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atovaquone/proguanil vs rifampin

Side-by-side comparison of atovaquone/proguanil and rifampin. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

moderate Known Drug Interaction

7 DRUG INTERACTIONS • Administration with rifampin or rifabutin is known to reduce atovaquone concentrations; concomitant use with MALARONE is not recommended. ( 7.3 ) 7.1 Rifampin/Rifabutin Concomitant administration of rifampin or rifabutin is known to reduce atovaquone concentrations [see Clinical Pharmacology ( 12.3 )] . The concomitant administration of MALARONE and rifampin or rifabutin is not recommended.

Recommendation: This combination is not recommended, and your doctor should use a different medication instead.

Drug Class
atovaquone/proguanil Antimalarial Combination
rifampin Rifamycin Antibiotic
Type
atovaquone/proguanil Prescription
rifampin Prescription
Summary
atovaquone/proguanil

Malarone is a drug used to prevent and treat malaria. It contains two medicines, atovaquone and proguanil, that work together to kill the malaria parasite.

rifampin

Rifampin is an antibiotic medicine. It fights bacteria in your body to treat infections.

What It Treats
atovaquone/proguanil

Malarone is used to prevent malaria, especially in areas where the malaria parasite is resistant to chloroquine. It is also used to treat malaria infections that are not severe. Malarone can be effective even when other malaria drugs don't work well.

rifampin

Rifampin treats tuberculosis (TB) and helps eliminate the bacteria that cause meningitis from your nose and throat. It is important to use rifampin only for infections that are proven or strongly suspected to be caused by bacteria. This helps to prevent bacteria from becoming resistant to the medicine.

How It Works
atovaquone/proguanil

Malarone contains two active ingredients: atovaquone and proguanil. Atovaquone stops the malaria parasite's energy production. Proguanil disrupts the parasite's ability to multiply. Together, they kill the parasite and treat or prevent malaria.

rifampin

Rifampin works by stopping bacteria from growing and multiplying. It does this by blocking a key enzyme that the bacteria need to make proteins. This helps your body fight off the infection.

Common Side Effects
atovaquone/proguanil
  • Abdominal pain
  • Headache
  • Cough
  • Vomiting
  • Diarrhea
rifampin
  • Heartburn
  • Upset stomach
  • Loss of appetite
  • Nausea
  • Vomiting
FAERS Reports
atovaquone/proguanil
  • Fever 429
  • Diarrhea 408
  • Feeling sick to your stomach 370
  • Lung infection 355
  • Death 294
rifampin
  • Drug Interaction 970
  • Drug Reaction With Eosinophilia And Systemic Symptoms 727
  • Nausea 628
  • Condition Aggravated 550
  • Pyrexia 541
Serious Warnings
atovaquone/proguanil

Elevated liver tests, hepatitis, and liver failure have been reported with Malarone. If you have severe kidney problems, do not use Malarone to prevent malaria. Malarone has not been tested for treating severe malaria affecting the brain, lungs, or kidneys.

rifampin

Rifampin can cause liver problems. Tell your doctor right away if you have yellowing of the skin or eyes, dark urine, or stomach pain. Rifampin can also cause blood problems. Tell your doctor if you have unusual bleeding or bruising.

Pregnancy
atovaquone/proguanil

It is not known if Malarone can harm an unborn baby. Pregnant women should continue taking folate supplements. Talk to your doctor if you are pregnant or plan to become pregnant before taking this medicine.

rifampin

Tell your doctor if you are pregnant or plan to become pregnant. Rifampin can make birth control pills less effective, so use other forms of birth control. Talk to your doctor if you are breastfeeding.

How to Read This atovaquone/proguanil vs rifampin Comparison

atovaquone/proguanil is classified in the Antimalarial Combination drug class, while rifampin sits within the Rifamycin Antibiotic class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, atovaquone/proguanil has 1,856 submissions while rifampin has 3,416. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known moderate interaction flagged in FDA labeling, attributed to rifampin lowers the amount of atovaquone in your blood, which can make the medicine less effective at fighting infection.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between atovaquone/proguanil and rifampin - always consult your physician or pharmacist first.

Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.