Atovaquone and proguanil and Rifampin interaction

Atovaquone and proguanil and Rifampin: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Atovaquone and proguanil (MALARONE) label · effective 2026-06-10

Major

• Administration with rifampin or rifabutin is known to reduce atovaquone concentrations; concomitant use with MALARONE is not recommended.

Drug interactionsnames RifampinView label on DailyMed
Major

The concomitant administration of MALARONE and rifampin or rifabutin is not recommended.

Drug interactionsnames RifampinView label on DailyMed
Moderate

Rifampin/Rifabutin Concomitant administration of rifampin or rifabutin is known to reduce atovaquone concentrations [see Clinical Pharmacology ( 12.3 )] .

Drug interactionsnames RifampinView label on DailyMed

From the Rifampin (Rifadin IV) label · effective 2026-05-27

Major

Coadministration of rifampin with atovaquone is not recommended.

Drug interactionsnames Atovaquone and proguanilView label on DailyMed
Moderate

Other Interactions Atovaquone: Concomitant use of rifampin with atovaquone decrease concentrations of atovaquone and increase concentrations of rifampin which may increase the risk of RIFADIN toxicities.

Drug interactionsnames Atovaquone and proguanilView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.