Are there specific contraindications or precautions for malaria prophylaxis in pregnant or breastfeeding women?

Malaria prophylaxis in pregnant or breastfeeding women requires specific precautions and contraindications. Certain antimalarial drugs are contraindicated or should be used with caution during pregnancy and breastfeeding due to potential risks to the fetus or infant.

For example, drugs such as doxycycline are contraindicated in pregnancy because of risks to fetal bone and teeth development, and should be avoided in breastfeeding women as well. Chloroquine and mefloquine are generally considered safer options for malaria prophylaxis in pregnancy and breastfeeding, but mefloquine should be used cautiously due to limited safety data.

Primaquine is contraindicated in pregnancy and breastfeeding due to the risk of haemolysis in G6PD-deficient infants.

Overall, the choice of malaria prophylaxis in pregnant or breastfeeding women must balance the risk of malaria infection against potential drug-related risks, and should follow current UK guidelines and specialist advice.