Atovaquonedosage

The daily dose should be taken at the same time each day with food or a milky drink. In the event of vomiting within 1 hour after dosing, a repeat dose should be taken. Atovaquone and proguanil hydrochloride tablets may be crushed and mixed with condensed milk just prior to administration to patients who may have difficulty swallowing tablets. Atovaquone and proguanil hydrochloride tablets should be taken with food or a milky drink.

Prophylaxis: Start prophylaxis 1 or 2 days before entering a malaria-endemic area and continue daily during the stay and for 7 days after return.

Adults: One adult strength tablet per day.

Pediatric Patients: Dosage based on body weight (see Table 1).

Treatment: Adults: Four adult strength tablets as a single daily dose for 3 days.

Pediatric Patients: Dosage based on body weight (see Table 2).

Renal Impairment: Do not use for prophylaxis of malaria in patients with severe renal impairment. Use with caution for treatment of malaria in patients with severe renal impairment.

2.1 Prevention of

Malaria Start prophylactic treatment with atovaquone and proguanil hydrochloride tablets 1 or 2 days before entering a malaria-endemic area and continue daily during the stay and for 7 days after return. Adults One atovaquone and proguanil hydrochloride tablet (adult strength = 250 mg atovaquone/100 mg proguanil hydrochloride) per day. Pediatric Patients The dosage for prevention of malaria in pediatric patients is based upon body weight (Table 1). Table 1. Dosage for Prevention of Malaria in Pediatric Patients Weight (kg) Atovaquone/ Proguanil HCl Total Daily Dose Dosage Regimen 11-20 62.5 mg/25 mg 1 atovaquone and proguanil hydrochloride pediatric tablet daily 21-30 125 mg/50 mg 2 atovaquone and proguanil hydrochloride pediatric tablets as a single daily dose 31-40 187.5 mg/75 mg 3 atovaquone and proguanil hydrochloride pediatric tablets as a single daily dose > 40 250 mg/100 mg 1 atovaquone and proguanil hydrochloride tablet (adult strength) as a single daily dose

2.2 Treatment of

Acute Malaria Adults Four atovaquone and proguanil hydrochloride tablets (adult strength; total daily dose 1 g atovaquone/400 mg proguanil hydrochloride) as a single daily dose for 3 consecutive days. Pediatric Patients The dosage for treatment of acute malaria in pediatric patients is based upon body weight (Table 2). Table 2. Dosage for Treatment of Acute Malaria in Pediatric Patients Weight (kg) Atovaquone/ Proguanil HCl Total Daily Dose Dosage Regimen 5-8 125 mg/50 mg 2 atovaquone and proguanil hydrochloride pediatric tablets daily for 3 consecutive days 9-10 187.5 mg/75 mg 3 atovaquone and proguanil hydrochloride pediatric tablets daily for 3 consecutive days 11-20 250 mg/100 mg 1 atovaquone and proguanil hydrochloride tablet (adult strength) daily for 3 consecutive days 21-30 500 mg/200 mg 2 atovaquone and proguanil hydrochloride tablets (adult strength) as a single daily dose for 3 consecutive days 31-40 750 mg/300 mg 3 atovaquone and proguanil hydrochloride tablets (adult strength) as a single daily dose for 3 consecutive days > 40 1 g/400 mg 4 atovaquone and proguanil hydrochloride tablets (adult strength) as a single daily dose for 3 consecutive days

2.3 Renal Impairment

Do not use atovaquone and proguanil hydrochloride tablets for malaria prophylaxis in patients with severe renal impairment (creatinine clearance < 30 mL/min). Use with caution for the treatment of malaria in patients with severe renal impairment, only if the benefits of the 3-day treatment regimen outweigh the potential risks associated with increased drug exposure. No dosage adjustments are needed in patients with mild (creatinine clearance 50 to 80 mL/min) or moderate (creatinine clearance 30 to 50 mL/min) renal impairment.