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ANTIPARASITIC PRODUCTS, INSECTICIDES AND REPELLENTS › ANTIPROTOZOALS › AGENTS AGAINST AMOEBIASIS AND OTHER PROTOZOAL DISEASES › Other agents against amoebiasis and other protozoal diseases
atovaquone
P01AX06
Forms & Strengths
- Oral Suspension: 750 mg / 5 mL
- Oral Tablets: 250 mg
Adult Dosing
- Pneumocystis jirovecii pneumonia (treatment): 750 mg orally twice daily with food for 21 days
- Pneumocystis jirovecii pneumonia (prophylaxis): 1500 mg orally once daily with food
- Toxoplasma gondii encephalitis (alternative): 750 mg orally every 6 hours with food
- Malaria prevention (with proguanil): 1 adult tablet (250 mg atovaquone / 100 mg proguanil) daily starting 1-2 days before, during, and 7 days after travel
Pediatric Dosing
- Pneumocystis jirovecii pneumonia treatment (13-24 months): 30 mg/kg orally twice daily with food for 21 days
- Pneumocystis jirovecii pneumonia treatment (>2 years): 45 mg/kg orally once daily (max 1500 mg/day) with food for 21 days
- Malaria prevention (pediatric tablets with proguanil): Dosed by weight categories ranging from 11 kg to >40 kg, taken daily with food
Indications
- Treatment and prophylaxis of Pneumocystis jirovecii pneumonia (PJP) in patients intolerant to trimethoprim-sulfamethoxazole
- Treatment and prevention of acute, uncomplicated Plasmodium falciparum malaria
Mechanism of Action
- Selectively inhibits mitochondrial electron transport in protozoa and fungi
- Collapses mitochondrial membrane potential by inhibiting cytochrome bc1 complex (Complex III)
- Indirectly inhibits pyrimidine biosynthesis required for nucleic acid replication
Contraindications
- Hypersensitivity to atovaquone or any component of the formulation
- Severe renal impairment (CrCl <30 mL/min) for malaria prophylaxis (when combined with proguanil)
Adverse Reactions
- Headache
- Insomnia
- Fever
- Rash
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Elevated liver transaminases
- Hyponatremia
Drug Interactions
- Rifampin and rifabutin significantly decrease atovaquone plasma concentrations (avoid coadministration)
- Metoclopramide decreases atovaquone bioavailability
- Tetracycline decreases atovaquone plasma concentrations
- Indinavir trough concentrations may be decreased when coadministered with atovaquone
Curated Content: Needs Vetting Before Put to Clinical Use