Atovaquone/Proguanil

• ​You may experience nausea, vomiting, stomach pain and diarrhea.
• Take the medication after food to reduce gastric side effects.
• If you vomit within 1 hour of taking the medication, repeat the dose.
• You may experience headache and insomnia.
• You should continue taking the medication unless you are unable to tolerate the side effects.
• You may experience dizziness while on this medication.
• If affected, do not drive, operate machinery or do work that requires you to be alert.

Rare but severe side effects include:

• Severe skin reactions
• Skin rash, which may blister and looks like small targets (central dark spots, surrounded by paler area with a dark ring around the edge) (erythema multiforme).
• Severe widespread rash with blisters and peeling skin, particularly occurring around the mouth, nose, eyes and genitals (Stevens-Johnson syndrome).
• Liver problems
• Symptoms include dark urine or light coloured stools, nausea, vomiting, loss of appetite, stomach pain, yellowing of your eyes or skin.
• Anemia
• A condition where you do not have enough red blood cells.
• May present with worsening tiredness, rapid breathing, pale skin/lips/nails, fast heartbeat while resting.
• Severe infection
• May present with high fever, severe chills, body aches, sore throat.
• Drug allergy (symptoms include one or more of the following)
• Swollen face/eyes/lips/tongue.
• Difficulty in breathing.
• Itchy skin rashes over your whole body.

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

​Inform your healthcare professional if:

• You are allergic to Atovaquone, Proguanil hydrochloride or any of the other ingredients of this medication.
• You are pregnant or breast-feeding. Avoid pregnancy and use contraceptives while taking this medication and for 2 weeks after the last dose.
• You are taking any other medications, including supplements, traditional medications and herbal remedies.
• You have a history of kidney problems, liver problems, seizures (epilepsy or convulsions) or depression.
• You have tuberculosis.

​Inform your pharmacist or doctor if you are taking any of the medications below:

• Tetracycline (antibiotic)
• Metoclopramide (medication to treat nausea or vomiting)
• Rifampin or Rifabutin (antibiotic)
• Etoposide (medication to treat cancer)
• Efavirenz, Zidovudine, Indinavir (medication to treat HIV)
• Warfarin, Dabigatran, Apixaban or Rivaroxaban (oral anticoagulants)

This is not a complete list of all possible drug interactions with this medication. Check with your healthcare professional if you are unsure.

To prevent malaria, you may protect yourself against mosquito bites by:

• Wearing long-sleeved clothing and long trousers between sunset and sunrise.
• Applying insect repellent containing more than 20% DEET (N-Diethyl-meta-toluamide) for adults or 10% and less DEET for children on exposed skin. DEET is a common active ingredient in mosquito repellents.
• Using mosquito coils in the room at night.
• Sleep with mosquito nets around your bed, with the net edges tucked under the bed or sleep in a screened room.
• Spray insecticide where mosquitos may rest. Mosquito larvae survive well in clear, slow-flowing streams.
• Avoid going to an area where malaria is common.

Following these guidelines and medication does not mean that you will not get malaria. If you have a fever or experience chills between 1 week and up to 1 year after your return, you should seek medical attention. Inform the doctor that you have been to a country where malaria is common. Malaria can be effectively treated if discovered early. A delay in treatment may result in serious health problems.