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ANTIPARASITIC PRODUCTS, INSECTICIDES AND REPELLENTS › ANTIPROTOZOALS › ANTIMALARIALS › Biguanides
proguanil
P01BB01
Forms & Strengths
- Tablet: 100 mg (often co-formulated with atovaquone 250 mg)
Adult Dosing
- Malaria prophylaxis: 200 mg orally once daily, starting 1-2 days before travel, during travel, and for 7 days after leaving the malarious area; take with food
Pediatric Dosing
- Malaria prophylaxis (pediatric fixed-dose combination with atovaquone): weight-based dosing once daily with food, starting 1-2 days before travel through 7 days post-travel
- 11-20 kg: 62.5 mg atovaquone / 25 mg proguanil daily
- 21-30 kg: 125 mg atovaquone / 50 mg proguanil daily
- 31-40 kg: 187.5 mg atovaquone / 75 mg proguanil daily
- Greater than 40 kg: 250 mg atovaquone / 100 mg proguanil daily
Indications
- Prevention of Plasmodium falciparum malaria
Mechanism of Action
- Dihydrofolate reductase inhibitor that inhibits the multistep synthesis of reduced folates and functional nucleic acids in malaria parasites, often synergizing with atovaquone
Contraindications
- Hypersensitivity to proguanil or any component of the formulation
- Severe renal impairment (CrCl < 30 mL/min) for malaria prophylaxis when combined with atovaquone
Adverse Reactions
- Headache
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Asthenia
- Dizziness
- Pruritus
Drug Interactions
- Warfarin: May increase anticoagulant effect, monitor INR closely
- Tetracycline: May decrease plasma concentrations of atovaquone when co-formulated
- Rifampin: May significantly decrease plasma concentrations of atovaquone/proguanil
Curated Content: Needs Vetting Before Put to Clinical Use