Malarone

How does it work?

Malarone tablets contain two active ingredients, proguanil hydrochloride and atovaquone. These are both medicines that are active against the parasite that causes malaria.

Malaria is a potentially fatal disease caused by various types of parasites known as Plasmodium. Plasmodium are carried by mosquitoes and injected into the bloodstream during a bite from an infected mosquito. Once inside the body the parasite reproduces, resulting in the disease.

Proguanil hydrochloride works by stopping the parasite from reproducing once it is in the bloodstream. It does this by blocking the action of a compound that is found in the Plasmodium parasite. This compound is an enzyme called dihydrofolate reductase, and is involved in the reproduction of the parasite.

Dihydrofolate reductase normally converts folic acid into folinic acid in the parasite, which is a step essential for the parasite to produce new genetic material (DNA). New DNA is necessary for the parasite to reproduce. By blocking it's production, proguanil prevents malarial parasites in the blood from reproducing and increasing in number.

Atovaquone also works by interfering with the production of substances needed by the malarial parasites to reproduce. It works in a slightly different way, however, so these two medicines work in combination against the Plasmodium parasite.

Proguanil with atovaquone is used to prevent malaria caused by a type of Plasmodium called Plasmodium falciparum. This parasite produces the most serious form of malaria (malignant malaria). Proguanil with atovaquone may be particularly useful for preventing malaria in travellers to areas where this parasite is known to be resistant to other antimalarial medicines, such as chloroquine. To prevent malaria, this medicine is taken every day, starting 24 to 48 hours before entering the malarious region. It should be taken throughout the stay, and continued for a week after leaving the malarious area.

Higher doses of proguanil and atovaquone are also used to treat uncomplicated malaria caused by infection with the Plasmodium falciparum parasite. However, this combination of medicines has not been evaluated for the treatment of more complicated or severe malaria affecting the brain, lungs or kidneys.

What is it used for?

Preventing Plasmodium falciparum malaria in people weighing over 40kg

Treating uncomplicated Plasmodium falciparum malaria in adults, and in children weighing between 11kg and 40kg

Warning!

To prevent malaria, this medicine is taken once a day. You should start taking it 24 to 48 hours prior to entering the malarial area. It should then be taken during the stay (which should not exceed 28 days) and continued for 7 days after leaving the area.

Take this medicine at the same time each day with food or a milky drink.

If you vomit within one hour of taking a dose, take another dose then go on as before. If this happens you will need to contact your doctor to replace the tablet(s) you brought up.

To prevent malaria it is important that this medicine is taken regularly. Try not to forget a dose. You should still take precautions to avoid being bitten by mosquitos, such as using mosquito repellants and sleeping under mosquito nets. This is particularly important if you have vomiting or diarrhoea, because this could make the tablets less effective. If you fall ill within one year of your return, and especially if within three months of your return, you should consult your doctor immediately and let him know that you have visited a country where malaria is endemic.

Malarone tablets are not recommended for preventing malaria in people who weigh less than 40kg, or for treating malaria in children who weigh less than 11kg. Malarone paediatric tablets can be used for this age group (see factsheet linked at end).

If you get Plasmodium falciparum malaria despite using this medicine for prevention, or if your malaria comes back after being treated with this medicine, the infection should be treated with a different antimalarial.

Use with caution in

Decreased kidney function

Not to be used in

Severely decreased kidney function (if for malaria prevention)

Breastfeeding

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine in pregnancy has not been established. It should therefore be used with caution during pregnancy, and only if the benefits to the mother outweigh any risks to the foetus. Seek medical advice from your doctor.

It is not known if atovaquone passes into breast milk. Proguanil passes into breast milk in small amounts. The manufacturer states that Malarone should not be used by breastfeeding mothers. Seek medical advice from your doctor.

Label warnings

Take this medication with or after food.

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