Malarone (
atovaquone and proguanil) is a combination
antimalarial medication used for both
prevention and treatment of malaria cause by bites from Plasmodium falciparum mosquitoes. The fixed-dose tablets contain
atovaquone, which disrupts the parasite’s mitochondrial electron transport, and
proguanil, which inhibits folate synthesis in the parasite. Together, these agents act synergistically to kill malaria parasites and reduce the risk of resistance.
Malarone is used before, during, and after travel to regions where malaria is common, and also to treat acute infections. The medication is not approved for severe or complicated malaria, and is not recommended for patients with severe kidney impairment or those who are pregnant.
Dosage
It is important to follow the dosage instructions printed on the label of the box. Check with a doctor or pharmacist if there are any doubts regarding the proper dosage and treatment regimen.
- Prevention: Adults and children ≥ 40 kg take 1 tablet once daily, beginning 1–2 days before travel, continuing during travel, and for 7 days after return.
- Treatment: 4 tablets once daily for 3 days in adults. Pediatric dosing is based on weight: for children ≥ 11 kg up to 40 kg, 1–3 pediatric tablets once daily for 3 days; children < 11 kg require medical guidance.
It should be taken with food or a milky drink to improve absorption of atovaquone and reduce stomach upset. If vomiting occurs within one hour, repeat the dose and continue the course. Malarone delivers precise dosing based on body weight and purpose, and it should be taken as a single dose each day for the appropriate duration. If a dose is missed do not double-dose to make up for a missed dose.
Storage
Store Malarone tablets at
room temperature, ideally between 20 -25 °C (68-77 °F). Short-term exposure to slightly cooler or warmer temperatures is acceptable.
Keep tablets in their
original container and tightly closed. Avoid heat, moisture, and direct sunlight, and do not store in bathrooms or places that may freeze. Keep the medication
out of reach of children. Dispose of unused or expired tablets following local regulations rather than discarding in household trash.
If in any doubt, consult our blog on safe medicine management.
This text is for informational purposes only. Please consult a doctor or pharmacist before using any medication.
The information leaflet that comes with the medication includes full information about the possible side effects. Be sure to read and understand these, and if there are any questions, discuss these with a healthcare provider or pharmacist before starting treatment.
Cautions
If a sudden allergic reaction (anaphylaxis) occurs shortly after taking Malarone, with symptoms like swelling of the face, tongue, or throat making it difficult to breathe or swallow, or there is wheezing, hives, rash, blistering, or peeling of the skin, call a doctor or 911 right away, or go to an emergency room immediately.
Pregnant women should not be using Malarone unless this has been discussed with a healthcare provider, as it might harm the unborn baby or pose a risk of miscarriage. Malarone may pass into breast milk, and mothers should consult with a doctor if already feeding or planning to feed an infant.
Most people who use Malarone do not experience serious side effects. Doctors prescribe this medication because they assess the benefits of such treatment outweigh any likely unwanted effects.
Very common side effects (more than 1 in 10 people):
- Headache
- Nausea and vomiting
- Stomach pain
- Diarrhoea
Common side effects (up to 1 in 10 people):
- Dizziness
- Sleeping problems (insomnia)
- Strange dreams
- Depression
- Loss of appetite
- Fever
- Rash, which may be itchy
- Cough
Not all side effects are listed here. If these or other unlisted symptoms persist or worsen, consult a healthcare provider.
Malarone is used for both prevention and treatment of uncomplicated Plasmodium falciparum malaria, including in areas where resistance to other antimalarials is common.
- For prevention – taken before exposure to malaria and for one week after exit from risk area.
- For treatment – used in a three-day regimen to clear acute infections.
Its dual mechanism helps kill parasites and reduce resistance. Malarone is not suitable for severe or complicated malaria, and alternative intravenous or injectable therapies should be used in such cases.
The medication is not approved for individuals with severe renal impairment (creatinine clearance < 30 mL/min) and should be used with caution in moderate impairment. It is also not recommended during pregnancy or breastfeeding, due to limited safety data. For children under 11 kg, guidelines require specialist dosing advice.
Because of its specific pharmacokinetic profile, Malarone requires precise adherence to timing and duration for both prevention and treatment to ensure effectiveness.