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Malarone (atovaquone/proguanil)

Indications

Malarone tablets protect against malaria caused by Plasmodium falciparum and Plasmodium vivax parasites in regions where these strains are known to be resistant to other antimalarial medications.

Dosage and Administration

• Take Malarone exactly as prescribed by your healthcare provider.
• Swallow the tablets whole with a meal or a milky drink to improve absorption.
• Start taking Malarone 1 to 2 days before entering a malaria-endemic area.
• Continue taking Malarone daily while in the malaria-endemic area.
• Take the tablets at the same time each day.
• Complete the full course of treatment as prescribed.
• Do not crush or chew the tablets.
• Do not skip doses or stop taking Malarone without consulting your doctor.
• Do not take Malarone for longer than necessary for malaria prevention.
• Do not use Malarone for treating malaria infections.

Mechanism of Action

Malarone tablets contain a combination of atovaquone and proguanil, which work together to prevent malaria. Atovaquone interferes with the parasite’s mitochondria, disrupting its energy production, while proguanil inhibits the parasite’s ability to reproduce within the liver.

Contraindications

• Allergy to Atovaquone or Proguanil: Do not use Malarone if you have a known hypersensitivity to atovaquone, proguanil, or any of the inactive ingredients in the tablets.
• Severe Renal Impairment: Avoid use in patients with severe renal impairment (creatinine clearance less than 30 mL/min).
• Pregnancy: Use caution during pregnancy, especially in the first trimester. Consult a healthcare provider before using Malarone.
• Breastfeeding: Consult a healthcare provider before using Malarone while breastfeeding.

Side Effects

Common Side Effects

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Headache
• Dizziness

Serious Side Effects

• Severe allergic reactions (rash, itching, swelling)
• Difficulty breathing
• Yellowing of the skin or eyes (jaundice)
• Dark urine
• Unusual bleeding or bruising
• Severe abdominal pain

Precautions

• Inform Your Doctor About All Medications: Ensure your doctor knows about all the medications you are taking to avoid drug interactions.
• Monitor for Signs of Liver or Kidney Problems: Report any symptoms such as jaundice, dark urine, or changes in urinary frequency to your doctor.
• Pregnancy and Breastfeeding: Consult a healthcare provider before using Malarone if you are pregnant or breastfeeding.
• Avoid Sun Exposure: Use sunscreen and protective clothing to prevent sunburn while taking Malarone, as it may increase sensitivity to sunlight.
• Complete the Full Course: Ensure you complete the full course of treatment to maximize effectiveness and reduce the risk of developing resistance.

Storage Instructions

• Store at room temperature, between 20°C to 25°C (68°F to 77°F).
• Protect from moisture and light.
• Keep in the original container tightly closed.
• Keep out of reach of children and pets.
• Do not use after the expiration date on the container.

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/021078s023lbl.pdf