Obtenir des comprimés contre le paludisme auprès de votre pharmacien

The MHRA took the decision saying "Pharmacists are experts in medicine, and have the necessary skills and training to ensure the safe and efficient supply of pharmacy medicines ... [they] will be able to advise if [the medicine] is suitable to protect from malaria depending on which countries are being visited, pre-existing medical conditions, and any other medicines being taken."

Over the years, lots of medicines have been re-classified in this way. Even ibuprofen was once a prescription-only medicine (POM), but was re-classified in 1988 and is now a staple of most people's medicine cabinets.

The new pharmacy medicine in question contains the ingredients atovaquone and proguanil; you might know it better as Malarone®, the original branded medicine prescribed by doctors. Why is this new 'POM to P' switch worth finding out about? Let me explain why I think this is such an important new development.

What's the risk?

Whilst it might not be the first thing on our minds when planning our dream holiday or visiting family, malaria can be fatal - even for travellers from the UK - and infection rates are on the rise again. Public Health England reports that 1,618 people in the UK contracted malaria whilst abroad in 2016. That is a 15% increase on 2015 and 4.5% above the average for the last ten years. For those people where data are available, 83% had not taken any antimalarial medicine. Six people in the UK died from malaria in 2016 so it's really important to take the right medication and get up-to-date travel advice before you go.

Fiona Genasi, Nurse Consultant in Travel Medicine for Health Protection Scotland said: "These days we're travelling abroad more than ever, both for recreation and work. The recent change from prescription-only atovaquone/proguanil to pharmacy over-the-counter sales of the drug, opens another route for travellers to access important malaria prevention medication.

"This change is welcomed on the understanding that malaria prophylaxis (taking preventive tablets) is just one element of pre-travel preparation. Importantly, travellers should obtain a full travel consultation and individual risk assessment prior to their trip, irrespective of where they are presenting for medication or advice."

Health Protection Scotland's travel health website fitfortravel.nhs.uk is packed with vital travel advice, a key feature of which are the country-specific malaria maps and advice on recommended antimalarial drugs for particular destinations.

Sélection de patients pour Infections liées aux voyages

Voyages et vaccinations

Faut-il s'inquiéter des effets secondaires des comprimés contre le paludisme ?

Le paludisme est une maladie presque entièrement évitable, mais en 2017, il y a eu 1 700 cas au Royaume-Uni et six décès dus à cette maladie. La plupart des personnes infectées n'avaient pas pris de comprimés antipaludiques ou ne les avaient pas pris conformément aux instructions. L'une des raisons d'éviter les médicaments contre le paludisme peut être l'association avec des effets secondaires. Mais quelle est la probabilité de ces effets ?

par Glynis Kozma

Voyages et vaccinations

Virus Zika

Le virus Zika était une maladie rare avant 2015, lorsqu'une épidémie soudaine au Brésil a fait la une des journaux internationaux. Toutefois, il est relativement peu répandu depuis 2018. Vous pouvez attraper le virus Zika si vous êtes piqué par un moustique infecté. Le virus Zika est généralement une maladie très bénigne. Cependant, il est possible qu'il soit à l'origine de malformations congénitales chez les bébés nés de mères ayant contracté l'infection pendant la grossesse. Il peut également entraîner d'autres complications. L'inquiétude suscitée par le lien possible entre ces pathologies et le virus Zika a conduit l'Organisation mondiale de la santé (OMS) à déclarer qu'il s'agissait d'une urgence de santé publique de portée internationale. Les recherches sur la prévention du virus Zika se poursuivent.

par le Dr Hayley Willacy, FRCGP

Atovaquone/proguanil on prescription

Up until now this combination has only been available with a prescription written by a doctor. Apart from in exceptional circumstances, doctors have to write private prescriptions so that the cost of antimalarials, considered a 'luxury' medicine, is not borne by the NHS. Of course, you still need an appointment with a doctor or nurse and you will usually be charged a fee for the prescription to cover costs, in addition to the cost of medication.

Once you have the prescription you need to take it to a pharmacy to be dispensed. Because it is a private prescription you pay for the actual cost of the medicine rather than the standard NHS charge of £8.60. The pharmacist will also add on a percentage to the price to cover their own costs and time involved - all private prescriptions need to be recorded in a register and stored for two years.

Atovaquone/proguanil from a pharmacy

So now you can buy this medication over the counter, what might the benefits be? Well first, you should save some money. You won't be paying the extra costs added on by the doctor and pharmacist for private treatment, so it just depends on the price of the medicine. The current price looks to be around £45 for a two-week trip (three weeks of medication); compare that to potentially £65-70 on prescription.

Secondly you will save time; you won't need to book or attend a doctor's appointment and you won't have to wait for your prescription to be dispensed. More importantly perhaps, you will have freed up a doctor's appointment for the NHS.

You will still need a consultation with the pharmacist to make sure the medicine is right for you and to give you the proper travel advice; this will take five to ten minutes. You could even do this from the comfort of your own home by using an online pharmacy and having it delivered. Always look for the 'green cross' registered pharmacy logo when buying medicines online.

Protect yourself before you go

Chloroquine, alone or with proguanil, has been available over the counter for years. Unfortunately chloroquine's usefulness has decreased due to widespread drug-resistant malaria parasites, as described by the American Centers for Disease Control and Prevention (CDC). In many countries around the world chloroquine no longer works to prevent malaria and, where the risk is high, atovaquone/proguanil is the recommended therapy.

This new Pharmacy medicine will provide cheaper, quicker and easier access to a potentially life-saving medicine, alongside professional advice for staying healthy abroad. The hope is that more people will protect themselves before they travel and so reduce the numbers coming home with malaria. Make sure you don't become a malaria statistic, visit your pharmacy first.

Always take the recommended antimalarial for the whole duration of your trip and continue upon your return as instructed. No medicine is 100% effective, so avoiding mosquito bites as much as possible and using insect repellent is also essential to reducing your risk. And malaria isn't the only tropical disease carried by mosquitoes: dengue, Zika virus, yellow fever - the list goes on. Whilst some diseases can be prevented by vaccines or medication, many can't, yet.

Importantly, if you develop any fever or illness up to a year after returning from a tropical country, you should get it checked out by your doctor.