atovaquone and proguanil (Malarone) oral
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
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.
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.
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.
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.
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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