Atovaquone and proguanil interactions

Atovaquone/ proguanil ↓ atovaquone ↓ proguanil Concomitant administration is not recommended. (Efavirenz, lamivudine, and tenofovir label, Drug interactions)

Penicillamine should not be used in patients who are receiving concurrently gold therapy, antimalarial or cytotoxic drugs, oxyphenbutazone or phenylbutazone because these drugs are also associated with similar serious hematologic and renal adverse reactions. (Penicillamine label, Precautions)

• Administration with rifampin or rifabutin is known to reduce atovaquone concentrations; concomitant use with MALARONE is not recommended. (Atovaquone and proguanil label, Drug interactions)

• Administration with rifampin or rifabutin is known to reduce atovaquone concentrations; concomitant use with MALARONE is not recommended. (Atovaquone and proguanil label, Drug interactions)

• Proguanil may potentiate anticoagulant effect of warfarin and other coumarin-based anticoagulants. (Atovaquone and proguanil label, Drug interactions)

• Proguanil may potentiate anticoagulant effect of warfarin and other coumarin-based anticoagulants. (Atovaquone and proguanil label, Drug interactions)

…ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine Monoamine Oxidase… (Articaine and epinephrine label, Drug interactions)

• Tetracycline may reduce atovaquone concentrations; parasitemia should be closely monitored. (Atovaquone and proguanil label, Drug interactions)

• Proguanil may potentiate anticoagulant effect of warfarin and other coumarin-based anticoagulants. (Atovaquone and proguanil label, Drug interactions)

• Drugs Associated with Methemoglobinemia : Patients are at increased risk of developing methemoglobinemia when concurrently exposed to nitrates, nitrites, local anesthetics, antineoplastic agents, antibiotics, antimalarials, anticonvulsants, and other drugs. (Bupivacaine label, Drug interactions)

• Drugs Associated with Methemoglobinemia : Patients are at increased risk of developing methemoglobinemia when concurrently exposed to nitrates, nitrites, local anesthetics, antineoplastic agents, antibiotics, antimalarials, anticonvulsants, and other drugs. (Bupivacaine and epinephrine label, Drug interactions)

…procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants Phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine (Chloroprocaine label, Precautions)

Patients infected with a resistant strain of plasmodia as shown by the fact that normally adequate doses have failed to prevent or cure clinical malaria or parasitemia should be treated with another form of antimalarial therapy. (Chloroquine label, Warnings)

• Proguanil may potentiate anticoagulant effect of warfarin and other coumarin-based anticoagulants. (Atovaquone and proguanil label, Drug interactions)

Antimalarial : artemether/lumefantrine ↓ artemether ↓ dihydroartemisinin ↑ lumefantrine ↔ darunavir The combination of PREZISTA/ritonavir and artemether/lumefantrine can be used without dose adjustments. (Darunavir label, Drug interactions)

Antimalarial: artemether/lumefantrine artemether: effect unknown lumefantrine: effect unknown Monitor for a potential decrease of antimalarial efficacy or potential QT prolongation. (Darunavir and cobicistat label, Drug interactions)

• Tetracycline may reduce atovaquone concentrations; parasitemia should be closely monitored. (Atovaquone and proguanil label, Drug interactions)

• Tetracycline may reduce atovaquone concentrations; parasitemia should be closely monitored. (Atovaquone and proguanil label, Drug interactions)

Possible pharmacodynamic interactions can occur between droperidol and potentially arrhythmogenic agents such as class I or III antiarrhythmics, antihistamines that prolong the QT interval, antimalarials, calcium channel blockers, neuroleptics that prolong the QT interval, and antidepressants. (Droperidol label, Drug interactions)

• Proguanil may potentiate anticoagulant effect of warfarin and other coumarin-based anticoagulants. (Atovaquone and proguanil label, Drug interactions)

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (Efavirenz label, Drug interactions)

• Proguanil may potentiate anticoagulant effect of warfarin and other coumarin-based anticoagulants. (Atovaquone and proguanil label, Drug interactions)

Antimalarial : artemether/lumefantrine ↔ etravirine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Caution is warranted when co-administering Etravirine and artemether/lumefantrine as it is unknown whether the decrease in exposure of artemether or its active metabolite, dihydroartemisinin, could result in decreased antimalarial efficacy. (Etravirine label, Drug interactions)

• Proguanil may potentiate anticoagulant effect of warfarin and other coumarin-based anticoagulants. (Atovaquone and proguanil label, Drug interactions)

• Proguanil may potentiate anticoagulant effect of warfarin and other coumarin-based anticoagulants. (Atovaquone and proguanil label, Drug interactions)

Co-administration of PLAQUENIL with other antimalarials known to lower the seizure threshold (e.g., mefloquine) may increase the risk of seizures. (Hydroxychloroquine label, Drug interactions)

Drugs Associated with Methemoglobinemia: Patients are at increased risk of developing methemoglobinemia when concurrently exposed to nitrates, nitrites, local anesthetics, antineoplastic agents, antibiotics, antimalarials, anticonvulsants, and other drugs. (Lidocaine and epinephrine label, Drug interactions)

…prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, isofamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sufonamides Antimalarials chloroquine, primaquine Anticonvulsants Phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine (Lidocaine and prilocaine label, Drug interactions)

Antiparasitic: atovaquone ↓ atovaquone Clinical significance is unknown; however, increase in atovaquone doses may be needed. (Lopinavir and ritonavir label, Drug interactions)

Other Antimalarial Drugs Concomitant administration of mefloquine and other related antimalarial compounds (e.g., quinine, quinidine and chloroquine) may produce electrocardiographic abnormalities and increase the risk of convulsions (see WARNINGS ). (Mefloquine label, Drug interactions)

…procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine (Mepivacaine label, Drug interactions)

Metoclopramide While antiemetics may be indicated for patients receiving MALARONE, metoclopramide may reduce the bioavailability of atovaquone and should be used only if other antiemetics are not available [see Clinical Pharmacology ( 12.3 )] . (Atovaquone and proguanil label, Drug interactions)

• Tetracycline may reduce atovaquone concentrations; parasitemia should be closely monitored. (Atovaquone and proguanil label, Drug interactions)

…ropivacaine, tetracaine Antineoplastic Agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine The administration… (Prilocaine and epinephrine label, Drug interactions)

However, the concomitant use of other antifolic drugs or agents associated with myelosuppression including sulfonamides or trimethoprim- sulfamethoxazole combinations, proguanil, zidovudine, or cytostatic agents (e.g., methotrexate), while the patient is receiving pyrimethamine, may increase the risk of bone marrow suppression. (Pyrimethamine label, Drug interactions)

…quinidine, tocainide Antibiotics Chloramphenicol, clarithromycin, dapsone, doxycycline; Fluoroquinolones (such as ciprofloxacin) Oral Anticoagulants Warfarin Anticonvulsants Phenytoin Antimalarials Quinine Azole Antifungals Fluconazole, itraconazole, ketoconazole Antipsychotics Haloperidol Barbiturates Phenobarbital Benzodiazepines Diazepam Beta-Blockers Propranolol… (Rifapentine label, Drug interactions)

Antiparasitic: atovaquone ↓ atovaquone Clinical significance is unknown; however, increase in atovaquone dose may be needed. (Ritonavir label, Drug interactions)

• Proguanil may potentiate anticoagulant effect of warfarin and other coumarin-based anticoagulants. (Atovaquone and proguanil label, Drug interactions)

…ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants Phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine NAROPIN should be… (Ropivacaine label, Drug interactions)

• Tetracycline may reduce atovaquone concentrations; parasitemia should be closely monitored. (Atovaquone and proguanil label, Drug interactions)

• Tetracycline may reduce atovaquone concentrations; parasitemia should be closely monitored. (Atovaquone and proguanil label, Drug interactions)

• Proguanil may potentiate anticoagulant effect of warfarin and other coumarin-based anticoagulants. (Atovaquone and proguanil label, Drug interactions)

Pediatric use In antimalarial trials, quinidine was as safe and effective in pediatric patients as in adults. (Quinidine label, Precautions)

Other antimalarials (e.g., halofantrine, mefloquine). (Quinine label, Drug interactions)