II. Indications
-
Human Immunodeficiency Virus (HIV)
- Pneumocystis carinii Pneumonia prophylaxis
- Pneumocystis carinii Pneumonia treatment
- Patients unable to tolerate Bactrim
-
Malaria Prophylaxis and Treatment (Malarone)
- Third line agent (Mefloquine preferred)
- Babesiosis
III. Contraindications
- Creatinine Clearance <30 ml/minute/1.73m2
- Pregnancy Category C
- Breast Feeding of infants under 11 klb (5 kg)
IV. Dosing: Pneumocystis carinii Pneumonia
- Prophylaxis: 1500 mg PO qd with food
- Treatment: 750 mg PO bid with food for 21 days
V. Dosing: Malaria (Atovaquone/Proguanil or Malarone)
- Adults
- Prophylaxis: 1 tablet (250 mg/100 mg) orally daily
- Start 1-2 days before travel
- Stop 7 days after return
- Treatment: 4 tablets (1000 mg/400 mg) orally daily for 3 days
- Prophylaxis: 1 tablet (250 mg/100 mg) orally daily
- Children (over age 1 month)
- Weight 5-8 kg
- Prophylaxis: 1/2 tablet (62.5 mg /25 mg) orally daily
- Weight 9-10 kg
- Prophylaxis: 3/4 tablet (62.5 mg /25 mg) orally daily
- Weight: 11-20 kg
- Prophylaxis: 1 tablet (62.5 mg /25 mg) orally daily
- Treatment: 1 tablet (250 mg/100 mg) orally daily
- Weight: 21-30 kg
- Prophylaxis: 1 tablet (125 mg /50 mg) orally daily
- Treatment: 2 tablet (250 mg/100 mg) orally daily
- Weight: 31-40 kg
- Prophylaxis: 1 tablet (187.5 mg /75 mg) orally daily
- Treatment: 3 tablet (250 mg/100 mg) orally daily
- Weight: >40 kg (Adult dose)
- Prophylaxis: 1 tablet (250 mg /100 mg) orally daily
- Treatment: 4 tablet (250 mg/100 mg) orally daily
- Weight 5-8 kg
VI. Precautions: Poor absorption
- Take with food (fatty meal) to ensure absorption
- Up to 10% of patients still may not absorb Mepron
VII. Efficacy: HIV
VIII. Adverse effects
- Less dose-limiting adverse reactions than Bactrim
- Atovaquone: 7%
- Bactrim: 20%
- Rash
- Abdominal Pain
- Nausea or Vomiting
- Diarrhea
- Headache
- Mild Liver Function Test abnormalities
IX. Drug Interactions: Reduced plasma levels of Atovaquone
- Tetracycline
- Metoclopramide (Reglan)
- Rifampin
X. References
Images: Related links to external sites (from Bing)
Related Studies
atovaquone (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
ATOVAQUONE 750 MG/5 ML SUSP | Generic | $2.62 per ml |
ATOVAQUONE-PROGUANIL 250-100 MG TABLET | Generic | $4.14 each |
mepron (on 1/1/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
MEPRON 750 MG/5 ML SUSPENSION | Generic | $2.62 per ml |
Ontology: Atovaquone (C0165603)
Definition (NCI) | A synthetic hydroxynaphthoquinone with antiprotozoal activity. Atovoquone blocks the mitochondrial electron transport at complex III of the respiratory chain of protozoa, thereby inhibiting pyrimidine synthesis, preventing DNA synthesis and leading to protozoal death. |
Definition (CSP) | broad-spectrum antiparasitic drug found to be active against Pneumocystis carinii pneumonia in AIDS patients. |
Definition (MSH) | A hydroxynaphthoquinone that has antimicrobial activity and is being used in antimalarial protocols. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D053626 |
SnomedCT | 391793007, 108718008, 386899002 |
LNC | LP94829-6, MTHU031993 |
English | atovaquone, 2-(4-(4'-chlorophenyl)cyclohexyl)-3-hydroxy-1,4-naphthoquinone, 2-(trans-4-(4-chlorophenyl)cyclohexyl)-3-hydroxy-1,4-naphthoquinone, Atovaquone, 3-(4-(4-chlorophenyl)cyclohexyl)-4-hydroxy-naphthalene-1,2-dione, atovaquone (medication), ATOVAQUONE, Atovaquone [Chemical/Ingredient], Atovaquone - chemical, Atovaquone - chemical (substance), Atovaquone (product), Atovaquone (substance) |
Portuguese | Atovaquona |
Spanish | Atovacuona, Atovaquona, atovacuona (producto), atovacuona (sustancia), atovacuona |
Russian | АТОВАКОН, ATOVAKON |
Italian | Atovaquone |
German | Atovaquon, 2-(4-(4'-chlorophenyl)cyclohexyl)-3-hydroxy-1,4-naphthoquinon, 2-(trans-4-(4-chlorophenyl)cyclohexyl)-3-hydroxy-1,4-naphthoquinon |
French | Atovaquone, 2-(4-(4'-Chlorophényl)cyclohexyl)-3-hydroxy-1,4-naphtoquinone |
Czech | 2-(trans-4-(4-chlorfenyl)cyklohexyl)-3-hydroxy-1,4-naftochinon, atovachon, 2-(4-(4'-chlorfenyl)cyklohexyl)-3-hydroxy-1,4-naftochinon |
Finnish | Atovakvoni |
Japanese | アトバコン |
Swedish | Atovakvon |
Polish | Atowakon |
Ontology: Mepron (C0378468)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D053626 |
English | Mepron, Wellvone, Glaxo Wellcome brand of atovaquone, GlaxoSmithKline brand of atovaquone, atovaquone GlaxoSmithKline brand, mepron |
German | Wellvone, Mepron |
French | Malarone, Wellvone, Mepron |
Czech | Mepron |
Ontology: Malarone (C0595490)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C109496 |
English | Malarone, malarone, GlaxoSmithKline brand of atovaquone-proguanil |