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Precautions and Warnings With Atovaquone/Proguanil

Let your healthcare provider know if you have any medical issues, such as problems with your kidneys or liver, before taking atovaquone/proguanil. Precautions and warnings with this drug also apply to women who are pregnant or nursing. Also, some people should avoid this prescription medication altogether, including those who have severe kidney disease or have certain allergies.

What Should I Tell My Healthcare Provider?

Atovaquone/proguanil (Malarone®) is a prescription medication used to prevent or treat malaria. You should talk with your healthcare provider prior to taking this medication if you have:
  • Kidney disease, such as kidney failure (renal failure)
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Recent vomiting or diarrhea
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Atovaquone/Proguanil Precautions and Warnings

Some warnings and precautions to be aware of prior to taking this drug include the following:
  • Atovaquone/proguanil may cause increases in liver enzymes, especially at the beginning of treatment. In rare cases, it has caused liver problems, including hepatitis and liver failure. If you experience any signs of liver problems, contact your healthcare provider right away. Signs of liver problems or liver failure include the following:
    • Dark urine
    • Loss of appetite
    • Pain in the upper part of the stomach
    • Yellowing of the whites of the eyes or skin (jaundice)
    • General feelings of discomfort.
  • Diarrhea and vomiting may reduce the amount of atovaquone/proguanil your body absorbs. If you vomit within one hour of taking it, you should take another dose. You may need a medication called an antiemetic to help prevent additional vomiting. If vomiting and diarrhea are persistent or severe, you may need to be given another medicine for malaria treatment.
  • If you are taking atovaquone/proguanil to prevent malaria and cannot complete the entire treatment course (before, during, and after travel), let your healthcare provider know. You will need another medicine to help prevent infection.
  • Although atovaquone/proguanil helps prevent malaria, you can still get the disease while taking it. If you develop fever or flu-like symptoms while in a malaria area or after returning, contact your healthcare provider immediately. Tell him or her you may have been exposed to malaria.
  • This medication may increase your skin's sensitivity to the sun, causing you to burn more easily. Make sure to wear protective clothing, such as a hat, long pants, and a long-sleeved shirt, or apply sunscreen when going outside.
  • In rare cases, atovaquone/proguanil has been reported to cause life-threatening skin rashes called Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). If you notice any skin rash while taking this medication, contact your healthcare provider right away. He or she will tell you if you need to stop taking atovaquone/proguanil.
  • Atovaquone/proguanil alone may not be enough to prevent malaria. If you are in a malaria area, it is important that you also use other prevention strategies, such as wearing insect repellent and protective clothing, and using bed nets. Be sure to talk to your healthcare provider before you travel about other ways to help prevent infection.
  • Atovaquone/proguanil may react with several other medications (see Drug Interactions With Atovaquone/Proguanil).
  • This product is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Malarone and Pregnancy).
  • Atovaquone/proguanil passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Malarone and Breastfeeding).

Atovaquone/Proguanil Drug Information

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