From the Guidelines
Atovaquone is an antiparasitic medication used to treat and prevent Pneumocystis jirovecii pneumonia (PCP), malaria, and toxoplasmosis, often prescribed as a combination product with proguanil (Malarone) for malaria prevention and treatment. Atovaquone works by inhibiting mitochondrial electron transport in parasites, disrupting their energy production. The medication should be taken with food to enhance absorption, as fatty meals can increase bioavailability by 2-3 times. Some key points to consider when using atovaquone include:
- It is often used as an alternative treatment for patients who cannot tolerate first-line therapy, such as trimethoprim-sulfamethoxazole for PCP treatment 1.
- Atovaquone can be used in combination with other medications, such as azithromycin or clindamycin, to treat babesiosis 1.
- The dosage regimen for atovaquone varies depending on the specific condition being treated and the patient's age and weight. Common side effects of atovaquone include rash, nausea, diarrhea, headache, and elevated liver enzymes. Atovaquone has fewer severe side effects than some alternative treatments, making it valuable for patients with sulfa allergies or those who cannot tolerate other antiparasitic medications 1.
From the FDA Drug Label
Atovaquone oral suspension USP is a quinone antimicrobial drug. The chemical name of atovaquone is trans-2-[4-(4-chlorophenyl)cyclohexyl]-3-hydroxy-1,4-naphthalenedione.
Atovaquone is a quinone antimicrobial drug. It has a chemical name of trans-2-[4-(4-chlorophenyl)cyclohexyl]-3-hydroxy-1,4-naphthalenedione and a molecular formula of C22H19ClO3 2.
From the Research
Definition and Mechanism of Atovaquone
- Atovaquone is a broad-spectrum antiprotozoal drug with a novel mechanism of action, via inhibition of parasite mitochondrial electron transport 3.
- It is used in combination with proguanil for the treatment and prophylaxis of Plasmodium falciparum malaria 4, 3, 5, 6.
Efficacy and Safety
- The combination of atovaquone and proguanil has been shown to be highly effective against drug-resistant strains of P. falciparum, with cure rates of over 98% in some studies 3, 5, 6.
- Atovaquone and proguanil are generally well tolerated, with the most common adverse events being headache, abdominal pain, nausea, and vomiting 4, 3, 5, 6.
- The combination has been compared to other antimalarial agents, such as mefloquine, amodiaquine, and chloroquine, and has been found to be equally effective or more effective in some cases 4, 3, 5, 6.
Uses Beyond Malaria
- Atovaquone has also been investigated as a treatment for opportunistic infections, such as Pneumocystis carinii pneumonia (PCP) and toxoplasmosis, in patients with AIDS 7.
- It has been found to be effective in the treatment of mild to moderate PCP, with similar therapeutic efficacy to conventional therapies, but with superior tolerability 7.
- Atovaquone has also shown promise in the treatment of toxoplasmosis, with complete or partial radiological response rates of 37 to 87.5% in some studies 7.