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Subject: Re: chloroquine plus proguanil Posted on: Wed, 24 Nov 2004 19:35:46 +0000 (UTC)

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nomail@please.invalid (Johan W. Elzenga) wrote in message news:<1gnrhgb.1pe04lme7r4duN%nomail@please.invalid>...
> bobthebuilder999@hotmail.com wrote:
>
> > I'm going to Namibia and Botswana shortly and have been told to take a
> > chloroquine plus proguanil combination. I suffered a terrible reaction
> > from taking Lariam on a trip to Gambia twelve months ago. Should I take
> > chloroquine?
>
> Why not?

1) the effectiveness of chloroquine in subsaharan Africa is considered
suboptimal - even if the drug is combined with proguanil:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5028a1.htm

2) the combination of chloroquine + proguanil is badly tolerated:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=14604928

>Chloroquine is quite different from Lariam.

I disagree. Both chloroquine and mefloquine are closely related
4-aminoquinolines while the other alternatives doxycycline or
atovaquone-proguanil (Malarone) are unrelated substances. No doubt
about it, chloroquine causes fewer neuropsychiatric adverse reactions
than mefloquine (Lariam), but intolerance against chloroquine in
patients who previously had a bad reaction from mefloquine can be
found in the literature:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9919736