Maloff Protect

What is Maloff Protect (atovaquone/proguanil hydrochloride)?

An anti-malarial for adults aged 18+ available over the counter for protection against the Plasmodium falciparum malaria parasite. The active ingredients are Atovaquone (250mg) and Proguanil Hydrochloride (100mg) per tablet. They work together to kill the malaria parasite if it enters the bloodstream. 

If you’re travelling to a high-risk malaria area, you need to check the Fit For Travel website here for the correct anti-malarial to take. Generally, Maloff Protect can be taken when travelling to:

• India
• Indonesia
• Kenya
• Namibia
• South Africa
• Venezuela

and many other destinations. 

Please ensure to check the Fit For Travel website for the area you are travelling to and the suitability before purchasing.  

Other preventative measures should be taken when travelling to malaria-risk countries, including long-sleeved clothing, mosquito nets and insect repellent.

The tablets must be taken as directed for them to be effective. One tablet needs to be taken at the same time each day, preferably with a milky drink. You should start taking Maloff Protect 1-2 days before travel, continue to take it for the duration of your trip and then for an additional 7 days after you return.

If you experience flu-like symptoms within the first year of returning from a malaria risk country, you will need to seek medical attention to rule out malaria, even when you have taken anti-malarials. 

Start the course of Maloff Protect 1 or 2 days before you travel, so that the drugs are in your system, ready to fight off any malaria parasites.

Keep taking the pills at the same time every day to ensure the protection is effective, until the course is finished (7 days after you return to a malaria-free area). Take Maloff Protect with food or a milky drink, where possible.

If you vomit within one hour of taking your Maloff Protect tablet, take another dose straight away. If you don’t start vomiting until more than one hour after taking Maloff Protect, do not take another Maloff Protect tablet until your next dose is due, as it is likely that Maloff Protect will already be in your system.

If any of the below affect you, or you’re unsure about anything, consult your pharmacy:

• You are under 18 years of age (If you are under 18, you are not allowed to buy Maloff Protect from the pharmacy, but you can get a prescription for malaria protection from your doctor)
• You weigh less than 40 kg/6 st 4 lbs
• You are breastfeeding
• You are pregnant, think you might be pregnant or are trying to become pregnant
• If you are currently taking any of the following medicines:
  • Metoclopramide (for nausea and vomiting)
  • The antibiotics tetracycline, rifampicin or rifabutin
  • Warfarin, any other coumarin–based anticoagulant, or new oral anticoagulants (NOACs) such as dabigatran etexilate, rivaroxaban, and apixaban
  • Indinavir, efavirenz, zidovudine or a boosted protease inhibitor (for HIV)
  • Etoposide (for cancer)

• You suffer from depression
• You have been diagnosed with kidney disease
• You have been diagnosed with liver disease
• You have been diagnosed with tuberculosis
• You have ever had epilepsy, convulsions or fits
• You are allergic to any of the ingredients in Maloff Protect or have previously had any side effects with this medication (check the patient information leaflet for a full list, or ask your pharmacist)

General Information:

• Maloff Protect can cause side effects, although not everybody gets them.
• If any side effect causes you to stop taking Maloff Protect, or if you vomit or have diarrhoea, you should continue to protect yourself against malaria as much as possible.
• Use bite avoidance measures in combination for maximum effectiveness.

Severe Reactions (frequency unknown):
Stop taking Maloff Protect and contact a doctor immediately if you notice:

• Severe allergic reactions:
• Rash and itching
• Sudden wheezing, chest or throat tightness, or difficulty breathing
• Swollen eyelids, face, lips, tongue, or other parts of the body
• Severe skin reactions:
• Skin rash with blisters and target-like appearance (erythema multiforme)
• Widespread rash with blisters and peeling skin, especially around the mouth, nose, eyes, and genitals (Stevens-Johnson syndrome)

Very Common Side Effects (may affect more than 1 in 10 people):

• Headache
• Nausea and vomiting
• Stomach pain
• Diarrhoea

Common Side Effects (may affect up to 1 in 10 people):

• Dizziness
• Insomnia
• Strange dreams
• Depression
• Loss of appetite
• Fever
• Rash
• Cough
• Allergic reactions
• Itching

Common Blood Test Findings:

• Reduced red blood cells (anaemia) causing tiredness, headaches, shortness of breath
• Reduced white blood cells (neutropenia) increasing infection risk
• Low sodium levels (hyponatraemia)
• Increased liver enzymes

Uncommon Side Effects (may affect up to 1 in 100 people):

• Anxiety
• Awareness of abnormal heartbeats (palpitations)
• Swelling and redness of the mouth
• Hives
• Hair loss

Uncommon Blood Test Findings:

• Increased amylase (enzyme from the pancreas)

Rare Side Effects (may affect up to 1 in 1,000 people):

• Hallucinations (seeing or hearing things that are not there)

Other Side Effects (frequency unknown):

• Decrease in all blood cell types (pancytopenia)
• Liver inflammation (hepatitis)
• Blockage of bile ducts (cholestasis)
• Increased heart rate (tachycardia)
• Inflammation of blood vessels (vasculitis), which may appear as red or purple raised skin spots
• Seizures
• Panic attacks, crying
• Nightmares
• Severe mental health issues affecting perception and judgment
• Mouth ulcers
• Blisters
• Peeling skin
• Increased sensitivity to sunlight
• Gastric intolerance (stomach discomfort)

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in the above description and patient information leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for “MHRA yellowcard” in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.