Proguanil with atovaquone for malaria prevention

About proguanil with atovaquone

Proguanil with atovaquone tablets are used to prevent malaria. Malaria is a serious infection. It is common in tropical countries such as parts of Africa, Asia and South America. Malaria is a disease which is passed on to humans by infected mosquitoes. A parasite called plasmodium lives inside the stomachs of infected female mosquitoes and is passed on to humans by a bite.

Because the pattern of malaria varies with the part of the world you are travelling to, as well as the season and the type of activity you have planned, you should always obtain the latest advice about malaria prevention from your doctor, pharmacist or travel organiser. A backpacking trip may well require different preventative measures against malaria to those needed for a business trip to a city.

Proguanil with atovaquone is usually obtained on a prescription from a doctor; however, it is not prescribable on the NHS. This means that you will be given a private (non-NHS) prescription and you will be asked to pay for the tablets. Proguanil with atovaquone tablets (Maloff Protect®) can also be bought from a pharmacy without the need for a doctor's prescription. You will still be asked for details of your health and travel plans to ensure the medicines are suitable.

Proguanil with atovaquone can also be used to treat some forms of malaria if you become infected. This leaflet does not contain information about this, but your doctor can give you more information if you have been prescribed it for this reason.

Before taking proguanil with atovaquone

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking the tablets it is important that your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breastfeeding.

• If you have kidney problems.

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have ever had an allergic reaction to a medicine.

How to take proguanil with atovaquone

• Before you take proguanil with atovaquone, read the manufacturer's printed information leaflet from inside the pack. The leaflet will give you more information about the tablets and a full list of side-effects which you may experience from taking them.

• You should start taking the tablets 1 or 2 days before you enter the area which has malaria. This is to ensure there is sufficient medicine in your bloodstream to give you the required protection. Take one dose each day throughout your stay, and then continue to take one dose a day for a further seven days after you leave the area. There are two strengths of tablets: 250 mg/100 mg tablets which are suitable for adults and children weighing more than 40 kg, and 62.5 mg /25 mg tablets which are suitable for children weighing between 11 kg and 40 kg:
  

  • The dose for an adult or a child weighing over 40 kg is one 250 mg/100 mg tablet daily.

  • The dose for a child weighing 31-40 kg is three 62.5 mg/25 mg tablets daily.

  • The dose for a child weighing 21-31 kg is two 62.5 mg/25 mg tablets daily.

  • The dose for a child weighing 11-21 kg is one 62.5 mg/25 mg tablet daily.

• Where possible, take the tablets with a snack or a milky drink and try to take your doses at about the same time of day, each day. The tablets are best swallowed whole, but for children who have problems swallowing tablets, they can be crushed and mixed into soft food or a milky drink if needed. You should ensure the child consumes the entire mixture to get the full dose.

• If you are sick (vomit) less than one hour after taking the tablet(s) you should take another dose. If it happens more than one hour afterwards, the medicines will have already entered your bloodstream so another dose is not needed.

• If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose. You should complete the course of tablets unless you are told otherwise by a doctor. Make sure you continue to take the tablets for seven days after your visit has finished.

Getting the most from your treatment

• These tablets will help prevent you from getting malaria, but it is also important that you take the following precautions against being bitten by mosquitoes:
  

  • Cover up bare areas of your arms and legs with long-sleeved, loose-fitting clothing, long trousers and socks. This is especially important if you are outside after sunset, as this is when mosquitoes feed.

  • Use an effective insect repellent spray on your clothing and any area of your skin which is bare.

  • Spray the room with an insecticide each evening a couple of hours before you go to bed. Check your sleeping areas for mosquitoes - pay particular attention to furniture and areas under your bed where insects can hide.

  • If you are sleeping in an unscreened room, use a mosquito net impregnated with an insecticide.

• If you need to take a medicine for indigestion (such as an antacid), do not take it during the two hours before you take proguanil with atovaquone, or during the two hours after you take it. This is because some magnesium-containing antacids interfere with the way one of the medicines (proguanil) is absorbed by your body, making it less effective.

• If you take a medicine called warfarin to prevent blood clots you may need to have your warfarin dose adjusted. You should ask for an INR appointment to be arranged prior to travel and start taking proguanil with atovaquone at least two days before the appointment.

• If you feel ill or develop a fever or flu-like symptoms while you are travelling or within one year of returning home, you should see your doctor straightaway. This is important, even if you have taken your anti-malarial tablets correctly.

Can proguanil with atovaquone cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

If you experience any other symptoms which you think may be due to this medicine, speak with a doctor or pharmacist.

How to store proguanil with atovaquone

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines