Malaria Tablets for India: Which Regions Actually Need Them
August 4, 2026
Ask whether you need malaria tablets for India and you’ll get two unhelpful answers. One says India has malaria so take them. The other says the tourist areas are fine so don’t bother. Neither survives contact with a real itinerary, because risk in India varies enormously by state, by altitude and by season. This page goes through it region by region, and our complete India vaccinations guide covers everything else the trip needs.
The short version
- Risk exists across India below 2,000 metres, but the level varies hugely.
- Delhi, Mumbai, Goa, Kolkata and the Golden Triangle are low risk. Bite avoidance rather than tablets for most short trips.
- Assam, Odisha and several eastern and central states are high risk, where tablets are advised.
- Ladakh and other high-altitude areas carry no transmission.
- Chloroquine is obsolete here. Resistance is widespread.
What you’re protecting against
Two species matter in India. Plasmodium falciparum accounts for roughly 60% of cases and is the dangerous one, capable of becoming severe quickly. Plasmodium vivax makes up most of the rest and can relapse months after you return home, which is why a fever after an India trip is worth mentioning to a doctor even weeks later.
Chloroquine-resistant falciparum is widespread across India, so any advice you find recommending chloroquine is out of date and should be ignored.
Where there’s no meaningful risk
Transmission does not occur above about 2,000 metres. That covers Ladakh and Leh, much of Himachal Pradesh, the higher parts of Sikkim, the Kashmir valley, higher parts of Uttarakhand and Arunachal Pradesh, and the hill stations of Kerala and Tamil Nadu above that line. The Lakshadweep Islands are also free of transmission.
If your whole trip sits in that bracket, malaria tablets aren’t part of the conversation. Other things may be, particularly altitude sickness, which is worth raising with us if you’re heading to Leh at around 3,500 metres.
Where risk is low and bite avoidance is usually enough
This covers most of the itineraries we see. Current guidance treats the major cities and the classic tourist route as low risk, where bite avoidance is recommended and tablets usually aren’t needed for a short stay.
That includes Delhi, Mumbai, Kolkata, Agra, and Rajasthan including Jaipur, Jodhpur and Udaipur. Goa also sits in this group, though it’s worth saying plainly that low risk is not the same as no risk, and Goa is not zero.
The Andaman Islands carry some risk and are better assessed individually rather than lumped in with the mainland cities.
Low risk means bite avoidance is the main protection, not that mosquitoes are irrelevant. Repellent, covered arms and legs after dusk, and a net where one is available still apply in Delhi and Goa.
Where tablets are recommended
Current guidance recommends antimalarials for a defined set of higher-risk areas. The headline states are Assam and Odisha, along with specific districts elsewhere: East Godavari, Srikakulam, Vishakhapatnam and Vizianagaram in Andhra Pradesh, and Balaghat, Dindori, Mandla and Seoni in Madhya Pradesh.
Beyond those, risk is high enough to warrant tablets across Chhattisgarh, Jharkhand and Tripura, in rural parts of West Bengal away from Kolkata, rural Maharashtra away from Mumbai, and in Meghalaya, Mizoram, Manipur, Nagaland and the lower parts of Arunachal Pradesh.
Seven states account for the bulk of India’s cases: Chhattisgarh, Jharkhand, Maharashtra, Odisha, Tripura, Uttar Pradesh and West Bengal. If your route touches any of them outside the major cities, the answer to the tablets question changes.
Season matters as much as place
Transmission peaks during and just after the monsoon, broadly June to September depending on the region. A village in eastern India in August is a different proposition from the same village in January.
This catches out family travellers in particular, because the summer school holidays coincide with the peak transmission window. If you’re travelling in July or August to anywhere on the higher-risk list, raise it early.
Which tablets, and what they cost
Where tablets are advised, there are three we commonly discuss.
Atovaquone with proguanil is the usual first choice. It’s £2.50 per tablet here, with a paediatric version at £1.20. It’s taken daily, started shortly before travel and continued for a week after leaving the risk area, which makes it well suited to shorter trips.
Doxycycline is £0.45 per capsule and is a sensible alternative for longer trips on cost grounds. It’s taken daily and continued for four weeks after leaving. It can increase sun sensitivity, which is worth weighing up for a beach or trekking itinerary.
Mefloquine is £3 per tablet and taken weekly, which some people prefer. It doesn’t suit everyone and needs a proper conversation about medical history before it’s considered.
Which one fits depends on how long you’re away, what else you take, and your own history. That’s a consultation question rather than something to settle from a website. Check availability and book, and bring your full route.
Tablets only work if the course is completed after you get home. Stopping the week you land back is the most common reason protection fails.
If you’re visiting family, read this bit
Travellers staying with relatives are disproportionately affected by malaria, and the reasons are structural rather than careless. Family homes rarely have air conditioning or nets. Stays are longer. Itineraries reach rural districts that no tour operator visits. And there’s a widespread belief that having grown up in India confers lasting protection, which it does not, particularly against falciparum.
If that’s your trip, our guide to what families visiting relatives in India need covers the wider picture, and the detailed India vaccination recommendations set out the full list.
Bite avoidance, wherever you’re going
Malaria mosquitoes bite between dusk and dawn, so evening and overnight protection matters most. Use a repellent containing DEET on exposed skin, cover arms and legs after dark, and use a net where one is available, particularly if windows are open.
Worth knowing: the mosquitoes that carry dengue bite during the day instead, and dengue is widespread across India including the cities. That means repellent is a daytime habit too, not just an evening one.
Malaria tablets are one part of the trip, not the whole of it. Before you travel, find out exactly what you need for India, because the vaccination list matters more often than the tablets do.
Questions we’re asked most
Do I need malaria tablets for Goa?
Usually not for a standard beach holiday. Goa is low risk and bite avoidance is normally the advice. It isn’t zero risk, and if the trip includes other parts of India the answer can change.
What about Delhi, Agra and Jaipur?
The Golden Triangle is low risk. Most travellers doing that route are advised on bite avoidance rather than tablets.
Is Kerala a risk area?
Mostly low risk, but it varies by specific area and elevation, so it’s assessed against your actual route rather than the state as a whole.
When do I start taking them?
It depends which tablet. Atovaquone with proguanil starts a day or two before you enter the risk area. Doxycycline starts a couple of days before. Mefloquine needs starting further ahead. We’ll set out the schedule at your appointment.
Can children take malaria tablets?
Yes, with the dose based on weight. There’s a paediatric version of atovaquone with proguanil at £1.20 per tablet.
I’m pregnant. What are my options?
Malaria in pregnancy is serious and the options are more limited, so this needs individual assessment. Avoiding higher-risk areas is often the advice.
I got a fever three weeks after coming home. Is that relevant?
Yes. Tell a doctor you’ve been to India, because vivax malaria can appear well after you return and it’s easily missed if nobody knows where you’ve been.
Not sure whether your route needs tablets?
Bring your itinerary, including short stops, and we’ll map it against current guidance at 30 Northfield Avenue, West Ealing.
This article is general information, not personal medical advice. Malaria advice depends on your exact route, dates and medical history, so please speak to our team for guidance based on current NaTHNaC recommendations.
