UK Faces Prolonged Shortage of Antimalarial Drug Mefloquine (Lariam) Until 2026

Supply Disruption and Official Guidance

The United Kingdom is currently facing a prolonged shortage of the 250mg mefloquine (Lariam) antimalarial tablets. Neon Healthcare, the supplier, has informed the National Travel Health Network and Centre (NaTHNaC) that the drug is out of stock and is not expected to be available again until January 2026.

This unavailability poses a challenge for UK travelers planning to visit malaria-endemic regions. NaTHNaC has issued advice to health professionals, urging them to prioritize any remaining supplies of mefloquine for travelers with imminent travel plans, especially those for whom it is the first-choice antimalarial. This includes specific groups such as pregnant travelers heading to high-risk malaria areas like Sub-Saharan Africa. For other travelers, health professionals are advised to prescribe alternative antimalarial medications to conserve the limited mefloquine stock.

Alternative Antimalarial Options

Given the shortage, travelers are encouraged to consult their general practitioner, pharmacist, or a travel clinic well in advance of their trip to discuss suitable alternatives. Common antimalarial options available in the UK include:

• Atovaquone/Proguanil (often known by the brand name Malarone, or its generic versions like Maloff Protect)
• Doxycycline
• Chloroquine (known by the brand name Avloclor)

The choice of antimalarial depends on various factors, including the specific travel destination, the prevalence of drug-resistant malaria strains, individual medical history, and potential side effects. While mefloquine is taken weekly, which some travelers find convenient, it is also known for potential side effects, including serious mental health issues, making it unsuitable for all individuals.

Broader Context of Malaria Risk

The shortage comes at a time when the UK has observed a significant increase in imported malaria cases. In 2023, a total of 2,106 malaria cases were reported in returned UK travelers, marking a 26% increase from the 1,555 cases reported in 2022. This figure represents the highest number of cases since 2001, with six deaths also recorded in 2023. The majority of these cases, approximately 69%, were acquired in Africa, particularly West Africa, and a significant proportion involved UK residents visiting friends and relatives abroad.

Public health bodies, including the UK Health Security Agency (UKHSA), consistently emphasize the importance of adhering to malaria prevention guidelines, which include 'Awareness of risk, Bite prevention, Chemoprophylaxis and Diagnose promptly and treat without delay'. Travelers are strongly advised to seek expert medical advice to ensure they receive appropriate prophylaxis for their specific travel plans, especially in light of the current mefloquine shortage.