Formulary
Atovaquone: Indications, Dosing, Side Effects and Interactions
Atovaquone clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Atovaquone: Indications, Dosing, Side Effects and Interactions
Atovaquone clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Treatment of mild to moderatePneumocystis jirovecii(Pneumocystis carinii) pneumonia in patients intolerant of co-trimoxazole**
- **Adult** (By Mouth): Treatment of mild to moderate Pneumocystis jirovecii ( Pneumocystis carinii ) pneumonia in patients intolerant of co-trimoxazole 750 mg twice daily for 21 days, dose to be taken with food, particularly high fat food.
**Prophylaxis against pneumocystis pneumonia**
- **Adult** (By Mouth): 750 mg twice daily.
**Treatment of mild to moderate Pneumocystis jirovecii (Pneumocystis carinii) pneumonia in patients intolerant of co-trimoxazole for atovaquone**
- **Child 1-2 months** (By mouth): 15-20 mg/kg twice daily for 14-21 days, dose to be taken with food, particularly high fat food.
- **Child 3 months-1 year** (By mouth): 22.5 mg/kg twice daily for 14-21 days, dose to be taken with food, particularly high fat food.
- **Child 2-17 years** (By mouth): 15-20 mg/kg twice daily (max. per dose 750 mg) for 14-21 days, dose to be taken with food, particularly high fat food.
Cautions
Elderly; initial diarrhoea and difficulty in taking with food may reduce absorption (and require alternative therapy); other causes of pulmonary disease should be sought and treated
Side effects
Common or very common Anaemia; angioedema; bronchospasm; diarrhoea; headache; hypersensitivity; hyponatraemia; insomnia; nausea; neutropenia; skin reactions; throat tightness; vomiting Frequency not known Stevens-Johnson syndrome
Interactions
**Severe interactions:**
- Concomitant treatment with metoclopramide has been associated with a significant decrease (about 50%) in plasma concentrations of atovaquone (see section 4.4).Another antiemetic treatment should be...
- Concomitant administration of Atovaquone Glenmark 750 mg/5 ml oral suspension and indinavir results in a significant decrease in the Cmin of indinavir (23% decrease; 90% CI 8-35%) and the AUC (9%...
**Other interactions (18):**
- As experience is limited, care should be taken when combining other drugs with Atovaquone.
- Concomitant administration of rifampicin or rifabutin is not recommended as it is known to reduce plasma concentrations of atovaquone levels by approximately 50% and 34%, respectively, (see section...
- When given with efavirenz or boosted protease-inhibitors, atovaquone concentrations have been observed to decrease as much as 75%.
- Concomitant treatment with tetracycline has been associated with decreases in plasma concentrations of atovaquone.
- The co-administration of atovaquone at doses of 45 mg/kg/day in children (n=9) with acute lymphoblastic leukaemia for prophylaxis of PCP was found to increase the plasma concentrations (AUC) of...
- In clinical trials of Atovaquone Glenmark 750 mg/5 ml oral suspension small decreases in plasma concentrations of atovaquone (mean < 3 g/ml) were associated with concomitant administration of...
Pregnancy
Manufacturer advises avoid unless potential benefit outweighs risk-no information available.
Breast feeding
Manufacturer advises avoid.
Hepatic impairment
Manufacturer advises use with caution in significant impairment and monitor closely-no information available.
Renal impairment
Caution in significant impairment (no information available). M
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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