PALUDRINE/AVLOCLOR TRAVEL PACK
The Paludrine/Avloclor Travel Pack contains two active ingredients used for the prevention of malaria. The Paludrine tablet contains the drug proguanil hydrochloride, and the Avloclor tablet contains the drug chloroquine phosphate.
Paludrine and Avloclor work together to prevent malaria in certain areas where there is no resistance to antimalarial medicines. The Paludrine/Avloclor travel pack is a cost effective method of malaria prevention that has fewer incidences of side effects compared with other antimalarial medicines.
Malaria can potentially be a fatal disease. It is caused by a type of parasite called plasmodium. These parasites are carried by mosquitos and are injected into the bloodstream following a bite from an infected mosquito. Once inside the bloodstream, the parasite travels to the liver before reentering the bloodstream, where it begins to invade the red blood cells and reproduces. A malaria attack is triggered when the red blood cells start to burst, releasing a mass of plasmodium parasites into the bloodstream. The attacks will not begin until large enough numbers of blood cells have been infected with the plasmodium parasites.
Avloclor (chloroquine) and Paludrine (proguanil) actively work to kill any malaria parasites present in your blood following a bite from an infected mosquito. Chloroquine works by attacking the parasites after they have entered the red blood cells. From here it kills the malaria parasite and prevents them from multiplying further. Chloroquine’s mechanism of action is not completely understood, but it is thought to work by inhibiting the action of a chemical the parasite produces to protect themselves. Once inside the red blood cells, the malaria parasite digests the oxygen carrying pigment (haemoglobin) found in these cells. This has the effect of dividing haemoglobin into two parts; haem and globin. The haem part is toxic to the malaria parasite. To prevent itself from being harmed by haem, the parasite produces a chemical that converts the toxic haem into a non-harmful compound. Chloroquine inhibits the action of this chemical, causing the levels of haem to rise, which in turn kills the malaria parasites.
Proguanil works by preventing the malaria parasites from reproducing once they are inside the red blood cells. It achieves this by blocking the action of an enzyme called dihydrofolate reductase. This enzyme is found in the malaria parasites and is a key component in its reproductive process. Dihydrofolate reductase normally converts folic acid into folinic acid, which is an essential step for the parasite to produce new genetic material (DNA). Without new DNA the parasite is unable to reproduce.
Chloroquine and proguanil are taken together to prevent malaria. The chloroquine is only taken once weekly whereas the proguanil needs to be taken every day. However, the malaria parasite has developed a resistance to these medicines in certain areas of the world, which makes it very important to check with your pharmacist regarding the recommended treatment for your destination.
If the Paludrine and Avloclor Travel Pack is recommended, your treatment should be started one week prior to travel. They should be taken throughout your stay and continued for a further four weeks upon your return. This will ensure there is enough medicine in the blood to kill any remaining parasites released by the liver. In areas of possible chloroquine resistance, being combined with proguanil will help ensure you are adequately protected during your travels.
To find out whether Paludrine/Avloclor is the appropriate choice for your trip, check the Fit for Travel website for up to date travel health information.
Although Paludrine and Avloclor will help prevent contracting malaria, it is still important to prevent mosquito bites to further reduce your risk. For more information about malaria and effective bite prevention, visit our malaria page.
Additional steps you can take to minimise mosquito bites includes:
- Wear light, long sleeved clothing and long trousers when outside after the sun has set
- Use insect repellent, sprays or creams on the parts of your body not covered with clothes
- Sleep under a mosquito net or in a properly screened room
- Kill any mosquitos that have entered the rooms in spite of screening with sprays
Malaria can take up to one year to develop. If you experience symptoms including headaches, abdominal pains and night sweats any time during your travels or up to a year after returning, you must see a doctor straight away.
Chloroquine and Proguanil is suitable during pregnancy and breastfeeding. However, it should not be used by those who suffer with epilepsy or psoriasis. To help reduce potential side effects, these tablets should be taken with or just after food.
To prevent malaria, adults should take two Paludrine tablets once a day, at the same time each day. Two Avloclor tablets are taken once a week on the same day each week. Treatment should be commenced one week prior to travelling to the malaria area and continued throughout your stay. Upon returning form the malaria area, treatment should be continued for four weeks.
The correct dosage for children will depend on their age and body weight.
Paludrine and Avloclor should be taken with water, either with or just after food. If necessary, the tablets can be crushed and mixed with milk, jam or honey.
Do not take at the same time as indigestion remedies
If you forget to take your daily dose of Paludrine, take it as soon as you remember. However, if it is almost time for your next dose, skip the forgotten dose and take your next dose at the usual time. Never double-up a dose to compensate for a forgotten dose.
If you forget to take your weekly dose of Avloclor on the usual day, take it as soon as you remember. Then wait for seven days before taking your next dose. You should then continue to take Avloclor on this new day of the week.
If you do experience side effects from Avloclor they may include nausea, diarrhoea, headache, rashes, skin itch, blurred vision, hair loss, dizziness, mood change, sun sensitivity or seizures. As such you should not take Avloclor if you or a close relative suffers with epilepsy. Avloclor can also worsen psoriasis; people who suffer with psoriasis should avoid taking Avloclor if possible. The side effects of Paludrine can include anorexia, nausea, diarrhoea, constipation, skin itch and mouth ulcers. Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects.
If you experience any adverse effects from taking your prescribed medicine it is important to let us know immediately. Please log in to your online account and message one of our healthcare professionals or alternatively call us on 0117 971 1603. In a medical emergency you should contact the emergency services or go straight to your local Accident & Emergency.
Paludrine can prolong bleeding time if taken with anticoagulants such as warfarin. If you take an anticoagulant you should speak to your GP before taking Paludrine/Avloclor. Please read the Patient Information Leaflet enclosed with your medicines for further information.
You should try to avoid taking Avloclor around the same time as indigestion or heartburn remedies containing high levels of calcium, iron or magnesium as this can reduce its effectiveness.
Paludrine/Avloclor is not 100% effective at preventing malaria, however it is still very effective if taken properly and combined with bite avoidance methods.
It is also important to get the correct vaccinations for your trip before you travel. These should be administered around 6 weeks before you leave.
The Paludrine/Avloclor Travel Pack should not be taken without checking with your GP if you take any of the following medicines:
- Praziquantel (used to treat infections of the bowel and bladder caused by parasites).
- Ciclosporin (mainly used by transplant patients but also used to treat rheumatoid arthritis and psoriasis).
- Anti-convulsant medicines (used to prevent convulsions or fits).
- Digoxin (used to treat heart problems).
- Warfarin or other medicines used to prevent blood clots. Paludrine may increase the effect of these medicines.
- Other medicines used to prevent malaria, such as mefloquine. There is a risk of convulsions or fits when these medicines are taken at the same time as Avloclor.
- Cimetidine (used to treat stomach problems). This medicine affects how Avloclor is broken down by your body and may affect the amount of Avloclor in your blood.
- Medicines like kaolin (used for diarrhoea) which are called ‘adsorbents’.
- Antacids (aluminium, calcium and magnesium salts that are used to treat heartburn or indigestion).
You should not take Paludrine/Avloclor if you suffer with:
- Problems with your kidenys or liver
- Myasthenia gravis
- Glucose-6-phosphate dehydrogenase deficiency