Atovaquone proguanil drug interactions
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chetan Lokhande, M.B.B.S [2]
Drug Interactions
Rifampin/Rifabutin
Concomitant administration of rifampin or rifabutin is known to reduce atovaquone concentrations [see Clinical Pharmacology ]. The concomitant administration of Atovaquone proguaniland rifampin or rifabutin is not recommended.
Anticoagulants
Proguanil may potentiate the anticoagulant effect of warfarin and other coumarin-based anticoagulants. The mechanism of this potential drug interaction has not been established. Caution is advised when initiating or withdrawing malaria prophylaxis or treatment with Atovaquone proguanilin patients on continuous treatment with coumarin-based anticoagulants. When these products are administered concomitantly, coagulation tests should be closely monitored.
Tetracycline
Concomitant treatment with tetracycline has been associated with a reduction in plasma concentrations of atovaquone [see Clinical Pharmacology ]. Parasitemia should be closely monitored in patients receiving tetracycline.
Metoclopramide
While antiemetics may be indicated for patients receiving MALARONE, metoclopramide may reduce the bioavailability of atovaquone and should be used only if other antiemetics are not available [see Clinical Pharmacology ].
Concomitant administration of atovaquone and indinavir did not result in any change in the steady‑state AUC and Cmax of indinavir but resulted in a decrease in the Ctrough of indinavir [see Clinical Pharmacology ]. Caution should be exercised when prescribing atovaquone with indinavir due to the decrease in trough concentrations of indinavir.[1]
References
Adapted from the FDA Package Insert.