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Is it okay to dive whilst taking Mefloquine (Lariam) - 2000

Question: I'm travelling across East Africa for 3 months and hope to dive in Kenya and Mozambique. My GP has given me a tablet called mefloquine to take against malaria. Is it okay to dive whilst I take this?

Answer: As you may have read, mefloquine is one of the most recent medication against malaria. It was developed to combat the drug resistant strains of malaria that were spreading in some parts of the world. The main antimalarial that the malaria parasite was becoming resistant to is chloroquine. Now as you are going to a chloroquine resistant malaria area then the only way to effectively prevent malaria if you are bitten by the mosquito is by taking this tablet.

But what has become apparent over the last few years is that there are some side effects with this medication. Some of these may mimic decompression sickness and are hard to differentiate, such as tremors, dizziness, rashes and joint pains. Of course not everybody gets these problems but I would suggest that you will find out by the 3rd or 4th dose if you get them or not.

So take the tablets each week and start them at least this long before you plan to dive so you know how you feel each time you take them. If you find that you get any of these symptoms when you take the tablets then it may well be a good idea not to dive, as if a bend is incorrectly diagnosed as a lariam side effect then there could be disastrous results.

However, there is now news that another antimalarial is on the market that could be a good alternative to Lariam. This is called "malarone" and has been recently been released by Glaxo. It is a daily tablet, good against chloroquine resistant malaria and so far showing none of the psychiatric and neurological side effects of lariam. You only need to take it for 2 days before you go and for 7 days when you come back.

The only problem is that it is only available in a few places and on a private prescription from your doctor, so it can be quite expensive. If you can get this before you go then it may be a better option than the lariam if you are going to dive. If you have any problems getting hold of this antimalarial then please contact me.

The other important thing to do is make sure you don't get bitten by the mosquitos, as no medication can really offer 100% protection. You need to wear long sleeved shirts, avoid swampy areas at dusk, when they come out to feed and use a net at all times when you sleep.

If you are going out to that part of the world for that long, I recommend you join AMREF. This is a charitable organisation that provides a flying doctor service in East Africa. It costs a few pounds to join and they will give you medical support if you have any problems whilst you are out there including flying a medical team out to you if you have a critical illness. The planes are funded by donations like yours but then also serve the local community by flying sick Africans from remote destinations to hospitals in the cities. This one of the best schemes I have seen by which the tourist dollar helps the local population.


Dr Jules Eden

Dr Jules Eden
MBBs BSc MRCGP




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Information published on this website is not a substitute for professional medical care or advice but should be used only as an aid in understanding current medical knowledge. A Doctor should always be consulted for any health problem or medical condition.

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