An antimalarial medicine (part of Malarone)
Atovaquone
An antimalarial medicine, usually combined with proguanil (Malarone), to prevent and treat malaria.
What is Atovaquone?
Atovaquone is an antimalarial medicine that is most often combined with proguanil to make Malarone, one of the most widely used tablets for preventing malaria when travelling to areas where it is found. The combination is also used to treat malaria once someone has caught it. It is generally well tolerated, which is why many travellers choose it, and it is started shortly before travel, continued throughout the trip and for a short while after returning. No tablet is completely protective, so avoiding mosquito bites still matters, and any fever after travel needs urgent medical attention.
Education and reference only. This is a plain-language guide to Atovaquone — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Atovaquone is a medicine that works against the malaria parasite. On its own (as Wellvone) it is used for certain other infections, but for malaria it is almost always combined with proguanil in a single tablet known as Malarone. This combination is one of the most popular choices in the UK for preventing malaria in travellers and is also used to treat uncomplicated malaria. It is taken by mouth as a tablet, with food or a milky drink to help it be absorbed.
How it works
Atovaquone interferes with the malaria parasite's ability to produce energy, blocking a key step the parasite needs to survive inside red blood cells and the liver. Proguanil, its usual partner, blocks a different step the parasite needs to make its genetic material, so the two together hit the parasite in more than one way. When taken for prevention, the combination stops the parasite establishing itself; when taken for treatment, it clears an active infection. Taking it with food helps the body absorb enough for it to work properly.
Company & origin
Originated / developed by: Generic (long-established).
An antimalarial medicine used in the UK, most often combined with proguanil as Malarone to prevent and treat malaria in travellers.
Practical use
How to take Atovaquone
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it with food or a milky drink at the same time each day, as fat helps your body absorb it.
- For prevention, start it before you travel, continue every day while you are away, and keep taking it for the short period after you return as advised.
- If you are sick within a short time of taking a dose, take another one, as you may not have absorbed it.
- Keep using mosquito-bite protection such as repellent, covering up and a net, because no tablet is fully protective.
- Finish the full course exactly as prescribed, even once you feel well or have come home.
- Seek urgent medical help for any fever or flu-like illness during or after travel, and mention where you have been.
Weighing it up
Advantages & disadvantages of Atovaquone
Advantages
- Generally very well tolerated, making it a popular choice for travellers.
- Only needs to be continued for a short time after returning home, unlike some older antimalarials.
- Used both to prevent malaria and to treat uncomplicated malaria.
Disadvantages
- Needs to be taken every day, which is easy to forget.
- Should be taken with food, as it is poorly absorbed on an empty stomach.
- Not suitable for people with severe kidney problems when used for prevention.
Practical use
Good to know
Atovaquone with proguanil (Malarone) is popular because it is generally well tolerated and only needs to be continued for a short time after returning home, unlike some older antimalarials. It should be taken with food or a milky drink at the same time each day, as fat helps it be absorbed; if you are sick within a short time of taking it, you may need to take another dose. No antimalarial is completely protective, so covering up, using repellent and sleeping under a net remain essential. It is not suitable in severe kidney problems. Crucially, any fever or flu-like illness during travel or for up to a year afterwards should be treated as possible malaria and checked urgently, even if you took your tablets.
Who should not take it / use with caution
- People with severe kidney problems should not use the combination for malaria prevention.
- Anyone who has had a serious allergic reaction to atovaquone or proguanil.
- It should be used with care in pregnancy and breastfeeding, only on medical advice.
Monitoring
- Checking kidney function before prescribing for prevention, especially in older people.
- Reviewing that doses are taken with food and at the right times before and after travel.
- Watching for any fever after travel, which must be investigated urgently for malaria.
Side effects
- Stomach upset, nausea, tummy pain or diarrhoea are the most common effects.
- Headache, mouth ulcers or a cough in some people.
- Rarely, rash or, very rarely, more serious allergic or liver reactions.
Key interactions
- Rifampicin and rifabutin can lower atovaquone levels and reduce its protection, so are generally avoided.
- Metoclopramide and tetracycline can reduce how much atovaquone is absorbed.
- It can affect warfarin control, so anticoagulant monitoring may be needed.
Available as: Tablets taken by mouth, usually combined with proguanil as Malarone.
Answers
Atovaquone: frequently asked questions
Is atovaquone the same as Malarone?
Malarone is atovaquone combined with proguanil in one tablet; the two medicines work together, and this combination is one of the most popular for preventing malaria in travellers.
Why must I take it with food?
Atovaquone is much better absorbed when taken with food or a milky drink, so taking it on an empty stomach can leave you less protected.
Do I still need to use mosquito repellent?
Yes. No antimalarial tablet is completely protective, so covering up, using repellent and sleeping under a net remain essential alongside the medicine.
How long do I take it after I get home?
It only needs to be continued for a short period after returning, which is one reason many travellers prefer it; follow the exact schedule you were given.
What should I do if I get a fever after my trip?
Treat any fever during or after travel as possible malaria and seek urgent medical help, mentioning where you have been, even if you took your tablets correctly.
The wider class
About Antimalarials
Atovaquone belongs to the antimalarials class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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