Side Effects of atovaquone and proguanil: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Main Research Findings

Atovaquone and proguanil are effective medications for malaria prevention and treatment, as confirmed by multiple research studies. These drugs are particularly effective against malaria parasites resistant to conventional medications. 26 , 22 . Additionally, atovaquone and proguanil are generally well-tolerated and easier to take compared to other malaria prevention drugs. 21 , 11 .

Reasons for Side Effects

Side effects of atovaquone and proguanil are likely caused by the drug's mechanism of action and its impact on the body. Specifically, the drug inhibits energy metabolism in malaria parasites, potentially disrupting cell function and altering immune system responses, leading to side effects. 17 .

Common Side Effects

Gastrointestinal

Gastrointestinal symptoms are the most frequent side effects of atovaquone and proguanil. Diarrhea, nausea, and vomiting are commonly reported. 15 , 22 , 3 .

Nervous System

Nervous system symptoms include headache, dizziness, and drowsiness. 24 , 4 . In rare cases, mental health issues can occur. 4 .

Other

Other reported side effects include rash, itching, and fatigue. 21 .

Managing Side Effects

Gastrointestinal

If gastrointestinal symptoms occur, dietary modifications and medication can help alleviate them. Consult a doctor if experiencing severe diarrhea, nausea, or vomiting.

Nervous System

If nervous system symptoms occur, it's crucial to consult a doctor and consider medication as needed.

Other

If any other symptoms arise, consult a doctor.

Comparison Across Studies

Similarities

Most studies indicate that atovaquone and proguanil are effective for malaria prevention and treatment. Additionally, they generally demonstrate better tolerability and ease of use compared to other malaria prevention drugs.

Differences

Research findings regarding side effect frequency and types vary. This variation likely stems from differences in participant demographics (age, health status), malaria prevalence in the study location, and research methodology.

Applying Research Findings to Everyday Life

Atovaquone and proguanil are recommended for travelers visiting areas with high malaria risk. However, due to the potential for side effects, it's essential to consult a doctor before taking these medications. Special caution is advised for pregnant or breastfeeding women, individuals with liver or kidney disease, and those with neurological conditions. 2 , 10 , . Preventing mosquito bites is crucial for malaria prevention and goes beyond medication. Use insect repellent, wear long sleeves and pants, and ensure windows and doors are screened.

Limitations of Current Research

Further research on atovaquone and proguanil is needed, particularly regarding long-term side effects, impact on pregnant and breastfeeding women, and drug resistance. 2 , , 6 .

Future Research Directions

Future research should focus on the long-term safety and efficacy of atovaquone and proguanil, its impact on pregnant and breastfeeding women, and its susceptibility to drug resistance. 9 , 21 .

Conclusion

Atovaquone and proguanil are effective drugs for malaria prevention and treatment. However, the potential for side effects necessitates consulting a doctor before taking these medications. When planning travel to areas with high malaria risk, consult a doctor beforehand and implement appropriate preventative measures. 3 , 5 .

Literature analysis of 26 papers
Positive Content
19
Neutral Content
2
Negative Content
5
Article Type
1
1
2
12
25
1.

Symptoms of illness during travel and risk factors for non-adherence to malaria prophylaxis-a cross-sectional study in travellers from Germany.

Author: ReinsbergFriederike, MoehlmannMary W, KrumkampRalf, LandsmannLena, HeitkampChristian, JochumJohannes, AddoMarylyn, RamharterMichael, RadtChristiane, RotheCamilla, VinnemeierChristof, KreuelsBenno

Antimalarial chemoprophylaxis
Non-adherence
Travel-related illness

This cross-sectional study investigated the occurrence of symptoms of illness in travelers with and without antimalarial chemoprophylaxis. The study found that travelers with chemoprophylaxis had a lower prevalence of symptoms of illness.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

The safety of atovaquone-proguanil for the prevention and treatment of malaria in pregnancy: A systematic review.

Author: AndrejkoKristin L, MayerRomana C, KovacsStephanie, SlutskerEmma, BartlettEmily, TanKathrine R, GutmanJulie R

AP in pregnancy
limited data
more data needed

This systematic review evaluated the safety of atovaquone-proguanil (AP) for malaria prophylaxis during pregnancy. 16 studies were included, suggesting that outcomes after AP exposure during pregnancy are similar to expected rates in similar populations. While AP may be a promising option for pregnant women, further research is needed to confirm its safety in pregnancy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

Drug-free Holidays: Compliance, Tolerability, and Acceptability of a 3-Day Atovaquone/Proguanil Schedule for Pretravel Malaria Chemoprophylaxis in Australian Travelers.

Author: LauColleen L, RamseyLani, MillsLaura C, Furuya-KanamoriLuis, MillsDeborah J

Improved malaria prevention
Pre-travel chemoprophylaxis

This study assessed the compliance, tolerability, and acceptability of the 3-day atovaquone/proguanil schedule for malarial chemoprophylaxis.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Mefloquine for preventing malaria during travel to endemic areas.

Author: Tickell-PainterMaya, MaayanNicola, SaundersRachel, PaceCheryl, SinclairDavid

Malaria prevention
Abnormal dreams
Anxiety
Depressed mood
Insomnia

Mefloquine is a highly effective antimalarial agent, but it may be associated with psychological side effects, particularly abnormal dreams, anxiety, insomnia, and depressed mood. The absolute risk of malaria during short-term travel appears low with all three established antimalarial agents (mefloquine, doxycycline, and atovaquone-proguanil). The choice of antimalarial agent depends on individual traveller's preference.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

5.

Safety of antimalarial medications for use while scuba diving in malaria Endemic Regions.

Author: PetersenKyle, RegisDavid P

Malaria prevention
Diving related illnesses

The safety and efficacy of antimalarials for travelers in a hyperbaric environment is unknown. More research is needed to evaluate the potential for adverse effects that could mimic or increase the risk of diving-related illnesses.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

Long term health outcomes among Returned Peace Corps Volunteers after malaria prophylaxis, 1995-2014.

Author: TanKathrine R, HendersonSusan J, WilliamsonJohn, FergusonRennie W, WilkinsonThomas M, JungPaul, ArguinPaul M

Psychiatric side effects

Malaria chemoprophylaxis use by Peace Corps Volunteers was safe. Avoiding mefloquine in those with prior psychiatric illness can reduce psychiatric side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Malaria prevention in the pregnant traveller: a review.

Author: RoggelinLouise, CramerJakob P

Malaria prevention
Travel safety
Anti-malarial safety
First trimester risks

Malaria is a serious health concern, particularly for infants and pregnant women in tropical areas. This review examines the current evidence for malaria prevention in pregnant travelers, analyzing the risks and benefits of both anti-mosquito measures and antimalarial drugs during pregnancy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Epilepsy triggered by mefloquine in an adult traveler to Uganda.

Author: GobbiFederico, RossaneseAndrea, BuonfrateDora, AnghebenAndrea, PostiglioneChiara, BisoffiZeno

Malaria prophylaxis
Loss of consciousness
Seizures

This case report describes a traveler who experienced seizures after taking mefloquine for malaria prophylaxis. The case highlights the potential for mefloquine to cause serious neurological side effects and suggests that it may be considered a second-line choice for short-term travelers.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

9.

Early treatment failure during treatment of Plasmodium falciparum malaria with atovaquone-proguanil in the Republic of Ivory Coast.

Author: WurtzNathalie, PascualAurélie, Marin-JauffreAdeline, BouchibaHousem, BenoitNicolas, DesbordesMarc, MartelloniMaryse, Pommier de SantiVincent, RichaGeorges, TaudonNicolas, PradinesBruno, BriolantSébastien

Malaria treatment
Mild side effects
Drug resistance
Treatment failure

Atovaquone-proguanil (Malarone®) has been shown to be highly effective against Plasmodium falciparum with only mild side effects. Treatment failures have been attributed to suboptimal dosages or parasite resistance.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Community management of anti-malarials in Africa and iatrogenic risk.

Author: OrosteguiLupé, BaluLaurent, ChevretLaurent, HabesDalila, PussardEric

Hepatic damage

Inappropriate use of anti-malarials can lead to missed diagnosis and severe side effects. A case of an 8-year-old girl receiving anti-malarial prophylaxis developed irreversible hepatic damage requiring transplantation due to cumulative drug toxicity. Early identification and discontinuation of drug-induced toxicity are crucial to limit tissue damage.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Selective ambulatory management of Plasmodium falciparum malaria in paediatric refugees.

Author: CherianSarah, BurgnerDavid

Malaria treatment

This observational study assessed the safety of selective admission of paediatric refugees with uncomplicated Plasmodium falciparum (Pf) malaria in Australia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

[Malaria prophylaxis for long-term travellers and expatriates].

Author: KurtzhalsJørgen A L, VestergaardLasse S

Malaria risk
Side effects

Long-term travellers and expatriates are often non-compliant with malaria chemoprophylaxis. In order to prevent the dire consequences of malaria, we suggest tailoring the antimalarial strategy to the individual traveller.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Danish

14.

[Malaria chemoprophylaxis].

Author: PetersenJørgen Eskild

Malaria risk
Side effects

Malaria is a serious infection, and prevention traditionally relies on chemoprophylaxis during and after exposure. The risk of side effects from chemoprophylaxis needs to be balanced against the risk of infection. Atovaquone/proguanil has been registered in Europe for travels of up to four weeks, but in the United States there is no upper limit for the duration of use. It is not possible to prescribe efficient prophylaxis to pregnant women in the first trimester or infants below 11 kilograms of body weight travelling to tropical Africa.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Danish

15.

Atovaquone-proguanil (malarone): an effective treatment for uncomplicated Plasmodium falciparum malaria in travelers from Denmark.

Author: ThyboSören, GjorupIda, RonnAnita M, MeyrowitschDan, BygbergIb C

Malaria treatment

Atovaquone-proguanil (Malarone) is an effective, safe, and acceptable oral treatment for uncomplicated Plasmodium falciparum malaria.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Malaria chemoprophylaxis: when should we use it and what are the options?

Author: PetersenEskild

Malaria chemoprophylaxis
Side effects

Malaria chemoprophylaxis involves taking medication to prevent malaria infection. The risk of malaria infection varies depending on the location and the standard of living. There are several different drugs used for malaria chemoprophylaxis, with varying levels of effectiveness and side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

CV8, a new combination of dihydroartemisinin, piperaquine, trimethoprim and primaquine, compared with atovaquone-proguanil against falciparum malaria in Vietnam.

Author: GiaoPhan T, de VriesPeter J, HungLe Q, BinhTran Q, NamNguyen V, KagerPiet A

CV8 effective against malaria
Malarone effective against malaria

This study compared the efficacy of two drug combinations, CV8 and Malarone, for treating uncomplicated falciparum malaria in Vietnam. Both combinations were effective against multi-drug resistant falciparum malaria, with similar cure rates and rapid parasite clearance. CV8 offers the advantage of a lower price.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Problems in prescribing malaria chemoprophylaxis for travelers.

Author: Dupouy-CametJean, YeraHélène, Tourte-SchaefferClaudine

Effective chemoprophylaxis
Malarone
High cost
Resistant strains
Side-effects

Effective malaria chemoprophylaxis for travelers requires careful evaluation of the traveler's health, exposure risk, and compliance with treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

21.

[What is the value of the combination atovaquone-proguanil for the clinician?].

Author: DelmontJ

Malaria prophylaxis
Malaria treatment
Few side effects

Malarone (atovaquone-proguanil), a new oral drug, is a highly effective option for malaria prophylaxis and treatment with few side effects. It is particularly effective for chemoprophylaxis against chloroquine-resistant Plasmodium falciparum. The low frequency of adverse effects and the short duration of chemoprophylaxis after leaving the endemic area (7 days) enhance compliance. Malarone is also useful for the treatment of uncomplicated forms of Plasmodium falciparum malaria.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : French

22.

[Clinical studies using the combination atovaquone-proguanil as malaria prophylaxis in non-immune adult and child travelers].

Author: CamusD, DutoitE, MassonV, InglebertP, DelhaesL

Malaria prophylaxis
Few side effects

Malarone (atovaquone/proguanil) is a promising antimalarial drug for short-term travel to malaria-endemic areas. It is effective against multidrug-resistant strains of Plasmodium falciparum and has a convenient single-dose administration, leading to good compliance. Malarone is well tolerated by adults and children.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : French

23.

[Value of malarone in therapy of malaria tropica].

Author: ZieglerTom, SchauAnja, WinklerChristina

Effective malaria prophylaxis
Effective malaria treatment

Malarone, a fixed combination of atovaquone and proguanil, is a valuable alternative malaria prophylaxis for travelers who cannot tolerate other antimalaria drugs. Malarone is also effective in treating uncomplicated malaria caused by multidrug-resistant strains of Plasmodium falciparum.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

24.

[Recommendations for prevention of malaria in patients with epilepsy].

Author: BurchardG D, BauerJ

Malaria prophylaxis
Seizures

Malaria prophylaxis in patients with epilepsy should consider the balance between the risk of malaria and the risk of side effects from the prophylaxis itself. Mefloquine has been shown to have proconvulsive effects and induce seizures. More research is needed regarding atovaquone-proguanil in epileptic patients.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

25.

Microbial drug resistance and the roles of the new antibiotics.

Author: LongworthD L

Antibiotic resistance prevention
Antibiotic resistance

This review highlights the increasing problem of antibiotic resistance due to the widespread use of broad-spectrum antibiotics, particularly vancomycin and fluoroquinolones.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

26.

Atovaquone and proguanil hydrochloride for prophylaxis of malaria.

Author: ShanksG D, KremsnerP G, SukwaT Y, van der BergJ D, ShapiroT A, ScottT R, ChulayJ D,

Effective for malaria
None mentioned

This review highlights the need for new antimalarial drugs due to the spread of drug-resistant malaria and side effects associated with existing treatments. The combination of atovaquone and proguanil hydrochloride has been shown to be safe and effective against malaria, including multi-drug-resistant Plasmodium falciparum.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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