Emergency treatment for malaria

Latest update: - Authors: Mieke Croughs, Ula Maniewski-Kelner

You will sometimes be advised to take emergency treatment for malaria with you when travelling to regions with a moderate risk. This is a treatment that you take with you, just in case you develop malaria despite the use of mosquito-repellent measures. Discuss with an expert doctor whether this is recommended for you. 

When to use

Start the emergency treatment if you have fever and cannot consult a doctor within 24 hours.

Seek medical assistance as soon as possible, to be certain whether your symptoms are being caused by malaria or another illness and to be certain that you are taking the correct treatment.

The emergency treatment can also be used if the diagnosis has been made, but the locally available treatment may be inferior.  

How to use

Atovaquone/proguanil (e.g. Malarone®)  is the first choice emergency treatment.

  • Take 4 tablets in one dose and repeat after 24 hours and again after 48 hours (a total of 12 tablets).
  • Always take this medicine with food or a drink containing milk.
  • If you vomit within three hours after taking the tablets, you must take four tablets again.
  • An adjusted dose must be given to children. 

Combination preparations that contain artemisinin derivatives can also be used as emergency treatment:

Artemether/lumefrantine (Riamet®)

  • The treatment consists of 6 intakes spread over 3 consecutive days: at diagnosis, 8 hours later, 24 hours later and then every 12 hours (after 36, 48 and 60 hours).
  • De dose at each intake depends on the body weight: for adults and children from 12years or older and weighing at least 35 kg: 4 tablets at each intake (24 in total)
  • Take this medicine with food or milk. 

Piperaquinetetrafosfaat with artenimol (Eurartesim®)

  • Since November 2021, this is no longer available in Belgium.
  • Take this medicine once a day during 3 consecutieve days, always at the same hour.
  • Take this medicine on an empty stomach. You should not eat or drink three hours before or after taking  it. Drinking water is allowed. 
  • Dose:
  • Between 36-74 kg: once a day 3 tablets of  320 mg/40 mg (9 tablet s in total)
  • Between 75 and 100 kg: once a day 4 tablets of 320 mg/40 mg (12 tablets in total) 

Please note that medicines containing only artemisinin and plant extracts with artemisinin  are not sufficiently effective. 


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