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Questions and Answers

Q
Dear Sir: I am a 69 year old male. I am currently taking a daily dose of Hytrin 5MG for prostate reduction and Zocor 10MG daily for cholesterol reduction. My 65 year old wife is taking 10MG of Fosamax daily for increasing her bone density.

We are going to Africa next month for a two week period, and have been prescribed Larium for malaria prevention and treatment. Are there any problems with these drugs in combination? If so, what can we take for malaria prevention instead?

Thank you.

A
The only possible problem is with Hytrin (terazosin), an 'alpha blocker' used originally, and still, to treat hypertension. Larium (mefloquine) is highly bound to certain blood proteins and may occupy some similar site(s) as terazosin. Should this happen, and the concentration of 'free' terazosin increase, the effectiveness of terazosin would increase and possibly induce side-effects. If during the several weeks you will be on mefloquine you start feeling such effects, the situation can be restored to normal by decreasing the dosage of terazosin - the dosage should then be returned to normal some time after you stop the antimalarial.

Antimalarial suppression and treatment is a complex subject and usually the simple answer is to prescribe mefloquine - a good antimalarial but with occasionally some unpleasant side-effects.

There are a number of different antimalarials and a rational choice depends on where and when you are going, what species of parasite is in that area, what is the epidemiology of drug sensitivity/resistance, how diligent you are with insect repellants and wearing adequate clothing.

Use your web browser to find a site for the area you're going to be spending time in ... there should be good and detailed health info.

Best wishes to you and your wife and have a great holiday.

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