Malarone

— THERAPEUTIC CATEGORIES —
  • Malaria

Malarone Generic Name & Formulations

General Description

Atovaquone 250mg, proguanil HCl 100mg; tabs.

Pharmacological Class

Naphthoquinone + dihydrofolate reductase inhibitor.

How Supplied

Tabs—24, 100; Ped tabs—100

Manufacturer

Malarone Indications

Indications

Prophylaxis of P. falciparum malaria (including chloroquine-resistant strains). Treatment of acute uncomplicated P. falciparum malaria.

Malarone Dosage and Administration

Adults and Children

Take at the same time each day with food or a milky drink. Children: may crush and mix with condensed milk if unable to swallow tabs. Repeat dose if vomiting occurs within 1 hour. Prophylaxis (once daily starting 1–2 days before entering endemic area, during stay, and for 7 days after return): <11kg: not recommended (see Treatment); 11–20kg: 62.5mg atovaquone/25mg proguanil; 21–30kg: 125mg/50mg; 31–40kg: 187.5mg/75mg. >40kg: 250mg/100mg. Treatment (give as single daily dose for 3 consecutive days): <5kg: not recommended; 5–8kg: 125mg/50mg; 9–10kg: 187.5mg/75mg; 11–20kg: 250mg/100mg; 21–30kg: 500mg/200mg; 31–40kg: 750mg/300mg. >40kg: 1g/400mg.

Malarone Contraindications

Contraindications

Prophylaxis in severe renal impairment (CrCl <30mL/min).

Malarone Boxed Warnings

Not Applicable

Malarone Warnings/Precautions

Warnings/Precautions

Use other therapy in severe malaria, recrudescence, or prophylaxis failure. Monitor parasitemia closely and consider other therapy in severe or persistent diarrhea or vomiting (may use antiemetics). Hepatic or renal impairment (CrCl <30mL/min): consider alternate therapy for treatment. Elderly. Pregnancy (Cat.C; may continue folate supplements). Nursing mothers.

Malarone Pharmacokinetics

See Literature

Malarone Interactions

Interactions

Concomitant rifampin, rifabutin: not recommended. Atovaquone antagonized by tetracycline, metoclopramide. Proguanil may potentiate warfarin or other coumarin-based anticoagulants (monitor). Caution with indinavir, CYP2C19 substrates or inhibitors.

Malarone Adverse Reactions

Adverse Reactions

GI upset/pain, headache, asthenia, anorexia, dizziness, elevated liver function tests; rare: anaphylaxis, vasculitis, hepatitis, cholestasis. Children: vomiting, pruritus.

Malarone Clinical Trials

See Literature

Malarone Note

Not Applicable

Malarone Patient Counseling

See Literature