title: Prophylactic use of antimalarials during pregnancy.
abstract: OBJECTIVE
  Some of my pregnant patients wish to travel to malaria-endemic regions. Are there medications that can be used safely during pregnancy for malaria prophylaxis?
  
  
  CONCLUSIONS
  Pregnant women should avoid travel to malaria-endemic areas if possible. However, if travel cannot be avoided, measures to prevent mosquito bites, along with an effective chemoprophylaxis regimen, should be implemented. Chloroquine or hydroxychloroquine are considered safe to use in all trimesters of pregnancy. Mefloquine is the agent of choice for chloroquine-resistant areas, and evidence suggests it is not associated with an increased risk to the fetus. Although the atovaquone-proguanil drug combination is not currently recommended for use during pregnancy, limited data suggest that it is not harmful to the fetus. Doxycycline and primaquine are not recommended during pregnancy.
authors.affiliation: Faculty of Pharmacy, University of Toronto, Ont.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Irvine
authors.forename: Adrienne
authors.initials: A
authors.lastname: Einarson
authors.forename: Pina
authors.initials: P
authors.lastname: Bozzo
mesh_terms: D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use*; D053626:Atovaquone / Q000009:adverse effects / Q000627:therapeutic use; D018890:Chemoprevention; D002738:Chloroquine / Q000009:adverse effects / Q000627:therapeutic use; D004318:Doxycycline / Q000009:adverse effects / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000009:adverse effects / Q000627:therapeutic use; D008288:Malaria / Q000517:prevention & control*; D015767:Mefloquine / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000517:prevention & control*; D011319:Primaquine / Q000009:adverse effects / Q000627:therapeutic use; D002727:Proguanil / Q000009:adverse effects / Q000627:therapeutic use; D014195:Travel
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C109496:atovaquone, proguanil drug combination; D006886:Hydroxychloroquine; D002738:Chloroquine; D011319:Primaquine; D004318:Doxycycline; D002727:Proguanil; D015767:Mefloquine; D053626:Atovaquone
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