Does anyone have a connection to acquire Deltaprim here in the US? I have had great success with this as an anti-malaria med. For me no complications at all. I have suffered through Larium and Doxy and that joy. I have conversely used Deltaprim several times. Any help would be appreciated.

Jeff

Deltaprim has not been approved by the FDA and is not sold in the U.S. Buying it on arrival or importation by someone from countries where it is available would be the best courses to take. I would not rely on an internet order.

Note that effectiveness of Deltaprim is being debated in the literature with some references listing it as ineffective. At least one current military medicine reference and other papers lists it as only slightly effective or partially effective. Malarone currently appears to be the prophylaxis of choice given the side effects and issues with Larium.

You can not import Deltaprim into the US. I tried and it was confiscated at customs. A few years ago both I and my PH came down with Malaria in Zimbabwe while taking Deltaprim.

It has been used there for a long time and an immunity to it by the mosies may have developed.

465H&H

quote:

Originally posted by Bwana Bunduki:
Does anyone have a connection to acquire Deltaprim here in the US? I have had great success with this as an anti-malaria med. For me no complications at all. I have suffered through Larium and Doxy and that joy. I have conversely used Deltaprim several times. Any help would be appreciated.

Jeff

Just because you didn't contract malaria doesn't prove that it was effective.

quote:

Originally posted by Will:

quote:

Originally posted by Bwana Bunduki:
Does anyone have a connection to acquire Deltaprim here in the US? I have had great success with this as an anti-malaria med. For me no complications at all. I have suffered through Larium and Doxy and that joy. I have conversely used Deltaprim several times. Any help would be appreciated.

Jeff

Just because you didn't contract malaria doesn't prove that it was effective.

But I did get to enjoy the lack of technicolor nightmares or extreme photosensitivity. Malarone is going to have to be it I guess.

Jeff

Malarone or a good Malt.

Fairgame-If you don't quit prescribing " a good malt" as a cure for everything I am going to revoke your licence to practice medicine. LOL

I am about to go to a very probable malaria area.

A quick search resulted in this article being saved to my laptop:GUIDELINES FOR THE PREVENTION OF MALARIA IN SOUTH

Now, despite the fact that it was complied under The Most (Dis)Honourable Dr. Mantho Tshabalala Maak-my-Bang, one of the many former Ministers of Health in the New Regime, [who is better known for curing aids by eating beetroot & garlic and advising State President Zuma to take a shower after having unprotected sex with a HIV positive whore to prevent getting infected by the HI virus] it looks like good advice to me. But who am I to judge?

How do the regular travel-to-Africa medics feel about this? I’m not asking for a full professional critique, just some thoughts expressed in lay terms please? Does anyone have any idea of the relative costs involved buying a full course of the different prophylactics? Which are available “over the counter” and which needs a doctor’s prescription?


In good hunting.

Andrew McLaren

Malarone

quote:

Originally posted by Andrew McLaren:
I am about to go to a very probable malaria area.

A quick search resulted in this article being saved to my laptop:GUIDELINES FOR THE PREVENTION OF MALARIA IN SOUTH

Now, despite the fact that it was complied under The Most (Dis)Honourable Dr. Mantho Tshabalala Maak-my-Bang, one of the many former Ministers of Health in the New Regime, [who is better known for curing aids by eating beetroot & garlic and advising State President Zuma to take a shower after having unprotected sex with a HIV positive whore to prevent getting infected by the HI virus] it looks like good advice to me. But who am I to judge?

How do the regular travel-to-Africa medics feel about this? I’m not asking for a full professional critique, just some thoughts expressed in lay terms please? Does anyone have any idea of the relative costs involved buying a full course of the different prophylactics? Which are available “over the counter” and which needs a doctor’s prescription?


In good hunting.

Andrew McLaren

Andrew,

We can get pretty much everything you want over the counter here and it is all cheap. And if you want some thing stronger then I know some good vets.

I've used Malarone, but found I couldn't sleep while taking that drug. I took it first thing in the morning, but I still couldn't sleep without taking a sleeping pill. At first I thought it was jet lag, but after 3 days of this I quit taking the Malarone and everything was fine. Fortunately, no Malaria.

Anyone else experience this with Malarone?

Gin and Tonic sundowners are great.

Andrew,

Based on a quick internet search for both US and ZA costs:

Malarone is about $6 per tab in the US and ZAR 45-48. Dosage is 1 daily.

Doxycycline is @ $0.15 in the US and @ZAR3. Dosage is 1 daily.

I was unable to find Choroquine & Proguanil (Paludrine/Avloclor) costs in the US or ZA but commercial packs each with one week's dosage are @ £13 in the UK.

All are effective. All have pluses and minuses. Example is increased sensitivity to sunlight and sunburn with Doxy. You can check the US CDC and medical references for more detailed health care and pharmacy (chemist) reference info if interested.

Never had a problem at all with Malarone until the last time I took it. Really tore my stomach up, which wasn't pleasant, but wasn't in a place where I felt I could just stop taking it.

I prefer Larium. I dream in color anyway and prefer once a week over daily-daily. Doxy will mess with you under the African sun.

Malarone seems to have the least side effects although it does play hindrance to my stomach.
Have been told Doxi is good in bad Tick areas as it also helps against Tick bite fever due to being an antibiotic.
I did use Delta Prim with another SA drug last season .
Can't say how well it works but the fact that I didn't contract Malaria during my extended time on the malaria ridden coast of northern Moz is a good indication . Must find out the name of the additional drug ..

Deltaprim worked really really well...until it was issued to the Zimbabwe Army fighting Renamo in Mozambique (under the name malasone)- of course, they didn't take it correctly and resistance began to develop.

Break throughs are rare but still common enough all along the zambezi valley as far as the falls for me to recomend something else.

As Parks we were issued deltaprim (malasone) and it was the senior officers Job to ensure all men took it on time. Never had a single game scout go down with Malaria while taking it prior to 1998- but I developed a sulphur allergy thanks to it and had to change.

Larium sure makes the nights interesting...I still think Hitler dressed as little bo peep prancing roundd a daisy field quoting Churchil was the best but there were others that came close

Had one of my PHs tell me that one of his clients is based in a mental home due to Larium.

Ganyana, you must make the time to jot down your Larium boosted fantasies. Should be good for a laugh or three.

quote:

Originally posted by ozhunter:
Had one of my PHs tell me that one of his clients is based in a mental home due to Larium.

Nothing like factual, documented information of an evidentiary value being contributed to the discussion. Thanks for sharing.

quote:

Originally posted by LionHunter:

quote:

Originally posted by ozhunter:
Had one of my PHs tell me that one of his clients is based in a mental home due to Larium.

Nothing like factual, documented information of an evidentiary value being contributed to the discussion. Thanks for sharing.

So you only contribute and want documented evidence for these discussion ?
I would consider what what he had to say as factual without question particularly when its similar to the reports that I hear from most PH which spend their time with Larium doped clients and even if part true, isn't it a concern??

Malerone X 4 safaris = worry free safari and no problems

Mike

I took Larium for a long time until the last time when the deep nightmares came along. Switched to Malarone.

quote:

Originally posted by Oday450:
Andrew,

Based on a quick internet search for both US and ZA costs:

Malarone (Mefloquine) is about $6 per tab in the US and ZAR 45-48. Dosage is 1 daily.

Doxycycline is @ $0.15 in the US and @ZAR3. Dosage is 1 daily.

I was unable to find Choroquine & Proguanil (Paludrine/Avloclor) costs in the US or ZA but commercial packs each with one week's dosage are @ £13 in the UK.

All are effective. All have pluses and minuses. Example is increased sensitivity to sunlight and sunburn with Doxy. You can check the US CDC and medical references for more detailed health care and pharmacy (chemist) reference info if interested.

A quick correction here: Malarone is NOT repeat NOT mefloquine. Lariam is mefloquine.

Malarone is the winner. It's used to cure malaria and to protect against getting it. Came down with both falcipirum (sp?) and vivax in 2004 after a trip to South Sudan. Diagnosed self, went to doctor here in DC for a blood test and checked into hospital where I was the center of attention of interns, residents and fully-fledged medicos delighted with such a rare thing as malaria. Took four tablets of malarone all at once every 24 hours for three days. Walked out of the hospital and was in Southern Africa hunting five days later.

Have since used the prophylactic dose of one tablet of malarone daily starting before entering a malarial area and ending some days after leaving. No recurrence. Oh, on leaving hospital was given a 10 day supply of primiquine to flush the vivax critters out of the liver so no recurrence of that old and best known form of the disease.

Regards

Good catch Tim - thanks,

The original post has been corrected - I was interrupted while writing that post and didn't pay enough attention to what was typed. Malarone (adult) is a combination of 250mg atovaquone and 100 mg proguanil hydrochloride. There is a pediatric strength as well.

Greatly embarrassed at the error. Thankfully it was caught before being dispensed!

ozhunter,

You get to believe anything you want and it's all OK with me. What I object to is the repeating of HEARSAY stories about an anti-malarial drug that works and is approved by the Center for Disease Control and recommended as an effective malaria preventative. Most PHs aren't MDs with specialties in Psycopharmacology.

All drugs have side effects, most of which you never know about or fail to associate with the drug, including aspirin. The crazy stories about Larium have been around as long as the drug, yet I know of no documented case confirming that the mental illness was attributable directly to the use of Larium. If you have a loose screw to start with, the colorful, vivid dreams might push you over the edge, but the pre-existing mental illness is the root cause, not the drug. I've taken Larium for more than 16 years and am no crazier now (debatable) then when I started.

Cheers Mate!

quote:

Originally posted by LionHunter:
ozhunter,

You get to believe anything you want and it's all OK with me. What I object to is the repeating of HEARSAY stories about an anti-malarial drug that works and is approved by the Center for Disease Control and recommended as an effective malaria preventative. Most PHs aren't MDs with specialties in Psycopharmacology.

All drugs have side effects, most of which you never know about or fail to associate with the drug, including aspirin. The crazy stories about Larium have been around as long as the drug, yet I know of no documented case confirming that the mental illness was attributable directly to the use of Larium. If you have a loose screw to start with, the colorful, vivid dreams might push you over the edge, but the pre-existing mental illness is the root cause, not the drug. I've taken Larium for more than 16 years and am no crazier now (debatable) then when I started.

Cheers Mate!

A close family member had a very bad (break-down type) reaction to Lariam. Fortunately recovered well. Not published in a medical journal, but diagnosed by the doctor and good enough for me.

quote:

Originally posted by LionHunter:
ozhunter,

You get to believe anything you want and it's all OK with me. What I object to is the repeating of HEARSAY stories about an anti-malarial drug that works and is approved by the Center for Disease Control and recommended as an effective malaria preventative. Most PHs aren't MDs with specialties in Psycopharmacology.

All drugs have side effects, most of which you never know about or fail to associate with the drug, including aspirin. The crazy stories about Larium have been around as long as the drug, yet I know of no documented case confirming that the mental illness was attributable directly to the use of Larium. If you have a loose screw to start with, the colorful, vivid dreams might push you over the edge, but the pre-existing mental illness is the root cause, not the drug. I've taken Larium for more than 16 years and am no crazier now (debatable) then when I started.

Cheers Mate!

Mike,

The FDA approves drugs and their uses. The CDC only provides information. The following is from the FDA approved package insert for Larium. The numbers inserted are line numbers in the printed materials.

It indicates that psychotic behaviors often continue after the drug has been stopped. While this is not a proven cause and effect and other contributory factors may be involved, cases of longer term drug caused behaviors have been reported.

Larium Package Insert

"142 Mefloquine may cause psychiatric symptoms in a number of patients,
143 ranging from anxiety, paranoia, and depression to hallucinations and
144 psychotic behavior. On occasions, these symptoms have been reported to
145 continue long after mefloquine has been stopped. Rare cases of suicidal
146 ideation and suicide have been reported though no relationship to drug
147 administration has been confirmed. To minimize the chances of these
148 adverse events, mefloquine should not be taken for prophylaxis in
149 patients with active depression or with a recent history of depression,
150 generalized anxiety disorder, psychosis, or schizophrenia or other major
151 psychiatric disorders. Lariam should be used with caution in patients
152 with a previous history of depression.
153 During prophylactic use, if psychiatric symptoms such as acute anxiety,
154 depression, restlessness or confusion occur, these may be considered
155 prodromal to a more serious event. In these cases, the drug must be
156 discontinued and an alternative medication should be substituted."

I am aware of both FDA and CDC roles. Combined them for the sake of brevity and because most don't know the distinction.

The operative word in the warning is "may" - line 42 - which does NOT mean will or shall. Further warning indicates that if you know you have a mental disorder, you shouldn't take Larium. Well no shit! There is no proven cause and effect, as you point out and that's the point I made as well. Reported incidents are not subject to the scientific method of proof nor even peer review. Larium has been veted by FDA and is recommended by CDC.

Like I said, I don't care what or who people believe, but I object vigorously to people who insist upon repeating hearsay as if it were fact when it is really only anecdotal and of no evidentiary value. Sorta like listening to Mark Sullivan tell you an animal can choose how it wants to die, and accepting that as fact.

I'm not trying to be argumentative, just pointing out flawed thinking and an inability to read the written word comprehensively. If you don't trust Larium, take something else as an anti-malarial. I think this discussion has gone as far as is productive.

Also it might be worth noting for those interested in Larium that it was (and may still be) banned in the UK.

does Larium make you argumentative????

Malarone is very effective and what I took on my last(fifth) safari.I had taken a combination of doxy and chloroquine in the past.Doxy alone can have break through infections.
As stated previously doxy can be handy for many other nasty infective agents in Africa.
What is the issue with photo sensitivity and doxy?Yes it exists but I am fair skinned Australian who used to have red hair-anyone with any sense covers up completely with long trousers and long sleaves in the african sun!

I have been taking Deltaprim for about 5 yrs as my antimalarial, no problems or side effects other than the occasional odd dream. Andrew, I am down to my last few pills, can I get any in Lusaka?

quote:

Originally posted by LionHunter:
I am aware of both FDA and CDC roles. Combined them for the sake of brevity and because most don't know the distinction.

The operative word in the warning is "may" - line 42 - which does NOT mean will or shall. Further warning indicates that if you know you have a mental disorder, you shouldn't take Larium. Well no shit! There is no proven cause and effect, as you point out and that's the point I made as well. Reported incidents are not subject to the scientific method of proof nor even peer review. Larium has been veted by FDA and is recommended by CDC.

Like I said, I don't care what or who people believe, but I object vigorously to people who insist upon repeating hearsay as if it were fact when it is really only anecdotal and of no evidentiary value. Sorta like listening to Mark Sullivan tell you an animal can choose how it wants to die, and accepting that as fact.

I'm not trying to be argumentative, just pointing out flawed thinking and an inability to read the written word comprehensively. If you don't trust Larium, take something else as an anti-malarial. I think this discussion has gone as far as is productive.

I use two words when deciding my recommendation of medication for use by my patients. Pretty simple really..... Risk vs. Benefit

Risk of not taking anti-malaria meds in a potientially endemic area = high.

Risk of taking Larium vs. Malarone I would have to say the risk is higher with Larium. The benefit is about the same.

For me it's a simple choice.

Your mileage may vary.