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atovaquone/proguanil

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Brand names: Malarone

Antimalarial Combination Rx

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.

Using the medicine for something it's not approved for
737
Fever
429
Diarrhea
408
The medicine is not working
387
Feeling sick to your stomach
370
Lung infection
355
Death
294
Feeling tired
286
Difficulty breathing
270
Sudden kidney damage
262

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

moderate rifampin

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?
If you have severe kidney problems, you should not use Malarone to prevent malaria. Talk to your doctor about other options.
What should I do if I vomit after taking Malarone?
If you vomit within 1 hour of taking Malarone, take another dose right away.
Can I crush the Malarone tablet?
Yes, you can crush the tablet and mix it with condensed milk if you have trouble swallowing it.
How long should I take Malarone for malaria prevention?
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.
What are the common side effects of Malarone?
Common side effects include abdominal pain, headache, cough, vomiting, diarrhea, and nausea.
Can Malarone be used to treat severe malaria?
No, Malarone has not been tested for treating severe malaria affecting the brain, lungs, or kidneys.
Is Malarone safe to take during pregnancy?
It is not known if Malarone can harm an unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant.
What drugs should I avoid while taking Malarone?
Avoid taking Malarone with rifampin or rifabutin. Be careful when taking Malarone with warfarin or tetracycline.
What should I do if I miss a dose of Malarone?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose.
How should I store Malarone?
Store Malarone at room temperature, away from heat and moisture.
What are the common side effects of atovaquone/proguanil?
The most commonly reported side effects of atovaquone/proguanil include Abdominal pain, Headache, Cough, Vomiting, Diarrhea. Based on 3,798 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does atovaquone/proguanil interact with other medications?
Yes, atovaquone/proguanil has 4 known drug interactions. Notable interactions include rifampin, warfarin, tetracycline. Always inform your doctor about all medications you are taking.
What drug class is atovaquone/proguanil?
atovaquone/proguanil belongs to the Antimalarial Combination drug class. It requires a prescription (Rx). Malarone is used to prevent malaria, especially in areas where the malaria parasite is resistant to chloroquine.
Is atovaquone/proguanil safe during pregnancy?
It is not known if Malarone can harm an unborn baby. Pregnant women should continue taking folate supplements. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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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

All federal data sources used on this page