Infectious Disease Book

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AtovaquoneAka: Mepron, Malarone

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  1. Indications
    1. Human Immunodeficiency Virus (HIV)
      1. Pneumocystis carinii Pneumonia prophylaxis
      2. Pneumocystis carinii Pneumonia treatment
      3. Patients unable to tolerate Bactrim
    2. Malaria Prophylaxis and Treatment (Malarone)
      1. Third line agent (Mefloquine preferred)
    3. Babesiosis
  2. Dosing: Pneumocystis carinii Pneumonia
    1. Prophylaxis: 1500 mg PO qd with food
    2. Treatment: 750 mg PO bid with food for 21 days
  3. Dosing: Malaria (Atovaquone/Proguanil or Malarone)
    1. Adults
      1. Prophylaxis: 1 tablet (250 mg/100 mg) PO qd
      2. Treatment: 4 tablets (1000 mg/400 mg) PO qd for 3 day
    2. Children
      1. Weight: 11-20 kg
        1. Prophylaxis: 1 tablet (62.5 mg /25 mg) PO qd
        2. Treatment: 1 tablet (250 mg/100 mg) PO qd
      2. Weight: 21-30 kg
        1. Prophylaxis: 1 tablet (125 mg /50 mg) PO qd
        2. Treatment: 2 tablet (250 mg/100 mg) PO qd
      3. Weight: 31-40 kg
        1. Prophylaxis: 1 tablet (187.5 mg /75 mg) PO qd
        2. Treatment: 3 tablet (250 mg/100 mg) PO qd
      4. Weight: >40 kg (Adult dose)
        1. Prophylaxis: 1 tablet (250 mg /100 mg) PO qd
        2. Treatment: 4 tablet (250 mg/100 mg) PO qd
  4. Precautions: Poor absorption
    1. Take with food (fatty meal) to ensure absorption
    2. Up to 10% of patients still may not absorb Mepron
  5. Efficacy: HIV
    1. Not as clinically active as Bactrim
    2. Pneumocystis Pneumonia treatment Failure rate: 17%
      1. Contrast with 6% for Bactrim
  6. Adverse effects
    1. Less dose-limiting adverse reactions than Bactrim
      1. Atovaquone: 7%
      2. Bactrim: 20%
    2. Rash
    3. Abdominal Pain
    4. Nausea or Vomiting
    5. Diarrhea
    6. Headache
    7. Mild Liver Function Test abnormalities
  7. Drug Interactions: Reduced plasma levels of Atovaquone
    1. Tetracycline
    2. Metoclopramide (Reglan)
    3. Rifampin
  8. References
    1. (2000) Med Lett Drugs Ther 42(1093):109

Atovaquone (C0165603)

Definition (CSP)broad-spectrum antiparasitic drug found to be active against Pneumocystis carinii pneumonia in AIDS patients.
Definition (MSH)A hydroxynaphthoquinone that has antimicrobial activity and is being used in antimalarial protocols.
Definition (NCI)A synthetic hydroxynaphthoquinone with antiprotozoal activity. Atovoquone blocks the mitochondrial electron transport at complex III of the respiratory chain of protozoa, thereby inhibiting pyrimidine synthesis, preventing DNA synthesis and leading to protozoal death.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD053626
EnglishAtovaquone, Atovaquone - chemical, ATOVAQUONE PREPARATION
Spanishatovacuona
Parent ConceptsAntifungal Agents (C0003308), Antiparasitic Agents (C0003404), Antiprotozoal Agents (C0003416), Naphthoquinones (C0027388), [AP109] ANTIPROTOZOALS, OTHER (C0973489), Drug allergen (C1320237), Duplicate concept (C1274013), Antiprotozoals (Non-antimalarials) (C1579412)
SourcesCSP, MSH, MTHSPL, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Mepron (C0378468)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD053626
Englishatovaquone GlaxoSmithKline brand, Glaxo Wellcome brand of atovaquone, GlaxoSmithKline brand of atovaquone, Mepron, Wellvone
SourcesCSP, MSH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


malarone (C0595490)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC109496
Englishmalarone
SourcesMSH, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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