Atovaquone and Proguanil

Atovaquone and proguanil is used to prevent or treat certain kinds of malaria infections (a serious infection that is spread by mosquitoes in certain parts of the world). Atovaquone and proguanil is in a class of medications called antimalarials. It works by killing the organisms that cause malaria.

Atovaquone and proguanil comes as a tablet to take by mouth. To treat malaria, take once a day with food or a milky drink for 3 days in a row. To prevent malaria, it is taken once a daily with food or a milky drink starting 1 or 2 days before you travel to an area where malaria is common, while you are traveling, and for 7 days after you return. Your doctor will tell you how many tablets to take for each dose.  Take atovaquone and proguanil at around the same time every day.

Take atovaquone and proguanil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you have trouble swallowing the tablets, they may be crushed and mixed with condensed milk just before taking them.

If you vomit within 60 minutes after you take atovaquone and proguanil, take another full dose.

You should begin to feel better during the first few days of treatment with atovaquone and proguanil. If your symptoms do not improve or get worse, call your doctor. This could be a sign that you still are infected with malaria.

Take atovaquone and proguanil until you finish the prescription, even if you feel better. If you stop taking atovaquone and proguanil too soon or skip doses, your infection may not be completely treated or you may not be protected from infection.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking atovaquone and proguanil,

• tell your doctor or pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking atovaquone and proguanil. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have kidney disease. Your doctor may tell you not to take atovaquone and proguanil.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking atovaquone and proguanil, call your doctor.
• plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Atovaquone and proguanil may make your skin sensitive to sunlight.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Atovaquone and proguanil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea, vomiting, diarrhea, stomach pain, loss of appetite
• headache
• dizziness
• cough
• mouth sores

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• rash; hives; swelling of the eyes, face, lips, tongue, or throat; difficulty breathing or swallowing; or hoarseness or throat tightness
• numbness, muscle or joint pain, fever, weight loss, or tiredness
• peeling or blistering skin
• yellow eyes or skin, dark urine, loss of appetite, fatigue, or pain or discomfort in right upper stomach area
• seizures
• hallucinations (seeing things or hearing voices that do not exist)

Atovaquone and proguanil may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• rash
• gray-bluish color of lips and/or skin
• headache
• tiredness
• shortness of breath
• vomiting
• stomach pain or discomfort
• hair loss
• dry, cracked skin on palms of hands or bottom of feet
• mouth sores

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

• Malarone^®