atovaquone at a glance
Medicine class
Antiprotozoal anti-infective
Licensed role
Treatment of mild-to-moderate PCP when co-trimoxazole is not tolerated
Food matters
Take with food, preferably containing fat, because this substantially improves absorption
Form
Oral suspension that should not be diluted
What is atovaquone used for?
The selected UK product has one licensed indication.
Acute treatment of mild-to-moderate Pneumocystis jirovecii pneumonia in patients who cannot tolerate co-trimoxazole.
Efficacy has not been systematically evaluated for severe PCP, PCP prophylaxis or infection after failure of another PCP treatment.
How does atovaquone work?
Atovaquone blocks the organism’s mitochondrial cytochrome bc1 complex, disrupting energy production and processes needed to make nucleic acids.
atovaquone preparations and strengths
Oral suspension
Route: Oral
Strengths: 750 mg/5 mL
How to take atovaquone
Follow the prescription and product instructions supplied by the treating team.
Shake the suspension before measuring it.
Take it with food, preferably food containing fat, to improve absorption.
Do not dilute the suspension.
Use the supplied measuring device rather than a household spoon.
Tell the treating team promptly if diarrhoea, vomiting or difficulty eating could prevent reliable absorption.
atovaquone side effects
Common or expected effects
- Nausea
- Rash or itching
- Diarrhoea or vomiting
- Headache
- Difficulty sleeping
- Fever
- Hives
- Changes in blood counts, sodium or liver enzymes
Get urgent medical advice
- Severe allergic reaction causing facial or throat swelling, wheezing or breathing difficulty
- Widespread, painful, blistering or peeling rash, including erythema multiforme or Stevens–Johnson syndrome
atovaquone in pregnancy
Human pregnancy information is limited. Use requires prescriber or specialist assessment of whether the expected maternal benefit outweighs the possible fetal risk.
atovaquone while breastfeeding
It is unknown whether atovaquone enters human milk. Breastfeeding is not recommended with the selected suspension; discuss the feeding plan with the specialist team.
atovaquone interactions
Review all prescribed, non-prescription and complementary treatments before starting atovaquone.
Rifampicin or rifabutin
These substantially reduce atovaquone exposure, so concurrent use is not recommended.
Metoclopramide
It can substantially reduce atovaquone concentrations; another anti-sickness treatment should be considered.
Efavirenz or boosted HIV protease inhibitors
These may markedly lower atovaquone concentrations, so the combination should be avoided where possible.
Common questions about atovaquone
Answers are fully visible for fast scanning and source review.
Why must atovaquone be taken with food?
Food, particularly food containing fat, substantially increases absorption.
What if I cannot take it with food?
Contact the treating team because absorption may be inadequate and an alternative treatment may need consideration.
Can diarrhoea make it less effective?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.