This medication contains 2 medicines, atovaquone and proguanil. It is used to prevent a certain type of parasite infection (malaria caused by Plasmodium falciparum), when traveling to an area that has malaria, including resistant malaria. Atovaquone/proguanil may also be used to treat less severe (uncomplicated) attacks of malaria. It belongs to a class of drugs known as antimalarials. It works by killing the malaria parasite.

Take this medication by mouth with food or a milky drink (e.g., milk, milkshake). For prevention of malaria, take atovaquone/proguanil usually once daily at the same time each day. Start this medication 1-2 days before you enter the malaria area, and continue for 7 days after leaving.

For treatment of an attack of malaria, take this medication usually once daily for 3 days. Usually, this dose will be larger than the dose used to prevent malaria.

If you have trouble swallowing tablets, this medication may be crushed and mixed with condensed milk. Take the entire mixture immediately. Do not save for future use.

If you vomit within 1 hour of taking a dose, repeat the dose. If you have persistent vomiting after taking atovaquone/proguanil, contact a doctor immediately for another medication.

Dosage is based on your weight, medical condition, and response to treatment.

It is very important to continue taking this medication exactly as prescribed by your doctor. This medication works best when the amount of drug in your body is kept at a constant level. Therefore, take this drug at evenly spaced intervals. To help you remember, take it at the same time each day for the entire prescribed time.

Do not take more or less of this drug than prescribed. Do not stop taking this drug before completing the full treatment unless directed to do so by your doctor, even if you feel better or do not feel sick. Skipping or changing your dose without approval from your doctor may cause prevention treatment to be ineffective, cause the amount of parasite to increase during treatment of a malaria attack, make the infection more difficult to treat (resistant), or worsen side effects.

No drug treatment is completely effective in preventing malaria. Seek immediate medical attention if you develop symptoms of malaria (e.g., fever, chills, headache, other flu-like symptoms), especially for 2 months after completing this prescription.

It is important to prevent mosquito bites (e.g., using appropriate insect repellents, wearing clothes that cover most of the body, remaining in air-conditioned or well-screened areas, using mosquito nets, using insect-killing sprays). Buy insect repellent before traveling. The most effective insect repellents contain diethyltoluamide (DEET). Ask your doctor or pharmacist to recommend an appropriate strength of mosquito repellant for you/your children.

The side effects are usually less severe for the dose used to prevent malaria than the higher dose used to treat attacks of malaria.

Side effects may include nausea, vomiting, abdominal pain, headache, diarrhea, weakness, loss of appetite, and dizziness. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if this unlikely but serious side effect occurs: sensitivity to sunlight (easily sunburned).

Tell your doctor immediately if any of these rare but very serious side effects occur: signs of serious liver problems (e.g., persistent/severe nausea and vomiting, abdominal pain, unexplained tiredness, dark urine, yellowing eyes/skin), signs of anemia (e.g., worsening tiredness, rapid breathing, pale skin/lips/nails, fast heartbeat while resting), signs of severe infection (e.g., high fever, severe chills, body aches, sore throat).

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking atovaquone/proguanil, tell your doctor or pharmacist if you are allergic to either atovaquone or proguanil; or if you have any other allergies.

Usually, this medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: severely decreased kidney function (creatinine clearance less than 30 milliliters per minute).

However, your doctor may choose to use this for treatment of a malaria attack and monitor you closely, even if you have severely decreased kidney function.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: current diarrhea, current vomiting, liver problems.

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

During pregnancy, this medication should be used only when clearly needed. While you are pregnant, travel to an area with malaria places you and your infant at a much higher risk for death and other problems. Discuss the risks and benefits of malaria prevention with your doctor.

The proguanil in this medication passes into breast milk. Consult your doctor before breast-feeding.

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

This drug should not be used with the following medication because very serious interactions may occur: penicillamine.

If you are currently using the medication listed above, tell your doctor or pharmacist before starting atovaquone/proguanil.

Before using atovaquone/proguanil, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: "blood thinners" (e.g., warfarin), tetracycline, metoclopramide, rifampin, rifabutin.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center.

Do not share this medication with others.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Store at room temperature at 77 degrees F (25 degrees C) away from light and moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Information last revised July 2009 Copyright(c) 2009 First DataBank, Inc.