6 mins read

Uses

What is atovaquone/proguanil used for?

Atovaquone/proguanil is commonly used for prevention or treatment of malaria caused by a parasite called Plasmodium falciparum.

Atovaquone/proguanil may not be appropriate for the infection listed above, depending on which parasite is causing the infection. Parasites in some locations may have developed resistance to atovaquone/proguanil, which will make it not work as well.

Atovaquone/proguanil may also be used for other conditions as determined by your healthcare provider.

How does atovaquone/proguanil work (mechanism of action)?

Atovaquone/proguanil shuts down production of substances needed for the parasite to grow and reproduce.

How is atovaquone/proguanil supplied (dosage forms)?

Brands and other names

  • Malarone
  • Malarone Pediatric

Dosage forms and strengths

  • 62.5 mg/25 mg oral tablets
  • 250 mg/100 mg oral tablets

How should I store atovaquone/proguanil?

Atovaquone/proguanil should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. If you are taking the medicine from a blister pack, do not remove tablets from blister packs until ready to take. 

Side Effects

What are the most common side effects of atovaquone/proguanil?

The most common side effects of atovaquone/proguanil are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Diarrhea and vomiting (see below)
  • Nausea
  • Stomach pain
  • Headache
  • Dreams
  • Mouth ulcers
  • Cough
  • Feeling unusually weak or tired
  • Loss of appetite
  • Dizziness
  • Itching

There may be other side effects of atovaquone/proguanil that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of atovaquone/proguanil?

While less common, the most serious side effects of atovaquone/proguanil are described below, along with what to do if they happen.

Severe Allergic Reactions. Atovaquone/proguanil may cause allergic reactions, which can be serious. Stop taking atovaquone/proguanil and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Diarrhea and Vomiting. Diarrhea and vomiting are common side effects of atovaquone/proguanil, which can cause the medicine to not be fully absorbed into the body. This may cause the medicine to not work as well. Tell your healthcare provider right away if you have diarrhea or vomiting that is severe or will not go away while taking atovaquone/proguanil. Your healthcare provider may prescribe you a medicine to help reduce these side effects or change you to a different medicine.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking atovaquone/proguanil. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Severe Skin Reactions. Atovaquone/proguanil can cause a severe skin reaction, called Stevens-Johnson Syndrome (SJS), that can lead to death if not treated. If you develop a rash, stop atovaquone/proguanil and call your healthcare provider right away. Get emergency help if you have any of the following symptoms.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Warnings & Precautions

Who should not use atovaquone/proguanil?

Allergies to Ingredients. People who are allergic to any of the following should not take atovaquone/proguanil.

  • Atovaquone
  • Proguanil
  • Malarone
  • Malarone Pediatric
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific atovaquone/proguanil products they stock.

Kidney Problems. Atovaquone/proguanil should not be used if your kidneys are not working as well as they should be. If there is a concern about the health of your kidneys, your healthcare provider may do tests to determine if they are working well enough to take this medicine.

What should I know about atovaquone/proguanil before using it?

Do not take atovaquone/proguanil unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share atovaquone/proguanil with other people, even if they have the same condition as you. It may harm them.

Keep atovaquone/proguanil out of the reach of children.

Take atovaquone/proguanil with a high fat food such as peanut butter or a high fat drink such as whole milk to help the medicine get absorbed into your body.

Atovaquone/proguanil may be crushed and mixed with condensed milk if you have trouble swallowing tablets. Take this mixture right away after preparing it.

Atovaquone/proguanil can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how atovaquone/proguanil affects you.

People who are 65 and older can be at greater risk for some side effects from atovaquone/proguanil. Talk to your healthcare provider about your risks if you are in this age group.

What should I tell my healthcare provider before using atovaquone/proguanil?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if atovaquone/proguanil is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

Other Medicines and Supplements. Atovaquone/proguanil may interact with other medicines and supplements. Before taking atovaquone/proguanil, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how atovaquone/proguanil could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. It is not known if atovaquone/proguanil passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take atovaquone/proguanil while breastfeeding.

Interactions

Does atovaquone/proguanil interact with foods or drinks?

There are no known interactions between atovaquone/proguanil and foods or drinks.

There are no known interactions between atovaquone/proguanil and alcohol, but heavy drinking can slow your immune response and make it harder for your body to fight infection.

Does atovaquone/proguanil interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking atovaquone/proguanil.

  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • Rifabutin (Mycobutin), which is a medicine used to prevent Mycobacterium avium complex infection
  • Warfarin, which is a medicine used to prevent or treat blood clots
  • Tetracycline, which is medicine used to treat a variety of infections
  • Metoclopramide (Reglan and others), which is a medicine for certain stomach problems

This may not be a complete list of medicines that can interact with atovaquone/proguanil. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much atovaquone/proguanil?

If you or someone else has used too much atovaquone/proguanil, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of atovaquone/proguanil?

If you vomit within one hour of taking the dose, you should take a repeat dose. If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses. 

It is important to complete your prescribed course of atovaquone/proguanil, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to atovaquone/proguanil or other similar medicines.