Comparative Pharmacology
Head-to-head clinical analysis: MALARONE PEDIATRIC versus QUININE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: MALARONE PEDIATRIC versus QUININE.
MALARONE PEDIATRIC vs Quinine
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
MALARONE PEDIATRIC is a fixed-dose combination of atovaquone and proguanil. Atovaquone selectively inhibits the mitochondrial electron transport chain of Plasmodium species at the cytochrome bc1 complex, collapsing mitochondrial membrane potential and disrupting pyrimidine synthesis. Proguanil is a prodrug converted to cycloguanil, which inhibits dihydrofolate reductase in the parasite, blocking DNA synthesis. The combination synergistically kills blood-stage schizonts and inhibits liver-stage hypnozoites of P. falciparum.
Quinine is a cinchona alkaloid that acts as a blood schizonticide against Plasmodium falciparum. It inhibits heme polymerase, leading to accumulation of toxic heme, and disrupts parasite membrane integrity. It also has mild analgesic and antipyretic properties.
Adults: 250 mg atovaquone/100 mg proguanil orally once daily for 3 consecutive days for treatment; for prophylaxis, 250 mg/100 mg orally once daily starting 1-2 days before travel and continued for 7 days after leaving endemic area.
Adults: 648 mg (2 capsules) orally every 8 hours for 7 days for uncomplicated chloroquine-resistant malaria, typically used in combination with other antimalarials.
None Documented
Clinical Note
moderateQuinine + Gatifloxacin
"Quinine may increase the hypoglycemic activities of Gatifloxacin."
Clinical Note
moderateQuinine + Rosoxacin
"Quinine may increase the hypoglycemic activities of Rosoxacin."
Clinical Note
moderateQuinine + Levofloxacin
"Quinine may increase the hypoglycemic activities of Levofloxacin."
Clinical Note
moderateQuinine + Trovafloxacin
"Quinine may increase the hypoglycemic activities of Trovafloxacin."
None Documented
Atovaquone: terminal half-life 1.5-3 days (range 2-3 days in adults, longer in children). Proguanil: terminal half-life 12-21 hours (parent drug) and 14-23 hours (cycloguanil). Clinically, atovaquone's long half-life supports single daily dosing.
Terminal elimination half-life: 18 hours (range 8–21 h) in healthy adults; prolonged to 26–44 h in severe malaria or hepatic impairment.
Atovaquone: >90% excreted unchanged in feces via biliary elimination; <1% renal. Proguanil: ~40-60% excreted renally as unchanged drug and active metabolite cycloguanil; ~30% fecal.
Renal: ~20% unchanged; Hepatic metabolism (CYP3A4) to inactive metabolites, excreted in urine and feces. Total renal elimination of parent and metabolites ~80%.
Category C
Category C
Antimalarial
Antimalarial