TABLE 3.

Antimalarials for chemoprophylaxis and SBET in pregnancy

Antimalarial	Recommendation for chemoprophylaxis in pregnancy	Recommendation for emergency self-treatment in pregnancy	Description
Atovaquone-proguanil	No data; should not be used	No data; should be used only if no other options are available	Not recommended due to lack of safety data; inadvertent use in pregnancy probably safe, but few data are available
Chloroquine (hydroxychloroquine)	Can be used	Can be used	Regarded as safe
Proguanil	Can be used	Not used for treatment	Supplement with folic acid is recommended
Doxycycline	Contraindicated	Contraindicated	May cause bone malformation and discolored teeth
Mefloquine	Can be used after the first trimester; some authorities (WHO and CDC) allow the use of mefloquine in the first trimester if the risk of malaria is high and travel cannot be deferred	Can be used after 16th gestational wk or if no other options are available	Regarded as safe after 16th gestational wk based on postmarketing surveillance; inadvertent use periconception or during pregnancy is not considered an indication for termination
Artemisinins	Not used for prophylaxis	Few data; can be used only if no other options are available	One small study found no adverse impact on the pregnant mother or the fetusa
Quinine	Not used for prophylaxis	Can be used	Drug of choice for P. falciparum malaria; combination with clindamycin is recommended
Primaquine	Contraindicated	Treatment of P. vivax hypnozoites should be deferred until after pregnancy	Use of primaquine in pregnancy would necessitate G6PD testing for mother and fetus

^aSee reference 10.