Malaria

Is the patient aged 18 years or over? (If not, give details in the next question)

Yes

No

Is the child:
- Aged between 2-11 years of age AND weighing more than 11kg
- Aged 12 years and over AND weighing more than 45kg

Yes

No

Please give details of where you are travelling to. (Try to include as much detail as possible such as cities and what activities are planned)

Are you pregnant or breastfeeding?

Yes

No

Do you have any hypersensitivity to any of the following:
- Doxycycline
- Atovaquone
- Proguanil
- Mefloquine or related compounds (e.g. quinine, quinidine)

Yes

No

Do you have hepatic or renal impairment of any degree?

Yes

No

Are you taking any of the following medication:
- Warfarin and other coumarin based anticoagulants
- Efavirenz
- Boosted protease-inhibitors
- Metoclopramide
- Tetracycline
- Rifampicin
- Rifabutin
- Etoposide
- Isotretinoin or other systemic retinoids
- Penicillins
- Other Tetracyclines
- Barbiturates
- Carbamazepine
- Phenytoin
- Rifampicin
- Ciclosporin
- Methotrexate
- Ergotamine
- Methoxyflurane
- Beta blockers
- Calcium channel blockers
- Protein kinase inhibitors
- Tricyclic antidepressants
- Antiarrhythmics
- Other anti-malarials
- Triazole antifungals
- First generation antipsychotics: chlorpromazine, haloperidol, levomepromazine, pimozide, sulpiride, fluphenazine and zuclopenthixol
- Second generation antipsychotics: amisulpride, risperidone, paliperidone

Yes

No

Do you suffer from Myasthenia Gravis or Systemic Lupus Erythematosus?

Yes

No

Do you suffer from rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption?

Yes

No

Do you have active depression, a history of depression, generalised anxiety disorder, psychosis, suicide attempts, suicidal ideations and self-endangering behaviour, schizophrenia or other psychiatric disorder?

Yes

No

Do you have a history of convulsions or seizures of any origin?

Yes

No

Are you suffering from cardiac conduction disorders?

Yes

No

Have you suffered a traumatic brain injury?

Yes

No

Do you have retinal disorders or optic neuropathy?

Yes

No

Do you have a history of Blackwater Fever?

Yes

No

Have you taken malaria chemoprophylaxis for longer than 12 months?

Yes

No

Are you a UK CAA registered airline pilot or a member of the Armed Forces (different exclusion criteria set by Defence Medical Service)

Yes

No

Are you intending to scuba dive during their holiday?

Yes

No

About

How to check GPhC registration

Malaria

Login Details

Please Register as a New Patient

Forgot Password ?