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I would stay away from chloroquine (Aralen) and similar quinine-based anti-malarials. Atovaquone/proguanil (Malarone) is not quinine-based and does not cause auditory damage. I have seen it on one of the "ototoxic" drug lists (along with a gazillion other drugs) - but since Malarone does not cause auditory damage, I consider it to be safe. As a matter of fact, I took Malarone myself earlier this year for anti-malarial prophylaxis during a trip to East Africa. I am not sure exactly what you mean by "long term" use and would certainly discuss it with a specialist in travel medicine if you were going to need to take it for more than a few weeks.
I am attaching my thoughts on "Drugs To Avoid" as a pdf file.
Hope this helps.
Stephen M. Nagler, M.D.
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DrugsToAvoid.pdf
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