Atovaquone-proguanil: Difference between revisions

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==General==
==General==
*Type: Antimalarial
*Type: Antimalarial
*Dosage Forms: PO (62.5mg/25mg, 250mg/100mg)
*Dosage Forms: tablet
*Dosage Strengths: 62.5mg/25mg, 250mg/100mg
*Routes of Administration: PO
*Common Trade Names: Malarone
*Common Trade Names: Malarone


==Adult Dosing==
==Adult Dosing==
===Malaria prophylaxis===
===Malaria prophylaxis===
*250 mg/100 mg PO qd
*250mg/100mg PO QD
**Start 1-2 days prior to possible exposure
**Start 1-2 days prior to possible exposure
**Continue 7 days after possible exposure
**Continue 7 days after possible exposure


===Malaria treatment===
===Malaria treatment===
*1000 mg/400 mg PO qd x 3 days
*1000mg/400mg PO QD x 3 days
*Not for severe, complicated or cerebral malaria
*Not for severe, complicated or cerebral malaria
*See [http://www.cdc.gov/malaria/resources/pdf/treatmenttable.pdf CDC Recommendations] for complete dosing/recommendations
*See [http://www.cdc.gov/malaria/resources/pdf/treatmenttable.pdf CDC Recommendations] for complete dosing/recommendations
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====5-8 kg====
====5-8 kg====
*31.25 mg/12.5 mg PO qd
*31.25mg/12.5mg PO QD


====9-10 kg====
====9-10 kg====
*46.9 mg/18.7 mg PO qd
*46.9mg/18.7mg PO QD


====11-20 kg====
====11-20 kg====
*62.5 mg/25 mg PO qd
*62.5mg/25mg PO QD


====21-30 kg====
====21-30 kg====
*125 mg/50 mg PO qd
*125mg/50mg PO QD


====31-40 kg====
====31-40 kg====
*187.5 mg/75 mg PO qd
*187.5mg/75mg PO QD


====>40 kg====
====>40 kg====
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====5-8 kg====
====5-8 kg====
*125 mg/50 mg PO qd x 3 days
*125mg/50mg PO QD x 3 days


====9-10 kg====
====9-10 kg====
*187.5 mg/75 mg PO qd x 3 days
*187.5mg/75mg PO QD x 3 days


====11-20 kg====
====11-20 kg====
*250 mg/100 mg qd x 3 days
*250mg/100mg QD x 3 days


====21-30 kg====
====21-30 kg====
*500 mg/200 mg PO qd x 3 days
*500mg/200mg PO QD x 3 days


====31-40 kg====
====31-40 kg====
*750 mg/300 mg PO qd x 3 days
*750mg/300mg PO QD x 3 days


====>40 kg====
====>40 kg====
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*Nausea/Vomiting
*Nausea/Vomiting
*Cough
*Cough
*Diarrhea
*[[Diarrhea]]
*Asthenia
*Asthenia
*Vivid dreams
*Vivid dreams
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[[Malaria]]
[[Malaria]]


==Sources==
==References==
*Epocrates
*Epocrates


<references/>
<references/>
[[Category:Drugs]]
[[Category:Pharmacology]] [[Category:ID]]

Latest revision as of 20:17, 19 September 2019

General

  • Type: Antimalarial
  • Dosage Forms: tablet
  • Dosage Strengths: 62.5mg/25mg, 250mg/100mg
  • Routes of Administration: PO
  • Common Trade Names: Malarone

Adult Dosing

Malaria prophylaxis

  • 250mg/100mg PO QD
    • Start 1-2 days prior to possible exposure
    • Continue 7 days after possible exposure

Malaria treatment

  • 1000mg/400mg PO QD x 3 days
  • Not for severe, complicated or cerebral malaria
  • See CDC Recommendations for complete dosing/recommendations

Pediatric Dosing

Malaria prophylaxis

  • For all dosing regimins
    • Start 1-2 days prior to possible exposure
    • Continue 7 days after possible exposure

5-8 kg

  • 31.25mg/12.5mg PO QD

9-10 kg

  • 46.9mg/18.7mg PO QD

11-20 kg

  • 62.5mg/25mg PO QD

21-30 kg

  • 125mg/50mg PO QD

31-40 kg

  • 187.5mg/75mg PO QD

>40 kg

  • See adult dosing

Malaria treatment

  • Not for severe, complicated or cerebral malaria
  • See CDC Recommendations for complete dosing/recommendations

5-8 kg

  • 125mg/50mg PO QD x 3 days

9-10 kg

  • 187.5mg/75mg PO QD x 3 days

11-20 kg

  • 250mg/100mg QD x 3 days

21-30 kg

  • 500mg/200mg PO QD x 3 days

31-40 kg

  • 750mg/300mg PO QD x 3 days

>40 kg

  • See adult dosing

Special Populations

  • Pregnancy Rating: C
  • Lactation: Safety unknown; caution advised
  • Renal Dosing: Adult and Pediatric
    • CrCl>30: No adjustment
    • CrCl<30
      • Contraindicated for malaria prophylaxis
      • Risk/benefit analysis for malaria treatment
  • Hepatic Dosing: Adult and Pediatric
    • Undefined for severe impairment otherwise no adjustment

Contraindications

  • Allergy to class/drug
  • CrCl <30
  • Caution
    • CrCl<30 for treatment
    • Persistent severe diarrhea/vomiting

Adverse Reactions

Serious

Common

  • Elevated LFTs
  • Abdominal pain
  • Headache
  • Nausea/Vomiting
  • Cough
  • Diarrhea
  • Asthenia
  • Vivid dreams
  • Oral ulcers
  • Anorexia
  • Dizziness
  • Gastritis
  • Pruritus
  • Insomnia

Pharmacology

  • Half-life: 12-21 hours
  • Metabolism:
    • Atovaquone
      • CYP450
    • Proguanil
      • liver; CYP450
  • Excretion: feces and urine
  • Mechanism of Action:
    • Atovaquone
      • bacteriostatic or bactericidal
    • Proguanil
      • Inhibits parasite dihydofolate

Administration

  • Give with food or milk
  • If vomiting occurs within 1 hour repeat dose

See Also

Malaria

References

  • Epocrates