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|Type of medicine
|Kills the malaria parasite
|Atovaquone 250mg, Proguanil 100mg
|Common side effects
|Coughing, Diarrhoea, Dizziness, Headache, Loss of Appetite, Mouth Sores, Nausea, Stomach Pain or Vomiting, Weakness
|Amarox, Glenmark Pharmaceuticals Europe, Mylan
|Use with alcohol
|No known issues
What are Atovaquone/Proguanil tablets and what are they used for?
Atovaquone/Proguanil Tablets (Generic Malarone) are available to buy from The Independent Pharmacy Online Doctor service, following a free consultation, to help prevent malaria. To find out more about malaria and see all the available treatments, see our Malaria page.
Atovaquone and proguanil are now available as a generic alternative to Malarone. They are still manufactured to the same high standards as Malarone but are available at a lower cost because the patent on the Malarone brand has now expired. They are taken once daily for malaria prophylaxis, 1-2 days before travel and continuing 1 week after returning.
Atovaquone oral suspension (generic Malarone) contains the active ingredients: Proguanil Hydrochloride 100 mg and Atovaquone 250mg. Its main use is for the prevention of malaria. Atovaquone/Proguanil Tablets are classified as a prescription-only-medicine (POM). Each box contains 12 film-coated tablets.
How does Atovaquone/Proguanil work?
Atovaquone and Proguanil are both anti-parasitic drugs, which are active against the malaria-causing plasmodium (malaria) parasite. Once the plasmodium parasite enters the bloodstream it begins to reproduce, which can result in malaria. Proguanil works by inhibiting the parasite’s ability to reproduce. It does this by blocking the action of an enzyme (dihydrofolate reductase) found inside the plasmodium parasite.
Atovaquone works in a similar way to Proguanil. It inhibits the production of new genetic material from inside the malaria parasite, resulting in an inability to reproduce. Both these ingredients combined work effectively together in a dual attack against malaria, helping to prevent an infection from taking hold.
Atovaquone/Proguanil are highly effective against the strains of malaria caused by the plasmodium falciparum parasite. This parasite is responsible for producing the most serious form of malaria (malignant malaria). For areas where the plasmodium falciparum parasite is predominant, Atovaquone/Proguanil will usually be the recommended choice of prevention.
Atovaquone vs. Chloroquine
Chloroquine has been used for some time to prevent malaria, but Atovaquone/Proguanil may be more suitable in areas where there is known resistance to this form of antimalarial medicine. Chloroquine-resistant malaria is now found in almost all malarious areas of the world, except for Haiti, certain rural parts of Mexico and Central America, and some areas of the Middle East. Another key difference is that Chloroquine is taken weekly, whereas Atovaquone is taken daily.
Does Atovaquone/Proguanil cause weight gain?
According to some reports, weight gain is one side effect that can occur among people who take Atovaquone/Proguanil tablets, particularly in females over 50 years old who have been taking this medication for less than one month.
Alternatives to Atovaquone/Proguanil
Atavaquone/Proguanil tablets are a generic brand of the more commonly known brand of antimalarial Malarone. These tablets are also available from The Independent Pharmacy under the brand name Maloff Protect.
Other popular types of antimalarial tablets include Lariam and Doxycycline. These contain different antiparasitic active ingredients to help prevent malaria whilst travelling abroad. All antimalarials can cause side effects in some people, so it is important that you look at all the available information surrounding these tablets before deciding on which one is right for you.
- You should take 1 tablet every day at roughly the same time each day.
- Atovaquone/Proguanil tablets need to be taken 1 – 2 days before entering an area where malaria is present and continued until 7 days after leaving the malaria area.
- You should take Atovaquone/Proguanil tablets with or after food or milk
- Atovaquone/Proguanil remains effective with moderate alcohol intake.
It is important to complete the course as it can take 7 days to ensure any parasites that remain in your blood are effectively killed.
Each tablet contains the active ingredients: Proguanil Hydrochloride 100mg and Atovaquone 250mg
The other ingredients are: poloxamer 188, microcrystalline cellulose, hydroxypropyl cellulose, povidone K30, sodium starch glycollate (Type A), magnesium stearate, hypromellose, titanium dioxide (E171), iron oxide red (E172), macrogol 400 and polyethylene glycol 8000.
Atovaquone/Proguanil side effects
If you do experience side effects from Atovaquone/Proguanil they may include:
- Loss of appetite
- Mouth sores
- Nausea, stomach pain or vomiting
Please read the Patient Information Leaflet enclosed with your medicines for a full list of side effects.
If you are worried about any side effects or adverse reactions you should speak to a doctor as soon as possible for advice.
Atovaquone/Proguanil should not cause a harmful interaction with any of your other current medicines. Please read the Patient Information Leaflet enclosed with your medicines for further information.
Unfortunately, Atovaquone/Proguanil is not 100% effective at preventing malaria, however, it is still very effective if taken properly and combined with bite avoidance methods. See the Pharmacist Tips for bite avoidance techniques.
Remember it is also important to get the correct vaccinations for your trip before you travel. These should be administered around 6 weeks before you leave.
Atovaquone/Proguanil isn’t suitable for everyone. Do not take or take if:
- You are allergic to any of the ingredients
- You have severe Kidney disease
- You are pregnant or breastfeeding
Atovaquone/Proguanil can also interact with other medicines, it may not be suitable if taking any of the following:
- Metoclopramide (anti-emetic)
- Tetracycline, Rifampicin and Rifabutin (antibiotics)
- Efavirenz (protease inhibitor)
- Warfarin (anticoagulant)
- Etoposide (cancer treatment)
Should you be taking any of the above medications it will be necessary to seek medical advice before deciding upon the most suitable treatment. Please read the Patient Information Leaflet enclosed with your medicines for further information.
Atovaquone/Proguanil 250mg/100mg Tablets (Generic Malarone) reviews
Atovaquone/Proguanil 250mg/100mg Tablets (Generic Malarone) FAQs
Atovaquone/Proguanil tablets are an anti-malarial medication. The tablets contain two active ingredients, atovaquone and proguanil. They are used to prevent malaria spread by the bite of mosquitoes encountered in tropical countries whilst traveling.
Malaria is caused by four different organisms all belonging to the family called plasmodiums. The fiercest strain is Plasmodium falciparum which can cause malignant malaria. Atovaquone/Proguanil tablets are most effective against the falciparum strain and less effective against the others.
Malaria can lie dormant and resurface weeks, months or sometimes years after you return from your trip. Always see a Doctor if you have flu-like symptoms up to a year after returning from a malaria zone.
Atovaquone and proguanil both interfere with the cell replication of the malaria parasite meaning it cannot replicate in the bloodstream, therefore preventing infection. When used in combination, progaunil makes atovaquone more effective.
Malaria is a disease can be caused by four different strains of malaria parasite. There are different treatments depending on the strain that is most common in the area you are traveling in. The appropriate malaria treatment also varies depending on the levels of drug resistance that the malaria parasites in each location have developed.
To ensure you have chosen the right medication for you trip we recommend you visit the government Fit For Travel website. It is a comprehensive and continually updated site which has the travel information needed to make you trip a safe one.
For adults 16 years and over who are over 40kg, take one tablet daily. Preferably at the same time each day with food or a milky drink (this helps to prevent most of the common side effects and increases the drug absorption, making the medicine more effective).
The course needs to be started 1-2 days before travel, taken for the entire length of time you are in the malaria zone and for 7 days after.
It is important to finish the course and take the 7 tablets after you have exited the malaria zone, even if you have returned home (parasites from an infected bite will need 7 days of treatment to ensure they are killed).
If you miss a dose, take the tablet when you next remember. If too much time has elapsed, carry on as before. Continue taking one tablet a day until the course has finished. Do not take more than 1 tablet a day.
A replacement tablet needs to be taken if you are sick within an hour of taking a tablet. Continue taking the course as before until there are no tablets left.
You can crush the tablet and mix with honey, yoghurt or jam but it must be consumed straight away.
We understand that calculating how many tablets you may need for your trip can be difficult and confusing. When ordering, enter the amount of time that you are in the malaria zone and we will calculate how many tablets you need (including tablets for before and after your trip).
No prophylactic antimalarial tablet is 100% effective and it is important to continue to use mosquito nets, DEET-containing insect repellents, and other measures at the same time as the medication to prevent mosquito bites.
Atovaquone/Proguanil tablets are very effective at preventing malaria. To ensure that you minimise your risk of contracting malaria as much as possible, confirm that these are the correct treatment option for your destination, take your tablets regularly and always complete the full course.
As no preventive treatment is 100% effective, it is still important to avoid mosquito bites wherever possible.
Atovaquone/Proguanil is the newest of the anti-malarial medications that is currently available. It is normally recommended for use in trips to a malaria-risk zone for up to 28 days. There is no evidence of any adverse effects if it is used for longer.
The most common side effects include headaches, nausea, vomiting, diarrhoea and stomach/abdominal pain. These are experienced by approximately 10% of patents and most can be prevented if the tablets are taken with food or a milky drink.
Less common side effects that affect fewer than 1% of patients include: fever, cough, dizziness, loss of appetite, rash and difficulty in sleeping. If any side effects become severe you should see a doctor to discuss the risk of not taking your tablets or to chose an alternative anti-malarial.
There is no known interaction between Malarone and alcohol. Malarone may you feel dizzy, if this occurs, avoid alcohol consumption, as it will make the dizziness worse.
The use of Atovaquone/Proguanil tablets is not advised before speaking to a doctor if you:
- Are pregnant, breastfeeding, or planning to become pregnant in the next 3 months.
- Weigh less than 40 kg (a paediatric version is available for children from your doctor).
- Have liver or kidney disease.
- Have an allergy to either of the active ingredients atovaquone and proguanil.
Atovaquone/Proguanil should not be taken with the following medication:
- Rifampacin and rifabutin (antibiotics used for the treatment of TB).
- Metoclopramide (anti-sickness medication).
- Tetracycline (an antibiotic commonly used for acne and other skin conditions).
- Warfarin and other blood thinning agents.
A study to show whether Atovaquone/Proguanil tablets are harmful to pregnant or breastfeeding mothers has not been carried out. However, there is documented evidence to show that each of the individual active ingredients should not be administered to pregnant and breastfeeding women as they can be harmful to the child.
We recommend that you speak to you Doctor who will assess the benefits and risks of prescribing the medication to you.
Atovaquone/Proguanil is not indicated for all travel destinations, as it is only effective against certain strains of malaria parasite that occur in specific areas in the world. Check the government Fit For Travel website for an up-to-date list of the medication and vaccines recommended for your trip.
Some people prefer Malarone (or in this case, its generic version) because you only need to take it for a week after leaving a high-risk area whereas with Doxycycline you will need to continue to take it for 28 days.
Doxycycline is a cheaper option compared to branded Malarone but the unbranded Atovaquone/Proguanil costs less than its branded counterpart.
A further factor to consider is that Doxycycline can cause increased sun sensitivity, so a higher SPF should be used to combat this side effect. Doxycycline is actually an antibiotic treatment, which is also used for the treatment of infections like Chlamydia.