You are running a travel clinic with your pharmacy and as an independent
prescriber you can write prescriptions for malarial prophylaxis. Within your clinic,
you use the maximum recommended treatment length for all courses.
A family of two are travelling to Ghana for 14 days. The most recent weights
of the family members are shown below.
Mum: 54kg
Child 1: 27kg
Below are the prices that you charge each of the drugs that are suitable for this family. They
can either all take Lariam or the Malarone/Malarone Paediatric
Lariam tabs £14.48 per pack (8 tablets)
Malarone £25.20 per pack (12 tablets)
Malarone Paediatric £6.24 per pack (12 tablets)
Using the information available to you and the relevant SPC (at the end of the worksheet), calculate the price difference between the two regimens. (Give your answer to the nearest pound)
(Lariam 250 mg tablets)
Active ingredient -mefloquine hydrochloride
Legal Category - POM: Prescription only medicine
4.2 Posology and method of administration
Chemoprophylaxis
For malaria prophylaxis the stated dose of Lariam should be given once weekly, always on the same day.
In order to ensure, before arrival in endemic area, that Lariam administration is well tolerated, it is
recommended to start chemoprophylaxis with Lariam 10 days before departure (i.e. first intake 10 days
before departure and 2nd intake 3 days before departure). Subsequent doses should be taken once a
week (on a fixed day).
Treatment should be continued for 4 weeks after leaving a malarious area (minimum treatment period 6
weeks). The maximum recommended duration of administration of Lariam is 12 months.
The recommended chemoprophylactic dose of Lariam is approximately 5 mg/kg bodyweight once weekly.
The following dosage schedule is given as a guide:
Adults and children of more than 45 kg bodyweight 1 tablet
Children and adults weighing less than 45 kg
5 – 19 kg ¼ tablet 1/ 4 tablet
20 – 30 kg ½ tablet 1/ 4 tablet
31 – 45 kg ¾ tablet 3/ 4 tablet
The tablets should be swallowed whole preferably after a meal with plenty of liquid
Extracted text: Malarone Paediatric Tablets 4.2 Posology and method of administration Method of administration The daily dose should be taken once daily with food or a milky drink (to ensure maximum absorption) at the same time each day. If patients are unable to tolerate food Malarone paediatric tablets should be administered, but systemic exposure of atovaquone will be reduced. In the event of vomiting within 1-hour of dosing a repeat dose should be taken. Malarone paediatric tablets should preferably be swallowed whole. If difficulties are encountered when dosing young children, the tablets may be crushed and mixed with food or a milky drink just prior to administration. Posology The dosage for the prophylaxis and treatment of acute, uncomplicated P. falciparum malaria in children is based on body weight. Prophylaxis Dosage in individuals weighing 11-40 kg Dosage/day No of Tablets Body Weight Range (kg) Atovaquone (mg) Proguanil (mg) One Malarone paediatric tablet Two Malarone paediatric tablets Three Malarone paediatric tablet Subjects of >40 kg should receive ONE Malarone 250/100 mg tablet daily Refer to Malarone 250/100 mg Tablets SMPC 11-20 62.5 25 21-30 125 50 31-40 187.5 75 >40 250 100 Prophylaxis should • commence 24 or 48 hours prior to entering a malaria- endemic area, continue during the period of the stay, • continue for 7 days after leaving the area.
Extracted text: Malarone 4.2 Posology and method of administration Method of administration The daily dose should be taken with food or a milky drink (to ensure maximum absorption) at the same time each day. If patients are unable to tolerate food, Malarone should be administered, but systemic exposure of atovaquone will be reduced. In the event of vomiting within 1 hour of dosing a repeat dose should be taken. Posology. Prophylaxis: Prophylaxis should • commence 24 or 48 hours prior to entering a malaria- endemic area, • continue during the period of the stay • continue for 7 days after leaving the area. In residents (semi-immune subjects) of endemic areas, the safety and effectiveness of Malarone has been established in studies of up to 12 weeks. In non-immune subjects, the average duration of exposure in clinical studies was 27 days. Dosage in Adults One Malarone tablet daily. Malarone tablets are not recommended for malaria prophylaxis in persons under 40 kg bodyweight. Malarone paediatric tablets are recommended for malaria prophylaxis in persons weighing <40 kg>