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fitfortravel

Travel health information for people travelling abroad from the UK

Atovaquone/Proguanil  

A - Be Aware When There is a Risk However Small

  • Find out if there is a malaria risk in the area you are visiting.
  • Aspects of travel may increase the risk e.g. rural travel, rainy season or unscreened accommodation.

B - Keep Mosquito Bites to a Minimum

  • Use clothing to protect the skin, particularly between dusk and dawn when mosquitoes feed.
  • Use DEET- based insect repellent on exposed areas of skin.
  • Sleep under a mosquito net that is impregnated with insecticide.
  • Use air conditioning (if available) and plug in vapourisers to protect your room.

C - Use Antimalarials Correctly

  • The antimalarial tablets recommended for you will depend not only on effectiveness but also on suitability, side effects, cost and which regime suits you best.
  • Tablets must be taken regularly according to the manufacturer's instructions.
  • Delayed illnesses - the incubation period of the less severe form of malaria may be long (up to a year or more).

D - Report any Feverish Illness Promptly to a Doctor

(Particularly within 3 months of return but even up to 1 year and say you have been to a malarious area.)

  • You may need to take a supply of personal emergency treatment abroad with you if you are going to be remote from medical facilities since treatment should always be started promptly. Discuss this option with a Travel Advisor or other healthcare professional.

Atovaquone/Proguanil

Patient Information Leaflet (PIL) for atovaquone/proguanil

Licensed for prophylaxis in UK.

  • Adult dose is one tablet daily - each tablet contains 250mg atovaquone plus 100mg proguanil. It is licensed for children over 11kg of weight at a lower dosage and a children's tablet is available.
  • Should be taken to 1 or 2 days before entering the malarious area, throughout exposure, and continued for 7 days after leaving the infected area. Licensed for stays in malarious areas for periods of up to 28 days but can be used safely for up to 1 year (and possibly longer).
  • Take your tablets with food at the same time each day. If you miss a dose or vomit within one hour of taking your tablets, take another dose and carry on as before (you may have to get more tablets). If you have diarrhoea, continue taking your tablets as normal. It is very important to complete the course.
  • Side effects may include: rashes, abdominal pain, headache, anorexia, nausea, diarrhoea, dizziness, change in sleep pattern, coughing and mouth ulcers can occur.
  • Absorption of this medicine may be reduced by diarrhoea and vomiting.
  • Atovaquone/proguanil may interact with other medicines if taken at the same time. These include: tetracyclines, metoclopramide, rifampicin, rifabutin or indinavir.
  • Proguanil can affect the anticoagulant, warfarin, which may result in bleeding. If it has to be used, re-stabilising the prothrombin time before departure is advised. It may be necessary to monitor blood levels whilst overseas and on return.
  • Those with kidney disease should be assessed carefully before taking this medication. Should be avoided in pregnancy and breast feeding unless there is no suitable alternative.
  • Pregnancy should be avoided for 2 weeks after stopping the medication.

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