The combination prophylactic antimalarial, atovaquone/proguanil, was previously only available via a prescription or patient group direction (PGD). Maloff Protect can now be recommended OTC for malaria chemoprophylaxis of P. falciparum in people who are aged 18 or over and who weigh 40kg (6st 4lbs) or more.

Maloff Protect should be taken once daily, starting one to two days before travel, continued during the stay and for a further seven days after leaving an infected area. Stopping treatment early increases the risk of malaria developing as it takes seven days to ensure any malaria parasites, which have entered the bloodstream, are killed. 

It is preferable to take Maloff Protect at the same time each day. The tablets should be taken with food or a milky drink to aid absorption and should not be crushed. If a dose is missed for any reason, it should be taken as soon as possible but if it is nearly time for the next dose, the missed dose should be skipped. 

In the event of vomiting within an hour of taking a dose, another dose should be taken straight away and bite prevention methods continued. In the event of diarrhoea, normal dosing should continue.

The maximum duration of travel for which Maloff Protect can be supplied OTC is 12 weeks (93 tablets).

Maloff Protect cannot be supplied if:

• Adults weigh less than 40kg
• Allergic to proguanil or atovaquone or any of the excipients of Maloff Protect
• A child or adolescent
• A breastfeeding woman
• A pregnant woman or woman trying to become pregnant.

It should not be sold OTC to people who have:

• Renal impairment or kidney disease
• Hepatic impairment
• A history of depression or seizures
• Tuberculosis.

Maloff Protect should not be supplied to people who are taking:

• Metoclopramide, tetracycline, rifampicin or rifabutin
• Indinavir, efavirenz, zidovudine or boosted protease inhibitors
• Warfarin or other new oral anticoagulants (NOACs) such as dabigatran etexilate, rivaroxaban and apixaban
• Etoposide.

The most commonly reported side effects are headache, nausea/vomiting, abdominal pain and diarrhoea. There have been reports of severe allergic reaction or severe skin reactions following treatment with Maloff Protect. If a severe allergic reaction occurs, customers should stop taking it immediately and seek medical assistance. Bite prevention methods should be continued if stopping antimalarial medication, until further advice is sought.