atovaquone and proguanil (Malarone) oral

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GENERIC NAME: Atovaquone and proguanil hydrochloride

BRAND NAME: Malarone

DRUG CLASS AND MECHANISM: Atovaquone and proguanil is an anti-malarial medication. Atovaquone blocks mitochondrial electron transfer and thereby the production of energy for use by the parasites. Proguanil is metabolized into its active metabolite, cycloguanil, which blocks dihydrofolate reductase and enzymes required for making pyrimidine which is a chemical needed for production of DNA.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Atovaquone and proguanil tablets are available in two combination strengths: 250/100 mg (adults) and 62.5/25 mg (pediatric).

STORAGE: Store Atovaquone and proguanil tablets should be stored between 15 Cto 30 C (59 F to 86 F).

PRESCRIBED FOR: Atovaquone and proguanil is used for prevention and treatment of P. Falciparum malaria.

DOSING:

Prevention of malaria:

Adults: Take 1 tablet (250 – 100 mg) by mouth daily, starting 1 or 2 days before entering in malaria-endemic area; continue during the stay and for 7 days after return.

Pediatric: Preventive doses are based on a child's weight. All doses should be started 1 or 2 days before entering in malaria-endemic area; continued during the stay and for 7 days after return.

  • Weight 11 to 20 kg: Take 1 tablet (62.5/25 mg) by mouth daily.
  • Weight 21 to 30 kg: Take 2 tablets (125/50 mg) by mouth daily.
  • Weight 31 to 40 kg: Take 3 tablets (187.5/75 mg) by mouth daily.
  • Weight > 40 kg: Take 4 pediatric tablets (250/100 mg) OR 1 adult strength tablet (250/100 mg) by mouth daily.

Treatment of malaria:

Adults: Take 4 tablets (1000 – 400 mg) by mouth as a single dose daily for 3 days.

Pediatric: Treatment doses are based on child's weight.

  • Weight 5 to 8 kg: Take 2 pediatric tablets (125/50 mg) by mouth daily for 3 days.
  • Weight 9 to 10 kg: Take 3 pediatric tablets (187.5/75 mg) by mouth daily for 3 days
  • Weight 11 to 20 kg: Take 1 adult tablet (250/100 mg) by mouth daily for 3 days.
  • Weight 21 to 30 kg: Take 2 adult tablets (500/200 mg) by mouth daily for 3 days.
  • Weight 31 to 40 kg: Take 3 adult tablets (750/300 mg) by mouth daily for 3 days.
  • Weight > 40 kg: Take 4 tablets (1000/400 mg) by mouth daily for 3 days.

DRUG INTERACTIONS: Combining atovaquone/proguanil with tetracycline can lower atovaquone levels in the body, leading to lack of effectiveness of the antimalarial medication.

Concomitant use of atovaquone/proguanil and rifampin or rifabutin can lower atovaquone levels approximately 50% and 34%, reducing effectiveness of malarial medication.

Concomitant use of atovaquone/proguanil and metoclopramide (Reglan, Reglan ODT, Metozol ODT, Octamide) may lower the amount of atovaquone that the body can absorb, leading to lack of effectiveness.

PREGNANCY: There are no adequate studies of atovaquone and proguanil to determine safe and effective use in pregnant women.

NURSING MOTHERS: It is not known if atovaquone enters breast milk, but proguanil may enter breast milk in trace amounts. It is best to exercise caution before using these drugs in nursing mothers.

SIDE EFFECTS: Side effects of atovaquone and proguanil are headache, fever, dizziness, myalgia, nausea and vomiting, diarrhea, abdominal pain, loss of appetite, cough, upper respiratory infections, and itching.

REFERENCE: FDA Prescribing Information.


Medically Reviewed by a Doctor on 5/16/2014



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