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Atovaquone/Proguanil

Drug Class: Commonly Known As: Category:
Antimalarial Malarone Adult, Children

Atovaquone/Proguanil - Side Effects, Precautions, and Contraindications

What side effects can Atovaquone/Proguanil cause?

  • ​You may experience nausea, vomiting, stomach pain and diarrhea.
    • Take the medication after food to reduce gastric side effects.
    • If you vomit within 1 hour of taking the medication, repeat the dose.
  • You may experience headache and insomnia.
    • You should continue taking the medication unless you are unable to tolerate the side effects.
  • You may experience dizziness while on this medication.
    • If affected, do not drive, operate machinery or do work that requires you to be alert.

Rare but severe side effects include:

  • Severe skin reactions
    • Skin rash, which may blister and looks like small targets (central dark spots, surrounded by paler area with a dark ring around the edge) (erythema multiforme).
    • Severe widespread rash with blisters and peeling skin, particularly occurring around the mouth, nose, eyes and genitals (Stevens-Johnson syndrome).
  • Liver problems
    • Symptoms include dark urine or light coloured stools, nausea, vomiting, loss of appetite, stomach pain, yellowing of your eyes or skin.
  • Anemia
    • A condition where you do not have enough red blood cells.
    • May present with worsening tiredness, rapid breathing, pale skin/lips/nails, fast heartbeat while resting.
  • Severe infection
    • May present with high fever, severe chills, body aches, sore throat.
  • Drug allergy (symptoms include one or more of the following)
    • Swollen face/eyes/lips/tongue.
    • Difficulty in breathing.
    • Itchy skin rashes over your whole body.

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Before taking Atovaquone/Proguanil, what precautions must I follow?

​Inform your healthcare professional if:

  • You are allergic to Atovaquone, Proguanil hydrochloride or any of the other ingredients of this medication.
  • You are pregnant or breast-feeding. Avoid pregnancy and use contraceptives while taking this medication and for 2 weeks after the last dose.
  • You are taking any other medications, including supplements, traditional medications and herbal remedies.
  • You have a history of kidney problems, liver problems, seizures (epilepsy or convulsions) or depression.
  • You have tuberculosis.

What food or medicine must I avoid when I take Atovaquone/Proguanil?

​Inform your pharmacist or doctor if you are taking any of the medications below:

  • Tetracycline (antibiotic)
  • Metoclopramide (medication to treat nausea or vomiting)
  • Rifampin or Rifabutin (antibiotic)
  • Etoposide (medication to treat cancer)
  • Efavirenz, Zidovudine, Indinavir (medication to treat HIV)
  • Warfarin, Dabigatran, Apixaban or Rivaroxaban (oral anticoagulants)

This is not a complete list of all possible drug interactions with this medication. Check with your healthcare professional if you are unsure.

Atovaquone/Proguanil - Additional Information

To prevent malaria, you may protect yourself against mosquito bites by:

  • Wearing long-sleeved clothing and long trousers between sunset and sunrise.
  • Applying insect repellent containing more than 20% DEET (N-Diethyl-meta-toluamide) for adults or 10% and less DEET for children on exposed skin. DEET is a common active ingredient in mosquito repellents.
  • Using mosquito coils in the room at night.
  • Sleep with mosquito nets around your bed, with the net edges tucked under the bed or sleep in a screened room.
  • Spray insecticide where mosquitos may rest. Mosquito larvae survive well in clear, slow-flowing streams.
  • Avoid going to an area where malaria is common.

Following these guidelines and medication does not mean that you will not get malaria. If you have a fever or experience chills between 1 week and up to 1 year after your return, you should seek medical attention. Inform the doctor that you have been to a country where malaria is common. Malaria can be effectively treated if discovered early. A delay in treatment may result in serious health problems.

  • Updated on Monday, September 30, 2019
  • Article contributed by PSS National Medication Information Workgroup PSS National Medication Information Workgroup

    The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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