Malaria Prevention

We'll determine how many pills you'll need based on the number of days you'll be in a malaria-risk location.
Kindly provide more details

Can you relate to the following statement?
Lariam causes an allergic reaction or hypersensitivity in you (mefloquine).
You've previously used Lariam and experienced major adverse effects.
You're taking Lariam for a cause other than malaria prevention.

Yes

No

Are you aware that if you develop any of the following symptoms, you should stop taking Lariam immediately and seek medical help:
Should you develop any of these effects, stop taking Lariam and replace it with another malaria-prevention drug right away.
Suicidal ideation.
Self-destructive behavior.
Anxiety is really high.
Feelings of mistrust for other people (paranoia).
Not seeing or hearing what isn't there (hallucinations).
Nightmares and strange dreams.
Depression.
I'm becoming antsy.
This is unusual behavior.
Feeling perplexed.

Yes

No

Have you been examined with one or more of the following conditions
Depression, suicidal ideation, or self-destructive behavior
A mental illness of any kind including; anxiety disorder, schizophrenia, or psychosis.
Fits, seizures, or convulsions which are all symptoms of epilepsy.
Blackwater fever, a term used to describe a condition in which
Rhythmic changes in the heart.
Problems with the eyes such as loss of fine detail, colours seem faded, sudden loss of vision, poor vision at night.
Disorders of the blood or lymphatic system (abnormal blood test showing a decrease or an increase in white blood cells, a decrease in red blood cells or platelets).
Neuropathy, a condition that affects the nervous (e.g. pins and needles, weakness, numbness, new or worsening clumsiness or unsteadiness on your feet, or shaking of the hands and fingers).
Inflam

Yes

No

Do you have a history of using Larium?
If you have, were there any negative side effects?
If not, do you know that Lariam has neuropsychotic adverse effects thus, it should not serve as a first-line antimalarial if you answered no?

Yes

No

Are you experiencing any of the following problems:
Myasthenia gravis is a kind of myasthenia.
Porphyria.
Lupus erythematosus (SLE), is a type of lupus that affects the entire body

Yes

No

Can we share this information with your General practitioner?
Providing us with your physician's address means that you allow us to share this information with him/her for updated medical records if need be. It also allows our clinician to access your medical records if there is a need for that. We advice you share this treatment with your doctor for him/her to update your medical records.

Yes

No

Can you relate to any of the following?
You have an underlying medical condition
You've been through a major surgical procedure
You have allergic reactions
You have cardiovascular conditions or might have had suffered a stroke
You suffer from a low liver or kidney function

Yes

No

Can you relate to any of the following?

Your hair loss started recently, and you've lost a lot of hair in less than four weeks.

Hair loss has occurred in irregular spots on your head.

Your scalp is itchy or inflamed.

You've lost your hair as a result of your pharmacological treatment.

You're completely bald or have lost all of your body hair.

Yes

No

Are you currently receiving any treatment or under any medication?
Please provide more information of the medication being used if any.

Yes

No

If female or transmale, are you currently pregnant, breastfeeding or planning to do so?
Please select your option

Presently Pregnant

Presently Breastfeeding

Planning on getting pregnant

Neither Pregnant nor Breastfeeding

What is your biological gender?
Please select your option

Male

Female

Transmale (Born a female)

Transfemale (Born a male)

Do you have a history of being diagnosed with the following conditions?
Depression
Epilepsy, convulsions, or fits
Renal impairment/kidney disease
Hepatic impairment/liver disease
Tuberculosis

Yes

No

Are you on any of the following medication?
Antibiotics.
Antihistamines such as stemizole or terfenadine.
Cisapride for stomach discomfort.
Quinidine for circulatory problems.
Pimozide for schizophrenia.

Yes

No

Do you conscent to consulting a medic right away and inform them you've been in a malaria-risk area if you get any of the following symptoms while traveling or within a year of returning?
High-temperature
Sweats and chills
Headaches
Vomiting
Muscle aches
Diarrhoea
Do you require assistance?

Yes

No

Did you know that each registered account can only get treatment for one person?
Notably, if a spouse or family member requires therapy, they must create their own account and provide their own email address and medical information.
Orders placed by the same account will be reimbursed.

Yes

No

Have you visited a malaria-endemic country lately?
If so, have you had symptoms like fever, chills, pains, weariness, or headaches since you got back?

Yes

No

For which duration do you intend on staying in the malaria-affected area?
Kindly provide more details

Kindly make a list of all the malaria-risk nations or places you plan to visit during your trip.
Do you require assistance?

Have you ever been given the following diagnosis by a doctor:
Depression
Epilepsy, convulsions, or fits
Renal impairment/kidney disease
Hepatic impairment/liver disease
Tuberculosis

Yes

No

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