Atovaquone-proguanil: Difference between revisions
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==Adult Dosing== | ==Adult Dosing== | ||
===Malaria prophylaxis=== | ===Malaria prophylaxis=== | ||
*250mg/100mg PO | *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=== | ||
*1000mg/400mg PO | *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 | ||
| Line 22: | Line 22: | ||
====5-8 kg==== | ====5-8 kg==== | ||
*31.25mg/12.5mg PO | *31.25mg/12.5mg PO QD | ||
====9-10 kg==== | ====9-10 kg==== | ||
*46.9mg/18.7mg PO | *46.9mg/18.7mg PO QD | ||
====11-20 kg==== | ====11-20 kg==== | ||
*62.5mg/25mg PO | *62.5mg/25mg PO QD | ||
====21-30 kg==== | ====21-30 kg==== | ||
*125mg/50mg PO | *125mg/50mg PO QD | ||
====31-40 kg==== | ====31-40 kg==== | ||
*187.5mg/75mg PO | *187.5mg/75mg PO QD | ||
====>40 kg==== | ====>40 kg==== | ||
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====5-8 kg==== | ====5-8 kg==== | ||
*125mg/50mg PO | *125mg/50mg PO QD x 3 days | ||
====9-10 kg==== | ====9-10 kg==== | ||
*187.5mg/75mg PO | *187.5mg/75mg PO QD x 3 days | ||
====11-20 kg==== | ====11-20 kg==== | ||
*250mg/100mg | *250mg/100mg QD x 3 days | ||
====21-30 kg==== | ====21-30 kg==== | ||
*500mg/200mg PO | *500mg/200mg PO QD x 3 days | ||
====31-40 kg==== | ====31-40 kg==== | ||
*750mg/300mg PO | *750mg/300mg PO QD x 3 days | ||
====>40 kg==== | ====>40 kg==== | ||
Revision as of 07:41, 7 July 2017
General
- Type: Antimalarial
- Dosage Forms: PO (62.5mg/25mg, 250mg/100mg)
- 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
- Hypersensitivity reaction
- Stevens-Johnson Syndrome
- Erythema multiforme
- Photosensitivity
- Hepatotoxicity
- Neutropenia
- Anemia
- Pancytopenia
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
- Atovaquone
- Excretion: feces and urine
- Mechanism of Action:
- Atovaquone
- bacteriostatic or bactericidal
- Proguanil
- Inhibits parasite dihydofolate
- Atovaquone
Administration
- Give with food or milk
- If vomiting occurs within 1 hour repeat dose
See Also
References
- Epocrates