Jul
26
Atovaquone
July 26, 2009 |
Generic Name
Atovaquone (ah-TOE-vuh-quone)
Brand Name Mepron *
Type of Drug Anti-infective.
Prescribed For
Prevention and treatment of mild to moderate Pneumocystis carinii pneumonia (PCP).
General Information
Atovaquone is an anti-infective with specific activity against PCP, an infection commonly associated with HIV. It is used in people who cannot take the combination of trimethoprim and sulfamethoxazole. In studies comparing atovaquone with trimethoprimsulfamethoxazole (TMP-SMX), approximately 60% of people with PCP improved on each drug. However, more people died of PCP and other infections white being treated with atovaquone. Of those who died, most had less atovaquone in their bloodstream than those who lived. In studies comparing oral atovaquone with intravenous pentamidine for treating PCP in people with HIV, both drugs were equally effective, at 14%. Again, there was a direct correlation between the amount of atovaquone in the blood and survival.
The drug stays in the body for several days and is eliminated through the liver.
Cautions and Warnings
Do not take atovaquone if you are allergic or sensitive to any of its ingredients.
This drug has not been studied for severe PCP or in those who are failing on TMP-SMZ.
Atovaquone only works against PCP People with PCP who have bacterial, viral, fungal, or other infections of the lung may continue to worsen despite atovaquone therapy. If this happens, it may be a sign that another kind of infecting organism is the cause. Additional medicine will be necessary.
Atovaquone absorption is strongly influenced by food. People with gastrointestinal disorders or those who are unable to take atovaquone with food may not be able to absorb enough medicine for it to be effective. Intravenous treatments of other PCP antiinfectives may be necessary.
Possible Side Effects
Because atovaquone was evaluated in people with advanced HIV, it is difficult to discern side effects of the drug use from those caused by the disease. Overall, only 4-7% of people studied stopped taking the drug because of side effects, a much smaller percentage than occurs with other PCP treatments.
✓ Most common: rash, nausea, diarrhea, headache, vomiting, fever, sleeplessness, weakness, itching, oral fungal infections, abdominal pain, upset stomach, appetite loss, constipation, cough, dizziness, pain, increased sweating, anxiety, sinus inflammation, and runny nose.
✓ Less common: changes in sense of taste, low blood sugar, and low blood pressure.
Drug Interactions
b Atovaquone may increase blood levels of warfarin, oral anti-diabetes drugs, digoxin, and other drugs that bind strongly to blood proteins.
• Rifampin and rifabutin may reduce blood levels of atovaquone, possibly diminishing its effectiveness.
• Taking atovaquone with TMP-SMZ has resulted in reduced blood levels of TMP-SMZ. This should not reduce TMPSMZ’s effectiveness.
• Taking atovaquone with zidovudine (AZT) drastically reduces the rate at which zidovudine is eliminated from the body. For most people, this is not a problem.
Food Interactions
Take atovaquone with food or meals to improve drug absorption. A high-fat meal can increase the amount absorbed by 300%.
Usual Dose
Prevention: 1500 mg daily with food.
Treatment: 750 mg twice a day for 3 weeks, taken with food.
Overdosage
Little is known about the effects of atovaquone overdose; symptoms are likely to be exaggerated drug side effects. Call your local poison control center or hospital emergency room for more information. If you go to the hospital, ALWAYS bring the prescription bottle or container.
Special Information
Taking atovaquone regularly and with food is essential to the drug’s effectiveness. If you cannot eat 2 meals a day, your doctor may have to prescribe another PCP treatment.
Call your doctor if you develop any persistent or bothersome side effects.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, space your remaining doses equally throughout the rest of the day so that you can still take a total daily dose of 1500 mg, or 2 tsp.
Special Populations
Pregnancy/Breast-feeding: In animal studies. atovaquone has affected fetal development. This drug should only be used during pregnancy after carefully weighing its potentia(beneiAs against its ri*kS,
Atovaquone is likely to pass into breast milk because of its affinity for body fat. Nursing mothers should use infant formula.
Seniors: This drug has not been tested systematically in people over age 65. Seniors, especially those with kidney, heart, or liver disease, may be more sensitive to atovaquone side effects.
• Taking atovaquone with TMP-SMZ has resulted in reduced blood levels of TMP-SMZ. This should not reduce TMPSMZ’s effectiveness.
• Taking atovaquone with zidovudine (AZT) drastically reduces the rate at which zidovudine is eliminated from the body. For most people, this is not a problem.
Food Interactions
Take atovaquone with food or meals to improve drug absorption. A high-fat meal can increase the amount absorbed by 300%.
Usual Dose
Prevention: 1500 mg daily with food.
Treatment: 750 mg twice a day for 3 weeks, taken with food.
Overdosage
Little is known about the effects of atovaquone overdose; symptoms are likely to be exaggerated drug side effects. Call your local poison control center or hospital emergency room for more information. If you go to the hospital, ALWAYS bring the prescription bottle or container.
Special Information
Taking atovaquone regularly and with food is essential to the drug’s effectiveness. If you cannot eat 2 meals a day, your doctor may have to prescribe another PCP treatment.
Call your doctor if you develop any persistent or bothersome side effects.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, space your remaining doses equally throughout the rest of the day so that you can still take a total daily dose of 1500 mg, or 2 tsp.
Special Populations
Pregnancy/Breast-feeding: In animal studies. atovaquone has affected fetal development. This drug should only be used during pregnancy after carefully weighing its potentia(beneiAs against its ri*kS,
Atovaquone is likely to pass into breast milk because of its affinity for body fat. Nursing mothers should use infant formula.
Seniors: This drug has not been tested systematically in people over age 65. Seniors, especially those with kidney, heart, or liver disease, may be more sensitive to atovaquone side effects.