Adult Dosing
Prophylaxis of malaria
- 1 tab [250 mg atovaquone/100 mg proguanil] PO qd
- Start therapy 1-2 days before entering malaria-endemic region and continue therapy daily during stay and for 7 days after return
Treatment of acute malaria
- 4 tabs [1000 mg/400 mg] PO qd x3 consecutive days
Notes:- Administer with food or milky drink at the same time every day
- Repeat dose in the event of vomiting within 1 hr after dosing
Pediatric Dosing
Prophylaxis of malaria (based on body weight)
- <11 kg
- Safety and effectiveness in pediatric patients <11 kg have not been established
- 11-20 kg
- 1 pediatric tab [62.5 mg/25 mg] PO qd
- 21-30 kg
- 2 pediatric tabs [125 mg/50 mg] PO qd
- 31-40 kg
- 3 pediatric tabs [187.5 mg/75 mg] PO qd
- >40 kg
- 1 tab [250 mg/100 mg] PO qd
Notes:- Start therapy 1-2 days before entering malaria-endemic region and continue therapy daily during stay and for 7 days after return
Treatment of acute malaria (based on body weight)
- <5 kg
- Safety and effectiveness in pediatric patients <5 kg have not been established
- 5-8 kg
- 2 pediatric tabs [125 mg/50 mg] PO qd x 3 days
- 9-10 kg
- 3 pediatric tabs [187.5 mg/75 mg] PO qd x 3 days
- 11-20 kg
- 1 tab [250 mg/100 mg] PO qd x 3 days
- 21-30 kg
- 2 tabs [500 mg/200 mg] PO qd x 3 days
- 31-40 kg
- 3 tabs [750 mg/300 mg] PO qd x 3 days
- >40 kg
- 4 tabs [1000 mg/400 mg] PO qd x 3 days
Notes:- Administer with food or milky drink at the same time every day
- Crush and mix tablets with condensed milk for children who are unable to swallow them intact
- Repeat dose in the event of vomiting within 1 hr after dosing
[Outline]
Renal Dose Adjustment (Based on CrCl)
- 50-80 mL/min: No dose adjustments
- 30-50 mL/min: No dose adjustments
- <30 mL/min: Contraindicated for malaria prophylaxis. May be used with caution for malaria treatment, only if the benefits of the 3-day treatment regimen outweigh the potential risks associated with increased drug exposure
Hepatic Dose Adjustment
- Mild-moderate hepatic impairment: No dose adjustments
- Severe hepatic impairment: Dose adjustments not defined
See Supplemental Patient Information
- Atovaquone/proguanil is not indicated for treatment of cerebral malaria or other forms of complicated malaria, including hyperparasitemia, pulmonary edema, or renal failure
- Prophylactic use of atovaquone/proguanil may result in elevated liver function tests and rare cases of hepatitis
- Diarrhea or vomiting may result in reduced absorption of atovaquone. Consider use of antiemetics and monitor for parasitemia when used in patients who are vomiting
- If diarrhea or vomiting is severe or persistent, consider using an alternative antimalarial drug
- Monotherapy with atovaquone/proguanil for P. vivax malaria may result in parasite relapse
- Recrudescent P. falciparum infections following therapy with atovaquone/proguanil or due to failure of chemoprophylaxis with this agent should be treated with a different blood schizonticide
- Use of atovaquone/proguanil for malaria prophylaxis in patients with severe renal failure is contraindicated. It may be used in patients with severe renal failure for treatment of malaria, only if benefits of treatment outweigh the potential risks
- Rare cases of serious events like hepatitis, severe skin reactions, neurological, and hematological events have been reported with prophylactic or therapeutic use of atovaquone/proguanil
- Atovaquone/proguanil must be administered with food or a milky drink to improve its bioavailability
Cautions: Use cautiously in
Supplemental Patient Information
- Instruct patients to take the medication with food or a milky drink at the same time every day
- Advise patients to use protective clothing, insect repellents, and bednets as additional measures for prevention of malaria
- Advise patients to seek medical advice for any febrile illness occurring during or after return from a malaria-endemic area
Pregnancy Category:C
Breastfeeding: No information is available regarding the use of atovaquone/proguanil during breastfeeding. The CDC currently does not recommend its usage for prevention of malaria in mothers nursing infants <5 kg. However, atovaquone/proguanil may be used to treat women who are nursing infants of any weight when the potential benefit outweighs the potential risk to the infant. Breastfed infants requiring chemoprophylaxis should also receive the recommended dosages of antimalarial drugs as the amount of antimalarials excreted in breast milk is generally insufficient to provide adequate protection against malaria. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 24 June 2011). Manufacturer advises caution.
US Trade Name(s)
- Malarone
- Malarone Pediatric
US Availability
atovaquone/proguanil (generic)
Malarone (atovaquone/proguanil)
Malarone Pediatric (atovaquone/proguanil)
Canadian Trade Name(s)
- Malarone
- Malarone Pediatric
Canadian Availability
Malarone (atovaquone/proguanil)
Malarone Pediatric (atovaquone/proguanil)
UK Trade Name(s)
- Malarone
- Malarone Paediatric
UK Availability
Malarone (atovaquone/proguanil)
Malarone Paediatric (atovaquone/proguanil)
Australian Trade Name(s)
Australian Availability
Malarone (atovaquone/proguanil)
Malarone Junior (atovaquone/proguanil)
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Malarone 62.5-25 MG TABS [Bottle] (GLAXO SMITH KLINE)
7 mg = $31.99
21 mg = $71.97 - Malarone 250-100 MG TABS [Bottle] (GLAXO SMITH KLINE)
7 mg = $60.99
21 mg = $174.97 - Atovaquone-Proguanil HCl 250-100 MG TABS [Bottle] (GLENMARK PHARMACEUTICALS)
30 mg = $199.98
90 mg = $599.95
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
Drug Name: Malarone 250/100 (atovaquone / proguanil HCl) Oral Tablet
Ingredient(s): Atovaquone mixture with Proguanil
Imprint: GX;CM3
Color(s): Pink
Shape: Round
Size (mm): 11.00
Score: 1
Inactive Ingredient(s): hydroxypropyl cellulose, low substituted / magnesium stearate / cellulose, microcrystalline / poloxamer 188 / povidone k30 / sodium starch glycolate type a potato / hypromellose / polyethylene glycol 400 / polyethylene glycol 8000 / ferric oxide red / titanium dioxide
Drug Label Author:
GlaxoSmithKline LLC
DEA Schedule:
Non-Scheduled
Drug Name: Malarone 62.5/25 (atovaquone / proguanil HCl) Oral Tablet
Ingredient(s): Atovaquone mixture with Proguanil
Imprint: GX;CG7
Color(s): Pink
Shape: Round
Size (mm): 7.00
Score: 1
Inactive Ingredient(s): hydroxypropyl cellulose, low substituted / magnesium stearate / cellulose, microcrystalline / poloxamer 188 / povidone k30 / sodium starch glycolate type a potato / hypromellose / polyethylene glycol 400 / polyethylene glycol 8000 / ferric oxide red / titanium dioxide
Drug Label Author:
GlaxoSmithKline LLC
DEA Schedule:
Non-Scheduled