atovaquone/proguanil
Brand names: Malarone
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.
Drug Pricing (NADAC)
Brand Price
$6.61/unit
Generic Available
No
GLAXOSMITHKLINE
Pricing data from NADAC (CMS), effective April 17, 2024. Compare all drug costs →
What it does
Malarone is used to prevent malaria, especially in areas where the malaria parasite is resistant to chloroquine.
Common side effects
Abdominal pain, Headache, Cough
Key warnings
Elevated liver tests, hepatitis, and liver failure have been reported with Malarone.
How It Works
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.
How to Take It
Take Malarone at the same time each day with food or a milky drink. If you vomit within 1 hour of taking it, take another dose. To help with swallowing, you can crush the tablet and mix it with condensed milk. Start taking Malarone 1 or 2 days before entering a malaria area, continue daily while you're there, and for 7 days after you leave.
Pregnancy & Breastfeeding
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.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store Malarone at room temperature, away from heat and moisture.
Side Effects (from patient reports)
Based on 3,798 FDA adverse event reports.
Serious Warnings
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.
Known Drug Interactions
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.
Mechanism: Rifampin lowers the amount of atovaquone in your blood, which can make the medicine less effective at fighting infection.
What to do: This combination is not recommended, and your doctor should use a different medication instead.
( 7.1 ) • Proguanil may potentiate anticoagulant effect of warfarin and other coumarin-based anticoagulants. 7.2 Anticoagulants Proguanil may potentiate the anticoagulant effect of warfarin and other coumarin-based anticoagulants.
Mechanism: Proguanil can increase the blood-thinning effects of warfarin, which may make you bleed more easily.
What to do: Your healthcare provider should monitor your blood clotting tests and may need to change your warfarin dose.
( 7.2 ) • Tetracycline may reduce atovaquone concentrations; parasitemia should be closely monitored. 7.3 Tetracycline Concomitant treatment with tetracycline has been associated with a reduction in plasma concentrations of atovaquone [see Clinical Pharmacology ( 12.3 )] . Parasitemia should be closely monitored in patients receiving tetracycline.
Mechanism: Tetracycline can lower the amount of atovaquone in your body, making it harder for the drug to fight off the infection.
What to do: Your doctor should check your blood frequently to ensure the infection is being properly treated.
7.4 Metoclopramide While antiemetics may be indicated for patients receiving MALARONE, metoclopramide may reduce the bioavailability of atovaquone and should be used only if other antiemetics are not available [see Clinical Pharmacology ( 12.3 )] .
Mechanism: Metoclopramide speeds up the digestive system, which can lower the total amount of atovaquone that gets into your blood.
What to do: You should only use this combination if there are no other medicines available to treat your nausea.
Common Questions
Can I take Malarone if I have kidney problems?
What should I do if I vomit after taking Malarone?
Can I crush the Malarone tablet?
How long should I take Malarone for malaria prevention?
What are the common side effects of Malarone?
Can Malarone be used to treat severe malaria?
Is Malarone safe to take during pregnancy?
What drugs should I avoid while taking Malarone?
What should I do if I miss a dose of Malarone?
How should I store Malarone?
What are the common side effects of atovaquone/proguanil?
Does atovaquone/proguanil interact with other medications?
What drug class is atovaquone/proguanil?
Is atovaquone/proguanil safe during pregnancy?
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What the FDA Data Shows for atovaquone/proguanil
The FDA label for atovaquone/proguanil (sold under brand names such as Malarone) classifies it as a prescription-only medication in the Antimalarial Combination class. Malarone is used to prevent malaria, especially in areas where the malaria parasite is resistant to chloroquine. Official labeling lists 12 commonly reported side effects, including Abdominal pain, Headache, Cough.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 3,798 voluntary reports. The database also lists 4 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: November 14, 2023
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages