From the Guidelines
Malarone (Atovaquone/Proguanil) is indicated for the prevention and treatment of uncomplicated malaria, including areas with chloroquine and mefloquine resistance, as well as for the treatment of uncomplicated Plasmodium falciparum malaria in patients who are not able to take other antimalarial medications due to certain health conditions or allergies 1.
Indications for Use
- Prevention of malaria in travelers to areas with endemic malaria
- Treatment of uncomplicated malaria, including Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae
- Alternative treatment for uncomplicated malaria in patients who are not able to take other antimalarial medications due to certain health conditions or allergies
Dosage and Administration
- For adults, the recommended dose for prevention is 1 tablet (250mg atovaquone/100mg proguanil) daily, starting 1-2 days before entering a malaria-endemic area, continuing throughout the stay, and for 7 days after leaving
- For treatment of acute malaria, the recommended dose is 4 tablets (1000mg atovaquone/400mg proguanil) once daily for 3 consecutive days
Important Considerations
- Malarone should be taken with food or a milky drink to enhance absorption
- Pregnant women, individuals with severe kidney impairment, or those with certain allergies should consult their healthcare provider before using Malarone, as alternative medications may be more appropriate
- Malarone is effective against many strains of Plasmodium falciparum, including some resistant to other antimalarials, but it is not recommended for severe malaria or for patients with a history of seizures or psychiatric disorders 1.
From the FDA Drug Label
Atovaquone and proguanil hydrochloride tablets are indicated for the prophylaxis of P. falciparum malaria, including in areas where chloroquine resistance has been reported. Atovaquone and proguanil hydrochloride tablets are indicated for the treatment of acute, uncomplicated P. falciparum malaria.
The indication for Malarone (Atovaquone/Proguanil) is for:
- Prophylaxis of P. falciparum malaria
- Treatment of acute, uncomplicated P. falciparum malaria 2
From the Research
Indication for Malarone (Atovaquone/Proguanil)
- Malarone is indicated for the prophylaxis of Plasmodium falciparum malaria, including drug-resistant strains 3, 4, 5, 6.
- It is also effective for the treatment of acute, uncomplicated malaria caused by Plasmodium falciparum 5, 7.
- The combination of atovaquone and proguanil is synergistic, providing enhanced efficacy compared to either drug alone for treatment of malaria 7.
- Malarone has a high efficacy rate for the prevention of P. falciparum malaria, estimated at 100% in nonimmune adults, adolescents, and children 3.
- It is also effective against other Plasmodium species, including P. vivax, with a protective efficacy of 84% 6.
Mechanism of Action
- Atovaquone inhibits parasitic mitochondrial electron transport, while proguanil enhances this effect 3, 7.
- The combination of atovaquone and proguanil provides causal prophylaxis, eliminating the need to continue post-travel treatment beyond 7 days 3.
Safety and Tolerability
- Malarone is generally well tolerated by both adults and children, with the most common adverse events being headache and abdominal pain 3, 4, 7.
- It has a favorable safety profile, with fewer gastrointestinal adverse events than chloroquine plus proguanil, and fewer neuropsychiatric adverse events than mefloquine 3, 4.