atovaquone

Generic Name: atovaquone (a TOE va kwone)
Brand Names: Mepron

Atovaquone is a medication that interferes with the reproduction of protozoa (single-cell organisms) that can cause disease in the body.

Atovaquone is used to treat or prevent pneumonia caused by a fungal infection called Pneumocystitis carinii (also called Pneumocystis jiroveci).

Atovaquone may also be used for other purposes not listed in this medication guide.

Before using this medication, tell your doctor if you have liver disease, or a stomach or intestinal disorder.

Also tell your doctor if you use other medications such as rifabutin (Mycobutin), rifampin (Rifadin, Rifater, Rifamate, Rimactane), a blood thinner such as warfarin (Coumadin), or a seizure medication such as carbamazepine (Carbatrol, Tegretol), divalproex (Depakote), phenytoin (Dilantin), or valproic acid (Depakene).

Call your doctor at once if you have a serious side effect such as easy bruising or bleeding, fever, flu symptoms, white patches in your mouth or throat, worsening cough, wheezing, trouble breathing, a severe red or peeling skin rash, or jaundice (yellowing of the skin or eyes).

If you have certain conditions, you may need a dose adjustment or special tests to safely take this medication. Before you take atovaquone, tell your doctor if you have:

• liver disease; or

• a stomach or intestinal disorder.

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

If you are taking a pre-measured atovaquone dose from a foil pouch, tear open the pouch along the perforated line and take all of the medicine in the pouch. You may drink it directly from the pouch or pour it into a spoon or cup before taking.

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention if you think you have used too much of this medicine.

Symptoms of an atovaquone overdose are not known.

Follow your doctor's instructions about any restrictions on food, beverages, or activity while you are using this medication.

• easy bruising or bleeding, unusual weakness;

• fever, flu symptoms;

• white patches in your mouth or throat;

• worsening cough;

• bronchospasm (wheezing, chest tightness, trouble breathing);

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or

• nausea, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• mild nausea, vomiting, stomach pain or upset,

• diarrhea, constipation;

• headache;

• weakness, dizziness;

• muscle pain;

• mild skin rash;

• sweating; or

• sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Pneumocystis Pneumonia:

750 mg orally twice a day for 21 days
Alternative therapy may be needed if arterial blood gas values do not improve or worsen after 7 to 10 days of therapy, or if the clinical status declines after 4 days.

Usual Adult Dose for Pneumocystis Pneumonia Prophylaxis:

1500 mg orally once a day

Usual Adult Dose for Babesiosis:

750 mg orally twice a day with azithromycin (500 to 600 mg on day 1, followed by 250 to 600 mg once a day thereafter or 1000 mg once a day for 3 days, followed by 500 mg once a day thereafter) for 7 to 10 days

Usual Adult Dose for Malaria:

500 to 750 mg orally every 12 hours for 7 days; should be used in combination with other antimalarial agents

Usual Adult Dose for Toxoplasmosis:

750 mg orally every 6 hours for 2 to 6 months
Similar doses given every 6 to 8 hours are used for toxoplasmosis maintenance therapy.

Atovaquone is considered second-line therapy for toxoplasmosis. It should be administered in combination with pyrimethamine and leucovorin, with sulfadiazine, or as a single agent in patients intolerant of pyrimethamine with sulfadiazine.

Usual Pediatric Dose for Pneumocystis Pneumonia:

1 month to 12 years: 20 mg/kg orally twice a day
13 years or older: 750 mg orally twice a day for 21 days

Maximum dose: 1500 mg/day

Usual Pediatric Dose for Pneumocystis Pneumonia Prophylaxis:

1 to 3 months: 30 mg/kg orally once a day
4 months up to 2 years: 45 mg/kg orally once a day
2 to 12 years: 30 mg/kg orally once a day
13 years or older: 1500 mg orally once a day

Maximum dose: 1500 mg/day

Usual Pediatric Dose for Babesiosis:

1 to 12 years: 20 mg/kg orally twice a day with azithromycin (12 mg/kg once a day) for 7 to 10 days
13 years or older: 750 mg orally twice a day with azithromycin (500 to 600 mg on day 1, followed by 250 to 600 mg once a day thereafter or 1000 mg once a day for 3 days, followed by 500 mg once a day thereafter) for 7 to 10 days

Maximum dose: 1500 mg/day

Tell your doctor about all other medications you are using, especially:

• carbamazepine (Carbatrol, Tegretol);

• clozapine (Clozaril, FazaClo);

• rifabutin (Mycobutin); or

• rifampin (Rifadin, Rifater, Rifamate, Rimactane).

This list is not complete and there may be other drugs that can interact with atovaquone. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

• Your pharmacist can provide more information about atovaquone.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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