Infectious Disease
Atovaquone/
Atovaquone/proguanil (Malarone and generics) is a once-daily tablet that prevents and treats falciparum malaria, taken with food or milk from a day or two before travel until a week after return. Adult and pediatric tablets are generic from several makers, so the cash price turns mostly on the tablet count.
This page is general information about a medication and how cash prices for it are set. It is not medical advice and does not replace the label, your prescriber or your pharmacist. How we handle medical information
Generic adult and pediatric tablets rated equivalent to Malarone come from several companies, and the brand is still sold by GlaxoSmithKline.
About Atovaquone/Proguanil
The two ingredients attack the malaria parasite at different points in its metabolism. The label covers prevention of Plasmodium falciparum malaria and treatment of acute uncomplicated falciparum malaria. For prevention, an adult takes one tablet a day from 1 or 2 days before entering the malaria area until 7 days after leaving; for treatment, four adult tablets once a day for 3 days. Children are dosed by weight with the pediatric tablet, from 11 kg for prevention and from 5 kg for treatment.
Each dose is taken at the same time of day with food or a milky drink, because atovaquone is poorly absorbed without it; if vomiting occurs within 1 hour of a dose, the label says to take a repeat dose. Abdominal pain, nausea, vomiting, headache and diarrhea are the common effects in treatment, and diarrhea, vivid dreams, mouth ulcers and headache in prevention. There is no boxed warning; rare liver injury and severe skin reactions mean a rash, fever or yellowing skin should be reported.
It must not be used for prevention in severe kidney impairment, and it is not for severe or complicated malaria, which needs hospital treatment. It does not prevent relapses of vivax malaria on its own. Rifampin and rifabutin lower atovaquone levels so much that the combination is not recommended, and proguanil can strengthen warfarin. Because it can be started a day or two before departure, it suits last-minute travel.
Taking Atovaquone/Proguanil
- How to take it
- Once a day at the same time, with food or a milky drink. For prevention, from 1 or 2 days before you enter the malaria area until 7 days after you leave; for treatment, once a day for 3 days. Tablets may be crushed into condensed milk for a child who cannot swallow them. If you vomit within 1 hour of a dose, take another full dose.
- If you miss a dose
- Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and continue your regular schedule. Do not take a double dose.
- Storage
- At room temperature in the container it came in, tightly closed, away from excess heat and moisture, and out of reach of children.
- Interactions to know about
- Rifampin and rifabutin lower atovaquone levels and are not recommended with it; tetracycline and metoclopramide also reduce them. Proguanil can strengthen warfarin, so clotting tests are watched. Tell the prescriber about kidney disease, pregnancy or breastfeeding, and protect your skin from strong sun.
This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.
Why the cash price for Atovaquone/Proguanil differs from pharmacy to pharmacy
Generic atovaquone/proguanil has several makers, but it is a travel medicine, so a pharmacy that seldom fills it may price it as a slow-moving item or need to order it in. The quote is driven by the tablet count, since the days before and after travel are added to every day away, and a prescription for Malarone by name without permission to substitute is quoted at the brand price.
Upload it and licensed pharmacies reply with their own cash price. You pay the pharmacy, not us.
Ways to pay less for Atovaquone/Proguanil without insurance
- Ask the prescriber to write it generically or allow substitution, and ask the pharmacy to quote the exact tablet count for your trip rather than a standard pack.
- Confirm stock a week or more before departure, since a pharmacy that does not keep it may need to order it.
- For a child, ask the prescriber which tablet strength the weight band on the label calls for, so the right product is quoted.
- Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.
How Script Unlock gets you a cash price for Atovaquone/Proguanil
Prices on this site come from pharmacies responding to a real prescription. We do not publish estimated, average or "typical" prices, because none of those would be your price.
- 1You upload your prescription
A photo of your Atovaquone/Proguanil prescription is enough. Nothing is sold on the site; you are asking pharmacies to quote.
- 2Licensed pharmacies respond
Pharmacies that Script Unlock has verified see the request and each can reply with its own cash price for your exact drug, strength and quantity.
- 3You choose and pay the pharmacy
You compare the responses, pick a pharmacy, and pay that pharmacy directly when you collect. Script Unlock never takes a patient payment and never sets the price.
Questions to ask your pharmacist about Atovaquone/Proguanil
- 1.When do I start, and how many days after I get home do I keep taking it?
- 2.What should I do if I vomit after a dose or miss a day?
- 3.Is it safe with my blood thinner or other medicines?
- 4.Can the tablet be crushed for my child?
- 5.Is my kidney function a problem?
Related medications
Sources
Script Unlock is a marketplace that lets licensed pharmacies quote a cash price on your prescription. It does not prescribe, dispense or sell medication, does not process patient payments, and does not give medical advice. Always follow the instructions of your prescriber and pharmacist and read the medication guide supplied with your medicine.