What is malarone?
Malarone® is a combination preparation of atovaquon and proguanil which is used for the prevention (Prophylaxe) and treatment of an uncomplicated malaria tropica (Plasmodium falciparum). It is the most commonly used medicine for malaria prevention for travellers worldwide.
The great advantage of Malarone® is the short intake time before and after the journey: beginning only 1–2 days before entering the Malaria area and ending 7 days after the departure. Generika (Atovaquon/Proguanil-ratiopharm® etc.) are significantly cheaper.
Active Ingredients & Mechanism of Action
Active ingredient: Atovaquon 250 mg + Proguanil 100 mg
Active mechanism: Both active ingredients attack the malaria parasite at various points:
- Atovaquon: inhibits mitochondrial electron transport of the parasite (complex III, cytochrome bc1)
- Proguanil: is converted to cycloguanil which inhibits the dihydrofolate reductase of the parasite
Double effect:
- Works against liver disease (prevents liver infection)
- Works against blood schizonts (kills parasites in blood)
- Due to the causal prophylaxis at the liver level: short follow-up time
**Why only 7 days after? * * Since Malarone® already acts in the liver, no parasites need to be "absorbed" from the liver. Other prophylaxis (e.g., doxycycline) only act in the blood and need 4 weeks post-emergence.
Who is it suitable for?
Malarone® is suitable for:
- Travellers in Malaria (Tropen and Subtropene)
- Short and long-term prophylaxis (travels up to 4 weeks ideal)
- Emergency self-treatment (stand-by therapy)
- Children from 11 kg body weight
Especially recommended at:
- Short trips (short lead time/after term)
- Areas with plasmodium-falciparum resistance to other means
- Incompatibility of mefloquin or doxycycline
Not suitable:
- Heavy kidney failure (GFR < 30 ml/min)
- Pregnancy (inappropriate data for prophylaxis)
- With known hypersensitivity
Available Dosages
Malariaprophylaxis adults:
- 1 tablet (250/100 mg) daily
- Start: 1–2 days before entering the Malaria area
- During the entire stay: daily
- After departure: another 7 days
Emergency treatment (Stand-by):
- 4 tablets as a single dose on 3 consecutive days (= 12 tablets total)
Children (Prophylaxe):
- 11–20 kg: 1 Malarone® Junior daily (62.5/25 mg)
- 21–30 kg: 2 Malarone® Junior daily
- 31–40 kg: 3 Malarone® Junior daily
- > 40 kg: 1 Malarone® adult per day
Maximum prophylaxis duration: Studies up to 28 days. Longer application after individual consultation possible.
How to Take
Intake:
- Once a day, always at the same time
- With a rich meal or milk drink (improves the absorption of Atovaquon!)
- When vomiting within 1 hour: Repeat dose
Prophylaxe plan: 1. Start 1–2 days before entry Two. Daily during the stay 3. Continue 7 days after departure
Important notes:
- Don't forget taking on travels! [Cocking arm]
- mosquito protection is also important (repellent, mosquito net, long clothes)
- At fever after tropics visit IMMER doctor (also at prophylaxis)
Contraindications
**Malarone® must not be accepted at:* *
- hypersensitivity to atovaquon or proguanil
- Heavy renal insufficiency (GFR < 30 ml/min) – only contraindicated for prophylaxis
Preview at:
- Low to moderate kidney failure
- Pregnancy (inappropriate data for prophylaxis)
- breastfeeding (proguanil passes into breast milk)
- diarrhea (reduced intake)
pregnant: Not recommended for prophylaxis due to insufficient data. For therapy it can be used in severe malaria (users outweigh risk).
Possible Side Effects
Family (1–10 %):
- stomach pain
- nausea
- Headaches
- diarrhea
- Sleep disorders, unusual dreams
** Occasionally (0.1-1 %):* *
- Break.
- Skin rash
- Squeeze
- Lost appetite
- Oral ulcers
Selten:
- Allergic reactions
- liver value increases
- Hair loss
General: Malarone® is one of the best tolerated malaria agents. The side effects are usually mild and temporary.
Interactions
Reduced Atovaquon mirror by:
- Metoclopramide (absorption reduced)
- Tetracycline (serum of Atovaquon sink)
- Rifampicin/Rifabutin (strong reduction of Atovaquon levels)
Proguanil + warfarin:
- Can increase the INR → narrow-meshed INR control
Important:
- Fatty meal improves the Atovaquon intake significantly
- With simultaneous diarrhea, the efficacy may be limited
Frequently Asked Questions
Similar Medications
Is malarone right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor. Read the package leaflet before use.