Malarone Side Effects: What's Common and How Long They Last
What to expect when taking Malarone, Maloff Protect or generic atovaquone/proguanil, and when a symptom needs medical help.
Part of our malaria guide.
Feeling ill during or after a trip? A fever, chills, sweats, headache or flu-like illness during or up to a year after visiting a malaria area needs medical help the same day: call NHS 111, see a GP urgently or go to A&E, and say where you've travelled. Call 999 if someone is confused, very drowsy or having a fit. Malaria tablets are for prevention only.
Key fact: Malarone is usually well tolerated. The most common side effects are headache and stomach upset, which are usually mild and settle on their own.
Travelling to a malaria area?
Tell us where you're going and when, and a UK pharmacist prescriber will check which malaria tablets are recommended for your trip. Adults 18 and over, trips up to 12 weeks. Order at least a week before you travel. Approved before 3pm, Monday to Friday? Dispatched the same day by Royal Mail Tracked 48, Tracked 24 or Special Delivery.
Start Malaria Tablets Consultation →Does Malarone have side effects?
Malarone (atovaquone and proguanil) is generally well tolerated, and many people have no side effects at all. When they happen, they're usually mild and settle on their own. The same applies to Maloff Protect and generic atovaquone/proguanil, which contain exactly the same medicines.
Common side effects of Malarone
From the official product information, the side effects reported most often are:
| How common | Side effects |
|---|---|
| Very common (more than 1 in 10 people) | Headache, nausea, vomiting, diarrhoea, stomach pain |
| Common (up to 1 in 10) | Dizziness, difficulty sleeping, unusual or vivid dreams, low mood, loss of appetite, itching, rash, fever, cough; changes in some blood tests |
| Uncommon (up to 1 in 100) | Anxiety, palpitations, mouth ulcers, hair loss, hives |
| Rare or frequency not known | Hallucinations, seizures, severe allergic reactions, serious skin reactions, liver inflammation |
Some of these, such as stomach upset, can also be caused by travel itself, so it isn't always the tablets.
How long do Malarone side effects last?
Most side effects, such as nausea or headache, are mild and settle within the first few days. If they carry on, they usually stop within a few days of finishing the course. Keep taking your tablets unless a doctor or pharmacist tells you to stop: stopping early leaves you unprotected.
If side effects are making it hard to take the tablets, speak to a pharmacist or doctor (abroad, a local doctor) about switching. Don't simply stop.
How long does Malarone stay in your system?
Atovaquone has a half-life of about 2 to 3 days in adults, and proguanil about 12 to 15 hours. That means most of the medicine has left your body within about 2 weeks of your last tablet. That's also why you only need to take it for 7 days after leaving a malaria area.
How to reduce side effects
- Take it with food or a milky drink, which helps your body absorb it and can reduce nausea.
- Take it at the same time each day.
- If you vomit within 1 hour, take another tablet.
- If you have diarrhoea, carry on as normal, drink plenty of fluids and take extra care to avoid bites.
- If you take it at night and get vivid dreams, try taking it in the morning with breakfast.
Malarone, dreams and mood
Unusual dreams, difficulty sleeping and low mood are listed as common side effects, and anxiety as uncommon. They're usually mild. Tell the prescriber if you've had depression, anxiety or seizures before, so they can check Malarone is right for you. Mood problems are much more strongly linked with mefloquine (Lariam), which we don't supply.
Serious side effects: when to get help
Stop taking Malarone and get urgent medical help if you have signs of a severe allergic reaction (swelling of the face, lips or throat, difficulty breathing, a widespread rash), blistering or peeling skin, yellow skin or eyes, a seizure, or hallucinations.
A fever during or after your trip may be malaria, not a side effect: get medical help the same day and say where you've travelled.
Malarone side effects compared with other malaria tablets
| Tablet | Main side effects |
|---|---|
| Atovaquone/proguanil (Malarone, Maloff Protect, generic) | Headache, stomach upset; generally well tolerated |
| Doxycycline | Sun sensitivity (burning easily), indigestion or heartburn, nausea, thrush |
| Mefloquine (Lariam) | Dizziness, sleep problems, vivid dreams, anxiety and depression; not suitable with any history of mental illness or epilepsy |
Our guide to the best malaria tablets in the UK compares them in full, and how to take malaria tablets explains when to start and stop.
Getting malaria tablets
Our pharmacist prescribers check your destinations, health and medicines before supplying malaria tablets. See our malaria tablets page.
UK safety and reporting side effects
In the UK, Malarone, generic atovaquone/proguanil and doxycycline are prescription-only medicines, and Maloff Protect is a pharmacy medicine. Before any malaria tablets are supplied, a GPhC-registered pharmacist prescriber reviews your consultation, including every destination, your dates, your health and the other medicines you take, and checks the UK malaria guidelines for your trip. Always read the patient information leaflet in the pack.
Buy malaria tablets in the UK before you travel. UK guidelines warn that antimalarials bought abroad may be fake or substandard. Only buy medicines from a registered UK pharmacy: you can check any online pharmacy on the GPhC register.
If you think you've had a side effect from a medicine, tell your pharmacist or doctor. You can also report it to the MHRA through the Yellow Card scheme, which helps keep medicines safe for everyone.
Malaria tablets are one part of travel health. Before you go, check FCDO travel advice for your destination and TravelHealthPro for vaccines and other health risks. We don't provide vaccinations, so book a travel clinic or speak to your GP practice if you need them.
Frequently Asked Questions
What are the most common side effects of Malarone?
Headache, nausea, vomiting, diarrhoea and stomach pain are the most common, each affecting more than 1 in 10 people. They're usually mild.
How long do Malarone side effects last?
Most settle within the first few days. If they continue, they usually stop within a few days of finishing the course. Speak to a pharmacist or doctor if they're making it hard to keep taking the tablets.
How long does Malarone stay in your system?
Atovaquone has a half-life of about 2 to 3 days, so most of it has left your body within about 2 weeks of your last tablet. Proguanil clears faster, within a few days.
Can Malarone cause vivid dreams or anxiety?
Unusual dreams and difficulty sleeping are common, and anxiety is uncommon. Taking your tablet in the morning may help. These effects are much more strongly linked with mefloquine (Lariam).
Does Maloff Protect have the same side effects as Malarone?
Yes. Maloff Protect and generic atovaquone/proguanil contain exactly the same medicines as Malarone, so the side effects are the same.
Should I stop Malarone if I get side effects?
Not without advice: stopping early leaves you unprotected against malaria. Speak to a pharmacist or doctor about switching. Stop and get urgent help only for signs of a severe allergic or skin reaction.
Can I drink alcohol while taking Malarone?
There's no known interaction between alcohol and Malarone, but drink in moderation. Alcohol can make nausea worse and makes it easier to forget a tablet or skip bite protection.
Is a fever a side effect of Malarone?
Fever is listed as a common side effect, but a fever during or after a trip to a malaria area must be treated as possible malaria. Get medical help the same day and say where you've travelled.
References
- Malarone 250mg/100mg film-coated tablets: summary of product characteristics. medicines.org.uk
- Maloff Protect 250mg/100mg film-coated tablets: summary of product characteristics. medicines.org.uk
- UK Health Security Agency. Malaria prevention guidelines 2026: chemoprophylaxis. gov.uk
- National Travel Health Network and Centre. TravelHealthPro. travelhealthpro.org.uk
Medical disclaimer: This article is for information only and isn’t medical advice. Malaria tablets need a clinical consultation before they can be supplied, and recommendations depend on your destination. If you feel unwell during or after travel to a malaria area, get medical help the same day. In a medical emergency, call 999.