Atovaquone/Proguanil tablets are an anti-malarial medication. The tablets contain two active ingredients, atovaquone and proguanil. They are used to prevent malaria spread by the bite of mosquitoes encountered in tropical countries whilst traveling.

Malaria is caused by four different organisms all belonging to the family called plasmodiums. The fiercest strain is Plasmodium falciparum which can cause malignant malaria. Atovaquone/Proguanil tablets are most effective against the falciparum strain and less effective against the others.

Malaria can lie dormant and resurface weeks, months or sometimes years after you return from your trip. Always see a Doctor if you have flu-like symptoms up to a year after returning from a malaria zone.

Atovaquone and proguanil both interfere with the cell replication of the malaria parasite meaning it cannot replicate in the bloodstream, therefore preventing infection. When used in combination, progaunil makes atovaquone more effective.

Malaria is a disease can be caused by four different strains of malaria parasite. There are different treatments depending on the strain that is most common in the area you are traveling in. The appropriate malaria treatment also varies depending on the levels of drug resistance that the malaria parasites in each location have developed.

To ensure you have chosen the right medication for you trip we recommend you visit the government Fit For Travel website. It is a comprehensive and continually updated site which has the travel information needed to make you trip a safe one.

For adults 16 years and over who are over 40kg, take one tablet daily. Preferably at the same time each day with food or a milky drink (this helps to prevent most of the common side effects and increases the drug absorption, making the medicine more effective).

The course needs to be started 1-2 days before travel, taken for the entire length of time you are in the malaria zone and for 7 days after.

It is important to finish the course and take the 7 tablets after you have exited the malaria zone, even if you have returned home (parasites from an infected bite will need 7 days of treatment to ensure they are killed).

If you miss a dose, take the tablet when you next remember. If too much time has elapsed, carry on as before. Continue taking one tablet a day until the course has finished. Do not take more than 1 tablet a day.

A replacement tablet needs to be taken if you are sick within an hour of taking a tablet. Continue taking the course as before until there are no tablets left.

You can crush the tablet and mix with honey, yoghurt or jam but it must be consumed straight away.

We understand that calculating how many tablets you may need for your trip can be difficult and confusing. When ordering, enter the amount of time that you are in the malaria zone and we will calculate how many tablets you need (including tablets for before and after your trip).

No prophylactic antimalarial tablet is 100% effective and it is important to continue to use mosquito nets, DEET-containing insect repellents, and other measures at the same time as the medication to prevent mosquito bites.

Atovaquone/Proguanil tablets are very effective at preventing malaria. To ensure that you minimise your risk of contracting malaria as much as possible, confirm that these are the correct treatment option for your destination, take your tablets regularly and always complete the full course.

As no preventive treatment is 100% effective, it is still important to avoid mosquito bites wherever possible.

Atovaquone/Proguanil is the newest of the anti-malarial medications that is currently available. It is normally recommended for use in trips to a malaria-risk zone for up to 28 days. There is no evidence of any adverse effects if it is used for longer.

The most common side effects include headaches, nausea, vomiting, diarrhoea and stomach/abdominal pain. These are experienced by approximately 10% of patents and most can be prevented if the tablets are taken with food or a milky drink.

Less common side effects that affect fewer than 1% of patients include: fever, cough, dizziness, loss of appetite, rash and difficulty in sleeping. If any side effects become severe you should see a doctor to discuss the risk of not taking your tablets or to chose an alternative anti-malarial.

There is no known interaction between Malarone and alcohol. Malarone may you feel dizzy, if this occurs, avoid alcohol consumption, as it will make the dizziness worse.

The use of Atovaquone/Proguanil tablets is not advised before speaking to a doctor if you:

• Are pregnant, breastfeeding, or planning to become pregnant in the next 3 months.
• Weigh less than 40 kg (a paediatric version is available for children from your doctor).
• Have liver or kidney disease.
• Have an allergy to either of the active ingredients atovaquone and proguanil.

Atovaquone/Proguanil should not be taken with the following medication:

• Rifampacin and rifabutin (antibiotics used for the treatment of TB).
• Metoclopramide (anti-sickness medication).
• Tetracycline (an antibiotic commonly used for acne and other skin conditions).
• Warfarin and other blood thinning agents.

A study to show whether Atovaquone/Proguanil tablets are harmful to pregnant or breastfeeding mothers has not been carried out. However, there is documented evidence to show that each of the individual active ingredients should not be administered to pregnant and breastfeeding women as they can be harmful to the child.

We recommend that you speak to you Doctor who will assess the benefits and risks of prescribing the medication to you.

Atovaquone/Proguanil is not indicated for all travel destinations, as it is only effective against certain strains of malaria parasite that occur in specific areas in the world. Check the government Fit For Travel website for an up-to-date list of the medication and vaccines recommended for your trip.

Some people prefer Malarone (or in this case, its generic version) because you only need to take it for a week after leaving a high-risk area whereas with Doxycycline you will need to continue to take it for 28 days.

Doxycycline is a cheaper option compared to branded Malarone but the unbranded Atovaquone/Proguanil costs less than its branded counterpart.

A further factor to consider is that Doxycycline can cause increased sun sensitivity, so a higher SPF should be used to combat this side effect. Doxycycline is actually an antibiotic treatment, which is also used for the treatment of infections like Chlamydia.