taking anti-malaria meds while trying to conceive/pregnant

[wildswimmerjones]

Hi there, DH and I are going on holiday to SE Asia this autumn and were thinking Myanmar, Bhutan or Sri Lanka but heard there is low risk of malaria. Has anyone been recently to these places and if so did you take anti-malarials? Is it safe to take anti malarials while pregnant or trying to conceive? Thanks so much!

You need to get an expert to say if the place your interested in is a Malaria risk at the time of year you want to go, and which drugs are effective in that region. Then look at the pregnancy info for those drugs.

The anti malaria tablets I was on suggested, iirc, 3 months after finishing the course before TTC.

That said, think Sri Lanka is just spray and cover at night, not medication??

GPs and travel medicine clinics may or may not be up to date about current malaria risk in particular places. I'm not saying they're all idiots, but in general I've always had to give them the info as to which vaccines I needed (and DH had to get out a map and show the travel clinic people where the place was that he was going, as they'd never heard of it...)

So, before going to your GP or a MASTA (private) clinic, you probably want to check/ print out NaTHNaC's info, nathnac.net/

for example in Myanmar -
travelhealthpro.org.uk/locations/myanmar/#Malaria

Also see the WHO country profiles:
www.who.int/malaria/publications/country-profiles/profile_mmr_en.pdf?ua=1

I don't know what the contraindications are with pregnancy, but I have seen people who are ill with malaria, and you really, really don't want to get that. However bad anti-malarials are, they are a lot better than the disease and its treatment.

You need to talk it through with a travel clinic (and the ones I've seen have been well-informed), but if you're that worried, then it might be better to choose a non-malarial country, or put off TTC.

Definitely agree with EBearhug. Malaria is far worse than the drugs (though i would also heed advice not to combine TTC with particular drugs, if it is given). BNF data should be up to date re malaria drugs & pregnancy; my point above is more to do with the GP (not necessarily) knowing which drugs are relevant to which country because of changing status of drug resistance, malaria prevention, etc.

Check out knowmalaria.com

The two malaria prophelactics are Larium, which has a dodgy reputation (tho I never had a problem with it) and Malarone but I believe they are both contra-indicated for pregnancy.

You could always go for something completely different like South Africa where malaria is only present in Kruger National Park in the north of the country.

Absolutely fabulous country too! I was there this year travelling solo.

We went on honeymoon to Tanzania and had to take anti-malarials. We were advised to take Malarone (well, we bought the generic version of it), and I was told that I should definitely not use them while TTC or pregnant. I had to wait two full weeks after we stopped taking them to ditch the contraceptives. Malarone is the generally recommended one for a lot of places as it's new (so low resistance problems) and you only have to take them for one week afterwards. I had no side effects at all.

There are some which are ok for pregnant women, but I think they are the ones with more resistance and more side effects. The WHO says you should not travel to a malaria area when pregnant.

I would HIGHLY recommend speaking to your practice nurse at your GP about it if you are determined to go while contraceptive free.

Definitely don't skimp on the anti-malarials as that will put back any TTC plans much further than the time it takes for the drugs to get out of your system. The WHO says you should not travel to a malaria area when pregnant if possible.

I was in Thailand ten years go, and we didn't need to take anti-malarials. If you're staying in a hotel, and not really going anywhere else, your risk will be much lower as hotels often spray to kill insects.

I opted to stay on the pill till after our honeymoon to Kenya due to needing to take Malaria tablets. There is an antibiotic based one you might be able to take but would need to ask.

I use this website to check what immunisations/malaria care is needed -- looks like Sri Lanka is low risk

www.fitfortravel.nhs.uk/destinations.aspx

If you are susceptible to bites then I would definitely not advise to not take it.

We delayed ttc until 3 months after our trip to India on medical advice due to anti malarials. This was 10 years ago and am not a medic but that was what we were told then anyway.

I was meant to fly to a malarial country when pregnant with my first. I was told categorically not to take anti-malarial drugs when pregnant and that malaria itself was much worse if pregnant. We cancelled.

If you're not pregnant now either stop TTC or go somewhere else.

Also even if you risk it the worry could ruin the pregnancy. You do not want to spend a pregnancy fretting could spoil it and you will kick yourself as entirely avoidable risk.