Atovaquone


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Mild to moderate Pneumocystis jiroveci pneumonia 750 mg bid for 21 days. Prevention of Pneumocystis jiroveci pneumonia 1,500 mg once/day.
Dosage Details
Oral
Prophylaxis of Pneumocystis (carinii) jirovecii pneumonia
Adult: 1,500 mg once daily.

Oral
Mild to moderate Pneumocystis (carinii) jirovecii pneumonia
Adult: 750 mg bid for 21 days.
Administration
Should be taken with food.
Contraindications
Hypersensitivity to atovaquone.
Special Precautions
Patient w/ GI disorders (e.g. diarrhoea, vomiting), pulmonary disease (due to causes other than pneumocystis pneumonia). Renal and hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Nausea, vomiting, diarrhoea, headache, cough; rash, pruritus, fever, anorexia, depression, dizziness, insomnia, hyponatraemia, elevated liver enzyme values, haematological disturbance (e.g. anaemia, neutropenia). Rarely, hypersensitivity reactions (e.g. angioedema, anaphylaxis, urticaria, vasculitis), cholestasis, hepatitis.
Potentially Fatal: Rarely, liver failure.
MonitoringParameters
Monitor hepatic function at baseline and during treatment. Assess patient’s food tolerance, post-dose vomiting and diarrhoea.
Drug Interactions
Decreased plasma concentration w/ metoclopramide, tetracycline, rifamycin derivatives (e.g. rifampicin, rifabutin), efavirenz or boosted protease-inhibitors (e.g. ritonavir). Slightly decreased plasma concentration w/ aciclovir, antidiarrhoeals, benzodiazepines, cephalosporins, laxatives, opioids, paracetamol. May decrease the rate of metabolism and increase the plasma concentration of zidovudine. May decrease the trough and area under the curve concentration of indinavir. May increase the plasma concentration of etoposide. May displace other highly protein-bound drugs from plasma-protein binding sites.
Food Interaction
Enhanced absorption w/ food.
Action
Description: Atovaquone, a hydroxynaphthoquinone, selectively inhibits the cytochrome bc1 complex (complex III) of the mitochondrial electron transport chain of a variety of protozoa and the parasitic fungus Pnuemocystitis jiroveci, resulting in the inhibition of nucleic acids and ATP synthesis. It is also used in combination w/ proguanil for the prevention and treatment of malaria caused by Plasmodium falciparum.
Pharmacokinetics:
Absorption: Absorption is enhanced w/ food. Bioavailability: 23% (tab); 47% (susp). Time to peak plasma concentration: 1-8 hr and 24-96 hr.
Distribution: Distributed into CSF (<1%). Plasma protein binding: >99%.
Metabolism: Limited metabolism; undergoes enterohepatic recycling.
Excretion: Via faeces (>94% as unchanged drug); urine (<1%). Plasma elimination half-life: 2-3 days.
Chemical Structure

Chemical Structure Image
Atovaquone

Source: National Center for Biotechnology Information. PubChem Database. Atovaquone, CID=74989, https://pubchem.ncbi.nlm.nih.gov/compound/Atovaquone (accessed on Jan. 21, 2020)

Storage
Store between 15-25°C. Do not freeze.
MIMS Class
ATC Classification
P01AX06 - atovaquone ; Belongs to the class of other agents used in the treatment amoebiasis and other protozoal diseases.
References
Anon. Atovaquone. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 14/10/2016.

Atovaquone Suspension (Amneal Pharmaceuticals of New York, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 14/10/2016.

Buckingham R (ed). Atovaquone. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 14/10/2016.

Joint Formulary Committee. Atovaquone. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 14/10/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Atovaquone. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 14/10/2016.

Disclaimer: This information is independently developed by MIMS based on Atovaquone from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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