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Atovaquone Proguanil Brand Names- Malarone | Malarone Pediatric
What is Atovaquone Proguanil
Atovaquone proguanil is an oral antimalarial combination. Plasmodium falciparum exhibits a high incidence of resistance to both atovaquone and proguanil as single agents for the treatment of malaria.
The combination, however, has potent synergistic antimalarial activity.
Atovaquone is structurally and pharmacologically related to older antimalarials, lapinone and parvaquone.
Proguanil is a synthetic biguanide derivative of pyrimidine and is actually a prodrug for the active drug cycloguanil.
In certain populations which are poor metabolizers (e.g., Asian and African populations), the conversion of proguanil to cycloguanil is inadequate and therapeutic concentrations of the active compound are not achieved.
Malarone was approved by FDA July 14, 2000 for the prevention and treatment of malaria.
Indications
- malaria
- malaria prophylaxis
- Plasmodium falciparum
- Plasmodium sp.
Side Effects
- abdominal pain
- anaphylactoid reactions
- anemia
- angioedema
- anorexia
- anxiety
- asthenia
- back pain
- cholestasis
- cough
- depression
- diarrhea
- dizziness
- dyspepsia
- elevated hepatic enzymes
- erythema multiforme
- fever
- gastritis
- hallucinations
- headache
- hepatic failure
- hepatitis
- infection
- influenza
- insomnia
- myalgia
- nausea
- neutropenia
- oral ulceration
- pancytopenia
- photosensitivity
- pruritus
- rash
- seizures
- Stevens-Johnson syndrome
- stomatitis
- urticaria
- vasculitis
- vomiting
Monitoring Parameters
- CBC
- LFTs
- serum amylase
- serum creatinine/BUN
- serum sodium
Contraindications
- Asian patients
- Black patients
- breast-feeding
- children
- diarrhea
- driving or operating machinery
- geriatric
- GI disease
- hepatic disease
- infants
- pregnancy
- pulmonary edema
- renal failure
- renal impairment
- sunlight (UV) exposure
- vomiting
Interactions
- Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
- Atazanavir
- Atazanavir; Cobicistat
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Esomeprazole
- Esomeprazole; Naproxen
- Fedratinib
- Indinavir
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Lamivudine, 3TC; Zidovudine, ZDV
- Lopinavir; Ritonavir
- Luliconazole
- Metoclopramide
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Oritavancin
- Penicillamine
- Phentermine; Topiramate
- Rabies Vaccine
- Rifabutin
- Rifampin
- Rifapentine
- Ritonavir
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Tetracycline
- Topiramate
- Trimethoprim
- Typhoid Vaccine
- Voriconazole
- Warfarin
- Zidovudine, ZDV
