Proguanil
Synonym :
Atovaquone/ Proguanil
Mechanism :
Proguanil is an antimalarial drug used mainly in the prophylaxis of falciparum malaria.
Indication :
- Malaria prophylaxis and treatment along with atovaquone
Contraindications :
Hypersensitivity to drug/class/component, CrCl <30 (prophylaxis use).
Dosing :
Available as a 62.5 mg Atovaquone/25 mg Proguanil FDC (Pediatric strength) and 250 mg/100 mg Atovaquone/Proguanil FDC (Adult strength).
5-8 kg: 2 Pediatric tab OD
9-10 kg: 3 Pediatric tab OD
11-20 kg: 1 Adult tab OD
21-30 kg: 2 Adult tab OD
31-40 kg: 3 Adult tab OD
>40 kg: 4 Adult tab OD
Malaria prophylaxis:
11-20 kg: 1 Pediatric tablet daily
21-30 kg: 2 Pediatric tablets daily
31-40 kg: 3 Pediatric tablets daily
>40 kg: 4 Pediatric tablets daily
To be given 1 day before entering area and to be continued for 1 week after return. Contraindicated in pregnant women.
Adverse Effect :
Abdominal pain, headache, myalgia, nausea, increase LFTs, renal impairment, vertigo, rash, hematological abnormality.
Interaction :
Interaction Characteristics:
CYP2C19 substrate.
Contraindicated:
Auranofin, Gold sodium thiomalate.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-60 | 100 mg daily |
| 10-20 | 50 mg every 48 hours |
| <10 | 50 mg weekly |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Dose as in GFR<10 mL/min |
| HD | Not dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Unknown dialysability. Dose as in GFR<10 mL/min |
| CAV/VVHD | Unknown dialysability. Dose as in GFR=10–20 mL/min |
Hepatic Dose :
No dosage adjustment required in mild to moderate hepatic impairment. No data available for use in severe hepatic impairment.