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Malarone
Malarone is a combination medication containing atovaquone and proguanil, used to both prevent and treat malaria. Malaria is a serious and sometimes life-threatening disease caused by parasites that are transmitted to people through the bites of infected mosquitoes. Malarone works by interfering with the parasite’s ability to grow and reproduce in the human body, thus preventing or treating malaria caused by Plasmodium falciparum, the most dangerous type of malaria parasite.
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Frequently Asked Questions
How effective is Malarone for preventing malaria?
Malarone is highly effective at preventing malaria caused by Plasmodium falciparum, with an effectiveness rate of over 90% when taken correctly.
When should I start taking Malarone for malaria prevention?
You should start taking Malarone 1 to 2 days before traveling to a malaria area, continue throughout your stay, and for 7 days after leaving the malaria zone.
Can I take Malarone if I’m pregnant?
Malarone should only be used during pregnancy if the potential benefits outweigh the risks. It’s important to consult your doctor before taking Malarone if you are pregnant or planning to become pregnant.
What should I do if I vomit after taking Malarone?
If you vomit within 1 hour of taking Malarone, take another dose as soon as possible. If you vomit after 1 hour, there is no need to take an extra dose.
Can Malarone be used for children?
Yes, Malarone can be used for children weighing at least 11 kg (24 lbs). The dosage is adjusted based on the child’s weight.
Comprehensive Drug Guide
How Does Malarone Work?
- Atovaquone: Disrupts the parasite’s mitochondrial electron transport, preventing it from generating energy needed for survival.
- Proguanil: Inhibits dihydrofolate reductase, an enzyme needed by the malaria parasite to reproduce and multiply. This combination effectively kills the parasites in the blood and prevents the progression of malaria.
Common Dosages
- 250 mg of atovaquone and 100 mg of proguanil (adult tablets).
- 62.5 mg of atovaquone and 25 mg of proguanil (pediatric tablets).
Typical Dosing
- For malaria prevention:
- Adults and children weighing 40 kg (88 lbs) or more: Take 1 adult tablet daily starting 1 to 2 days before traveling to a malaria area, continue during the stay, and for 7 days after leaving.
- Children: The dose is based on weight and involves pediatric tablets taken once daily, following the same schedule as adults.
- For malaria treatment:
- Adults: Take 4 tablets once daily for 3 consecutive days.
- Children: The dosage is based on weight, and the treatment is also given for 3 consecutive days.
Typical Dosing
FDA Approved Indications
- Prevention of malaria in adults and children weighing at least 11 kg (24 lbs).
- Treatment of acute, uncomplicated malaria caused by Plasmodium falciparum.
Who Shouldn't Take Malarone?
- Severe kidney impairment (creatinine clearance less than 30 mL/min).
- Known hypersensitivity to atovaquone, proguanil, or any of the other components of the formulation.
Advice From The Pharmacist
- Take Malarone with food or a milky drink, as this helps improve absorption of atovaquone and enhances its effectiveness.
- Start taking Malarone 1 to 2 days before traveling to a malaria-endemic area and continue for 7 days after returning to ensure full protection.
- Complete the full course of treatment or prophylaxis as prescribed, even if you feel well, to ensure all parasites are eliminated from the body.
- If you experience vomiting within 1 hour of taking a dose, take another dose as soon as possible.
- Store in a cool, dry place, away from direct sunlight and moisture.
Side Effects of Malarone
Common Side Effects
- Nausea
- Vomiting
- Abdominal pain
- Diarrhea
- Headache
- Dizziness
Uncommon/Severe Side Effects
- Severe allergic reactions (e.g., rash, itching, swelling of the face or throat, difficulty breathing)
- Liver dysfunction (yellowing of the skin or eyes)
- Severe abdominal pain or persistent vomiting
- Severe skin reactions (e.g., Stevens-Johnson syndrome)
Risks and Warnings of Malarone
- Renal Impairment: Malarone should be avoided in patients with severe kidney impairment. Patients with mild to moderate kidney issues should be closely monitored.
- Pregnancy and Breastfeeding: Malarone should only be used during pregnancy if the potential benefits outweigh the risks. It is not known if atovaquone passes into breast milk, so consult your doctor if you are breastfeeding.
- Drug Resistance: Malarone may not be effective against certain drug-resistant strains of Plasmodium falciparum. Always check with your healthcare provider about the current resistance patterns in the area you are traveling to.
Interactions with Malarone
Common Drug Interactions
- Tetracyclines (e.g., doxycycline): These antibiotics may reduce atovaquone levels, lowering the effectiveness of Malarone.
- Metoclopramide: This medication, often used to treat nausea, can reduce the absorption of atovaquone.
- Rifampin and rifabutin: These antibiotics may reduce the effectiveness of Malarone by lowering the concentration of atovaquone in the blood.
- Warfarin: Proguanil may affect warfarin levels, increasing the risk of bleeding. Patients on warfarin should have their clotting times monitored regularly.
Alternatives to Malarone
- Doxycycline: An alternative antimalarial medication used for prevention and treatment of malaria, especially in areas with resistance to other drugs.
- Chloroquine: Used for malaria prevention and treatment, but its effectiveness has decreased in many areas due to drug resistance.
- Mefloquine (Lariam): Another medication used for malaria prevention, although it is associated with psychiatric side effects in some patients.
