-day tail, which is why short and last-minute trips often pick it, while doxycycline must continue a full 4 weeks after you leave, a step travelers commonly cut short and a common reason prophylaxis fails. Acetazolamide for altitude is about gradual ascent first; the pill supplements it.
Doxycycline and atovaquone-proguanil (Malarone) are both started 1 to 2 days before you enter the malaria area, then taken once a day while you are there. Mefloquine, which we do not prescribe online, has to be started about 2 weeks before travel instead.
Atovaquone-proguanil (Malarone) is continued for 7 days after you leave the malaria area. That short tail is why many short-trip and last-minute travelers choose it over doxycycline.
Doxycycline is continued for 4 weeks (28 days) after you leave the malaria area. Stopping early is a common mistake that can leave you unprotected, so plan to fill enough tablets for the full course.
Acetazolamide is usually started the day before you ascend to high altitude and continued through the first couple of days at altitude, then stopped once you have acclimatized. Gradual ascent is still the most important prevention.