If the patient has P. vivax, P ovale, P. malariae, or has been in an area where there is no chloroquine resistance in P. falciparum, chloroquine is the best drug to use to treat malaria.

If the patient is infected with P. vivax or P. ovale, primaquine needs to be given as well. This drug is able to kill the liver stages of the parasites, unlike chloroquine. If primaquine is not used, the chloroquine will cure the acute attack, but the dormant liver stages will be able to cause recurrences in the future.

In cases where chloroquine resistant P. falciparum is suspected, either quinine, mefloquine, halofantrine or the artemesinins can be used. Parasites that are resistant to mefloquine are also often resistant to halofantrine. Mefloquine is also not licensed for use as treatment in South Africa. Halofantrine has been associated with cardiac side effects, and should not be used for routine treatment. Quinine was the first drug used to successfully treat malaria, and with increasing chloroquine resistance, it is making something of a "comeback". It is thought to be the best available agent for treating complicated chloroquine resistant falciparum malaria. Unfortunately, resistance to this drug is also being described.

A new class of drug is the artemesinin derivatives. This drug has been known for centuries in China and is derived from the wormwood plant. It shows great potential in being able to treat resistant falciparum malaria, and has been used often in SE Asia. Unfortunately, resistance to this agent is also being described. When these drugs are used to treat malaria, they should be combined with a second agent to try and reduce the development of resistance.

Talk to your doctor. Talk to you pharmacist. Also see the related link below.

Do not take this medicine with any of the following medications:

•antibiotics like chloroquine, clarithromycin, erythromycin, grepafloxacin, pentamidine, sparfloxacin, troleandomycin

•arsenic trioxide

•cisapride

•droperidol

•halofantrine

•haloperidol

•medicines for irregular heart beat like amiodarone, bretylium, disopyramide, dofetilide, procainamide, quinidine, sotalol

•pimozide

•ranolazine

•rasagiline

•selegiline

•sertindole

•ziprasidone

This medicine may also interact with the following medications:

•alcohol

•alfuzosin

•antibiotics like gatifloxacin, gemifloxacin, levofloxacin, mefloquine, moxifloxacin, ofloxacin, telithromycin

•antihistamines for allergy, cough and cold

•desipramine

•MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

•medicines for blood pressure

•medicines for depression, anxiety, or psychotic disturbances

•medicines for irregular heart beat like flecainide, propafenone

•medicines for nausea or vomiting like dolasetron, ondansetron, palonosetron

•medicines for seizures like carbamazepine, phenobarbital, phenytoin

•medicines for sleep

•medicines for sleep during surgery

•medicines to numb the skin

•muscle relaxers

•narcotic medicines for pain

•octreotide

•peginterferon Alfa-2b

•phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine

•rifampin, rifapentine

•some medcines for cancer like dasatinib, lapatinib, sunitinib

•some medicines for HIV like delavirdine, didanosine, efavirenz, nevirapine

•St. John's wort

•tacrolimus

•tramadol

•vardenafil

•vorinostat

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.