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Atovaquone
Aka: Atovaquone, Mepron, Malarone
- 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
- Contraindications
- Creatinine Clearance <30 ml/minute/1.73m2
- Pregnancy Category C
- Breast Feeding of infants under 11 klb (5 kg)
- Dosing: Pneumocystis carinii Pneumonia
- Prophylaxis: 1500 mg PO qd with food
- Treatment: 750 mg PO bid with food for 21 days
- 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
- 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
- Precautions: Poor absorption
- Take with food (fatty meal) to ensure absorption
- Up to 10% of patients still may not absorb Mepron
- Efficacy: HIV
- Not as clinically active as Bactrim
- Pneumocystis Pneumonia treatment Failure rate: 17%
- Contrast with 6% for Bactrim
- 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
-
Drug Interactions: Reduced plasma levels of Atovaquone
- Tetracycline
- Metoclopramide (Reglan)
- Rifampin
- References
- (2000) Med Lett Drugs Ther 42(1093):109-12 [PubMed]