Amazon · Manaus · Travel Medicine
Brazil's malaria lives in the rainforest you're flying into. Start the pill before you go.
One Rx of atovaquone-proguanil for the Amazon basin, plus hydroxyzine for the lodge nights and Lotrisone cream for the humidity. Reviewed by a US-licensed provider, sent to your pharmacy at home before you fly to Manaus.
- Physician-founded
- Licensed in all 50 states
- HSA / FSA eligible
- Same-day Rx in most cases
More than 99% of Brazil's malaria cases occur inside the Amazon. Six states carry the highest risk: Amazonas, Acre, Roraima, Rondônia, Pará, and Maranhão. About 81% of those cases are Plasmodium vivax and the remainder are P. falciparum, where PfHRP2/3 gene deletions detected in Acre and Amazonas can interfere with rapid diagnostic tests and slow a correct diagnosis abroad. The CDC first-line for the Brazilian Amazon is atovaquone-proguanil because chloroquine resistance is established across the basin. Transmission runs year-round, so jungle-lodge stays, river cruises out of Manaus, and cross-border itineraries that touch Iquitos, Cuyabeno, or Tambopata all sit inside the prophylaxis recommendation. The bundle adds hydroxyzine for the long-haul flight to Manaus and the first lodge nights, and Lotrisone for the inevitable humid-climate skin friction the rainforest produces.
Brazil travel health guide — vaccines, snapshot overview, and what to review before you go.
Orders are reviewed and prescriptions sent to your pharmacy within 24 hours.
Booking questions, platform help, or just not sure where to start, give us a call.
+1 (302) 251-2302Rx at your pharmacy in three steps.
No appointment. No waiting room. Answer a few questions and a licensed provider reviews within hours.
Your destination, dates, health history, and current medications. Takes about 2 minutes.
A licensed clinician reviews your health profile, checks for interactions, and approves your prescription.
- Allergy screen passed
- Drug interactions clear
- Prescription approved
Your approved prescription is sent electronically to the pharmacy of your choice. Pick it up when your pharmacy has it ready.
Skip the appointment. Get the same Rx.
Both columns cover the visit and prescribing only. Your pharmacy bills the medication itself on either side.
Medications in the Amazon Rainforest (Brazil) plan
Amazon expedition medication FAQ
- The city of Manaus and the immediate urban area sit in the lower-risk zone on the CDC map, but most travelers are not staying in the city. The standard Amazon itinerary is a jungle lodge stay or a river expedition that quickly moves into the chemoprophylaxis-recommended zone: Amazonas state outside the city, Anavilhanas Archipelago, the Rio Negro and Solimões basins, Mamirauá, Cristalino, and any extension toward Acre, Roraima, Rondônia, Pará, or Maranhão. CDC first-line for that zone is atovaquone-proguanil because chloroquine resistance is established and rapid diagnostic tests can be unreliable for P. falciparum due to PfHRP2/3 gene deletions detected in Acre and Amazonas. The conservative call is to take prophylaxis if your trip includes anything beyond Manaus city hotels.
- One tablet by mouth daily, taken with food or a milky drink to improve absorption. Start 1 to 2 days before you enter the malaria area, continue every day you are there, and keep taking it for 7 days after you leave. The short pre-trip and post-trip dosing window is the reason this is the preferred pill for Amazon itineraries that often run 5 to 10 days. Doxycycline requires 4 weeks of dosing after the trip, which is a significant difference for travelers with a typical Amazon plan and who do not want to manage a daily pill for a month back home.
- Three prescriptions in one visit. Atovaquone-proguanil (Malarone) for malaria prevention while you are in the basin. Hydroxyzine (Vistaril) for the long-haul flight to Manaus and the first nights in a jungle lodge, where the rainforest soundtrack of howler monkeys, cicadas, and tropical storms makes sleep harder than travelers expect, and where the connection from a US East Coast flight typically routes through São Paulo or Bogotá. Clotrimazole-Betamethasone (Lotrisone) for the tropical rashes and fungal skin issues humidity, river crossings, and multi-day hikes produce on every Amazon trip. Three risks, three prescriptions, one visit.
- Orders are reviewed by a US-licensed provider and the Rx is sent electronically to your pharmacy within 24 hours. Most travelers can pick it up the same day.
- After your provider approves the Rx, it's sent electronically to whichever pharmacy you choose during your visit. Your pharmacy will tell you when the medication is ready for pickup. You can use your pharmacy insurance to cover the medication itself.
- If a provider can't safely prescribe (rare, usually due to a contraindication), the visit fee is refunded in full. You only pay if the Rx is sent.
See the Meeting of the Waters with the prescriptions already in your pack.
One visit, three prescriptions for the malaria basin, the lodge nights, and the humidity. Reviewed by a US-licensed provider, ready at your pharmacy before you fly to Manaus.