 [PDF] |
Product Name: Atovaquone - ProguanilCommercial Name: Malarone Application: Anti-malarial drug for prophylaxis Date of Licensure: July 2000 Company of manufacture: : GlaxoSmithKline Type of product: Combination of atovaquone (hydroxy-1,4-naphthoquinone) and proguanil (biguanide). Atovaquone is currently marketed in the United States under the trade name Mepron for pneumocystis carinii pneumonia. Proguanil, which interferes with folic acid synthesis crucial to malaria parasite survival (via binding to the enzyme dihydrofolate reductiase in much the same way as pyrimethamine) was approved in the U.S. in 1948 for use in malaria. Because it was not widely used in this country, it ceased to be marketed here in the 1970s. It is still used as a prophylactic antimalarial in some countries. Reasons for development:: (1) resistance to the effective action of other antimalarial drugs used to prevent malaria; (2) adverse effects noted with other antimalarial drugs (photosensitivity, diarrhea with doxycycline, and neurotoxicity with mefloquine), (3) does not require daily administration to prevent malaria (as does doxycycline), (4) Malarone is effective against the early liver stage of malaria as well as the blood stage. Role of DoD: : Development of drug combination strategies, dose-ranging pre-clinical and clinical studies and pivotal efficacy trials were organized by the Walter Reed Army Institute of Research in partnership with GlaxoSmithKline. Dose-ranging studies were undertaken at the Armed Forces Research Institute of Medical Science (AFRIMS) in Thailand, and clincial trials were completed at WRAIR and research laboratories in Brazil, Kenya and Indonesia. The drug has few associated adverse effects other than gastrointestinal intolerance, but experience with this drug is limited. Rapid development of resistance has been noted when the drug has been used alone, and this medication is very expensive. |
| Chloroquine | Primaquine | Sulfadoxine | Mefloquine | Doxycycline | Halofantrine | Atovaquone |
