atovaquone + proguanil hydrochloride at a glance
Medicine class
Combination antimalarial
Main uses
Prevention and treatment of uncomplicated P. falciparum malaria
Food
Take with food or a milky drink to improve atovaquone absorption
Additional protection
Tablets do not replace mosquito-bite precautions
What is atovaquone + proguanil hydrochloride used for?
Selected UK products are licensed for:
Prevention of P. falciparum malaria; licensed body-weight ranges differ between adult and paediatric formulations.
Treatment of acute, uncomplicated P. falciparum malaria; the suitable formulation depends on body weight.
They are not established treatments for cerebral or other severe, complicated malaria and do not clear dormant liver forms of P. vivax or P. ovale.
How does atovaquone + proguanil hydrochloride work?
Atovaquone disrupts energy production within the malaria parasite. Proguanil strengthens the antimalarial action and interferes with parasite folate metabolism. Together they act against P. falciparum stages in the liver and bloodstream.
atovaquone + proguanil hydrochloride preparations and strengths
Tablet
Route: Oral
Strengths: 62.5 mg + 25 mg, 250 mg + 100 mg
How to take atovaquone + proguanil hydrochloride
Follow the product-specific instructions from your prescriber or pharmacist.
Take with food or a milky drink because atovaquone absorption is lower without food.
Swallow tablets whole where possible. Selected paediatric tablets may be crushed and mixed with food or a milky drink immediately before administration.
Seek advice if vomiting or diarrhoea occurs because absorption may be reduced.
Continue mosquito-bite precautions such as repellents and bed nets.
atovaquone + proguanil hydrochloride side effects
Common or expected effects
- Headache
- Abdominal pain
- Nausea or vomiting
- Diarrhoea
- Dizziness, sleep disturbance or unusual dreams
- Reduced appetite
- Cough, fever or an itchy rash
Get urgent medical advice
- Sudden wheezing, breathing difficulty, or swelling of the face, lips or tongue
- A widespread, blistering, target-like or peeling rash, especially around the eyes, mouth or genitals
- Seizure, jaundice or other symptoms suggesting a serious neurological or liver reaction
atovaquone + proguanil hydrochloride in pregnancy
Pregnancy safety evidence is limited. Product information recommends use only when the expected maternal benefit outweighs possible fetal risk. UK malaria guidance generally prefers other suitable options but allows consideration when none is appropriate. Specialist risk assessment is required, and any advised folic-acid supplementation should continue.
atovaquone + proguanil hydrochloride while breastfeeding
Product information advises against use while breastfeeding because human milk data for atovaquone are insufficient and proguanil enters milk. UK malaria guidance says it may be considered when no suitable alternative exists, following specialist or prescriber assessment.
atovaquone + proguanil hydrochloride interactions
Check all prescribed, over-the-counter and travel medicines before use.
Rifampicin or rifabutin
Substantially lowers atovaquone exposure, so concurrent use is not recommended.
Metoclopramide
Can substantially reduce atovaquone concentrations; another antiemetic should usually be considered.
Efavirenz or boosted HIV protease inhibitors
May markedly lower atovaquone exposure and should be avoided with the combination where possible.
Warfarin and other coumarin anticoagulants
Proguanil may increase anticoagulant effects, requiring closer INR assessment when treatment starts or stops.
Common questions about atovaquone + proguanil hydrochloride
Answers are fully visible for fast scanning and source review.
What is atovaquone + proguanil hydrochloride used for?
It prevents P. falciparum malaria and treats acute, uncomplicated infection. The appropriate product depends partly on body weight and intended use.
Should it be taken with food?
Yes, where possible. Food or a milky drink increases atovaquone absorption.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.