Page 295 - ATP-P 11th Ed

Atovaquone 250mg/Proguanil 100mg (Malarone )
®
GROUNDING medication for personnel on flight status
Description: Antimalarial
Indications: Prophylaxis and treatment of Plasmodium falciparum malaria
Adult dose:
• There are pediatric tablets as well as adult tablets.
• Prophylaxis
° Start treatment 1 or 2 days prior to entering malaria endemic area and continue daily
during the stay and for 7 days after return.
° 1 tablet (adult strength) daily
• Treatment
° 4 tablets (adult strength; total daily dose atovaquone 1g/400mg proguanil) as a single
daily dose for 3 consecutive days
Pediatric dose:
• There are pediatric tablets as well as adult tablets
• Tablets may be crushed and mixed with condensed milk just prior to administration for SECTION 3
those having difficulty in swallowing tablets
• Prophylaxis dosing based on body weight
° Safety and efficacy for prophylaxis have been established for children >11kg
• Treatment dosing based on body weight
° Safety and efficacy for treatment have been established for children >5kg
Contraindications:
• Hypersensitivity to atovaquone, proguanil
• Prophylaxis in patients with severe renal impairment (CrCL <30mL/min) unless po-
tential benefits outweigh risks of non-treatment (proguanil accumulates in severe renal
failure)
Pregnancy Category C
Side-effects:
• Headache
• Abdominal pain
• Nausea/vomiting/diarrhea
• Dizziness
• Cough (pediatrics)
Adverse reactions:
• Liver transaminase elevations
• Possible association with seizures and psychotic events (e.g., hallucinations)
• Cutaneous reactions, including photosensitivity, erythema multiforme, and Stevens-
Johnson syndrome

ATP-P Handbook 11th Edition 285