Malaria transmission occurs in large areas of Africa, Central and South America, parts of the Caribbean, Asia (including South Asia, Southeast Asia, and the Middle East), Eastern Europe, and the South Pacific. Choice of antimalarial for prophylaxis depends on traveler’s risk of acquiring malaria in area(s) visited, risk of exposure to drug-resistant P. Retinal thinning in plaquenil toxicity Plaquenil and low libido Chloroquine and primaquine Resistance The parasite develops a membrane pump to flush out heme and transporter to flush out chloroquine. A mutation in the gene encoding for chloroquine resistance transporter protein PfCRT has a role in the development of resistance by Plasmodium. Drug interactions. Antacids may decrease the oral absorption of chloroquine. Contraindications Malarone is used to treat or prevent malaria. Malarone may also be used for purposes not listed in this medication guide. Important information. You should not use Malarone if you are allergic to atovaquone or proguanil. You should not use Malarone to prevent malaria if you have severe kidney disease. Adult strength tablets 250 mg atovaquone; 100 mg proguanil per tablet PO once daily for 3 consecutive days. Guidelines recommend for chloroquine-resistant infections and for infections of unknown resistance; may also use for chloroquine-sensitive infections if necessary. For P. vivax infections, add primaquine phosphate. Active only against asexual erythrocytic forms of Plasmodium (not exoerythrocytic stages) and cannot prevent delayed primary attacks or relapse of P. vivax malaria or provide a radical cure; Information on risk of malaria in specific countries and mosquito avoidance measures and recommendations regarding whether prevention of malaria indicated and choice of antimalarials for prevention are available from CDC at [Web] and [Web]. Falciparum, other medical conditions (e.g., pregnancy), cost, and potential adverse effects. Randomised placebo-controlled study of atovaquone plus proguanil for malaria prophylaxis in children. Malarone for chloroquine resistance ncbi Medicines for the Prevention of Malaria While Traveling., Malarone Uses, Dosage & Side Effects - Plaquenil liverChloroquine resistant malaria drug of choiceActa plaquenil Atovaquone/Proguanil Malarone •Possible GI side effects •Chloroquine and Hydroxychloroquine •Chloroquine has high resistance in some areas, check travel location •Doxycycline •Photosensitive •Mefloquine Larium •Psychological complications •Primaquine •Must test for G6PD-deficiency prior to use 13 14 Malaria Update. Malarone atovaquone/proguanil hydrochloride dose.. Evidence of Plasmodium falciparum malaria resistant to.. Chloroquine-resistant P. falciparum first developed independently in three to four areas in Southeast Asia, Oceania, and South America in the late 1950s and early 1960s. Since then, chloroquine resistance has spread to nearly all areas of the world where falciparum malaria is transmitted. Malarone is indicated for the treatment of acute, uncomplicated P. falciparum malaria. Malarone has been shown to be effective in regions where the drugs chloroquine, halofantrine, mefloquine, and amodiaquine may have unacceptable failure rates, presumably due to drug resistance. Malarone Dosage and Administration Atovaquone is a naphthoquinone used for the prevention and treatment of Pneumocystis jevorici formerly carinii pneumonia and, in combination with proguanil, prevention and treatment of P. falciparum malaria. Atovaquone therapy is associated with low rates of serum enzyme elevations and has been linked to only rare cases of clinically apparent liver injury.