Malaria Prophylaxis

On the day of my flight to Brunei, they gave us some anti-malarial pills to take. A single pill of mefloquine, and 2 capsules of doxycycline. However, what the medic who issued the pills to us did not inform us was that we needed to take the pills with food. As a result, those of us who took the pills with an empty stomach suffered from nausea and vomitting. I was one of the unlucky people, and, just before the flight, ended up squating in front of a toilet bowl at Changi Airport trying unsuccessfully to vomit out the pills, as there was simply no bulk in my stomach to push the pills out. A terrible start to the trip.

Needless to say, we weren't too happy about not be pre-warned about how to consume the pills to mitigate their side-effects. The medic defended himself by saying that he had adhered to the directive for the pills to be consumed after a meal. Obviously the question that begs to be asked here is how soon after a meal. Well our flight was at 2am, so my take on this is that our dear medic wasn't exercising much common sense.

What was a bit more disturbing was during the medical brief after we had landed in Brunei, the MO informed us of the possible side effects of consuming doxycycline, in particular, and that it should be consumed straight after a heavy meal in order to ameliorate the effects. Now after surfing the web a bit, it appears that it is mefloquine, not doxycycline that induces the nausea. Was there some medical mis-information there?

Well at the end of the day, mis-information or not, all this was much ado about nothing. The pills were consumed weekly without problems subsequently as we were more well-informed of their effects. But man, the nausea on the first day wasn't pleasant at all.