Atovaquone

Atovaquone is a prescription medication used to treat the symptoms of Malaria (P. falciparum) and Pneumocystis Carinii Pneumonia. 

• Atovaquone is available under the following different brand names: Mepron

Adult and pediatric dosage

Oral suspension

• 750 mg/5 mL

Pneumocystis Carinii Pneumonia

Adult dosage

• Treatment: 750 mg orally two times a day for 21 days
• Prophylaxis: 1500 mg/day orally, once a day or divided two times a day, with food

Prevention of Pneumocystis jirovecii Pneumonia

Pediatric dosage

• Children below 13 years: Not established
• Children above 13 years: 1,500 mg (10 mL) once daily administered with food

Mild-to-Moderate Pneumocystis jirovecii Pneumonia

Pediatric dosage

• Children below 13 years: Not established
• Children above13 years: 750 mg (5 mL) twice daily (1,500 mg total daily dose) administered with food for 21 days

Malaria (P. falciparum)

Adult dosage

• 1000 mg (with proguanil 400 mg) orally once a day for 3 days

Pediatric dosage

• 11-20 kg: 250 mg (with proguanil 100 mg)
• 21-30 kg: 500 mg (with proguanil 200 mg)
• 31-40 kg: 750 mg (with proguanil 300 mg)
• All orally once a day for 3 days

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Atovaquone include:

• nausea,
• vomiting,
• diarrhea,
• headache,
• fever, and
• rash

Serious side effects of Atovaquone include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• severe skin reaction,
• fever,
• sore throat,
• burning in the eyes,
• skin pain,
• red or purple skin rash that spreads and causes blistering and peeling,
• loss of appetite,
• stomach pain (upper right side),
• tiredness,
• dark urine, and
• yellowing of the skin or eyes (jaundice)

Rare side effects of Atovaquone include:

• none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in your chest; shortness of breath; and sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, 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, health care provider, or pharmacist first.

• Atovaquone has severe interactions with no other drugs.
• Atovaquone has serious interactions with the following drugs:
  • dapsone topical
  • efavirenz
• Atovaquone has moderate interactions with the following drugs:
  • bupivacaine implant
  • indinavir
  • metoclopramide intranasal
  • rifabutin
  • rifampin
  • warfarin
• Atovaquone has minor interactions with the following drugs:
  • metoclopramide
  • tetracycline

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• History of hypersensitivity reactions (e.g., angioedema, bronchospasm, throat tightness, urticaria) to drugs or components 

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Atovaquone?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Atovaquone?”

Cautions

• Oral absorption is limited but can be significantly increased when the drug is taken with food; failure to administer with food may result in lower plasma concentrations and may limit response to therapy; consider therapy with other agents in patients who have difficulty taking oral suspension with food or in patients who have gastrointestinal disorders that may limit the absorption of oral medications
• Cases of cholestatic hepatitis, elevated liver enzymes and fatal liver failure were reported; if treating patients with severe hepatic impairment, closely monitor patients
• Hypersensitivity reactions were reported, including bronchospasm, angioedema, urticaria, and throat tightness

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy.
• Lactation
  • Excretion in milk unknown; use with caution