Taking Malaria Medication During Pregnancy

QUESTION: My husband is being transferred by his company to a Latin American
country. I am expecting a baby in a few months, but want to go with him now
to help him start up his new job. He is being put on medication to prevent
malaria. Can I use the same medication that he will be taking, even if I am
pregnant?
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ANSWER: It is always against the rules to take someone else's medication,
even when the circumstances seem so easy to understand, and the problem seems
to be the same. So the answer to your question is a resounding "NO!". The
usual recommendations for malaria prevention utilize a weekly dose of
chloroquine in a dose of 300 mg. Although not available in the United States,
proguanil may also be used, but must be taken every day, dose 100 mg.
However, many sections of South America harbor a chloroquine resistant strain
of P. falciparum, the germ responsible for the disease. (You can check with
the Centers for Disease Control in Atlanta for the latest conditions at your
destination). In such areas a second medicine, combining 25 mg of
pyrimethamine and 500 mg of sulfadoxine (brand name: Fansidar) might also be
considered. However it is plagued by some serious side effects and
complications including fatal skin reactions, and is no longer recommended as
routine prophylaxis. While chloroquine appears to be safe for use during
pregnancy, this is not as clear for Fansidar. Frankly, some of my
knowledgeable colleagues would have me caution you about even going with your
husband at this time, and recommend that you stay put until the baby is born.
It is clear that you run substantial risks from the medications, even if the
threat to your health and that of the baby is greater from the infection. It
is a hard call to make, so employ the counsel of your own physician as well.