Usual Adult Dose for Pneumocystis Pneumonia

750 mg orally twice a day for 21 days
Alternative therapy may be needed if arterial blood gas values do not improve or worsen after 7 to 10 days of therapy, or if the clinical status declines after 4 days.

Usual Adult Dose for Pneumocystis Pneumonia Prophylaxis

1500 mg orally once a day

Usual Adult Dose for Babesiosis

750 mg orally twice a day with azithromycin (500 to 600 mg on day 1, followed by 250 to 600 mg once a day thereafter or 1000 mg once a day for 3 days, followed by 500 mg once a day thereafter) for 7 to 10 days

Usual Adult Dose for Malaria

500 to 750 mg orally every 12 hours for 7 days; should be used in combination with other antimalarial agents

Usual Adult Dose for Toxoplasmosis

750 mg orally every 6 hours for 2 to 6 months
Similar doses given every 6 to 8 hours are used for toxoplasmosis maintenance therapy.

Atovaquone is considered second-line therapy for toxoplasmosis. It should be administered in combination with pyrimethamine and leucovorin, with sulfadiazine, or as a single agent in patients intolerant of pyrimethamine with sulfadiazine.

Usual Pediatric Dose for Pneumocystis Pneumonia

1 month to 12 years: 20 mg/kg orally twice a day
13 years or older: 750 mg orally twice a day for 21 days

Maximum dose: 1500 mg/day

Usual Pediatric Dose for Pneumocystis Pneumonia Prophylaxis

1 to 3 months: 30 mg/kg orally once a day
4 months up to 2 years: 45 mg/kg orally once a day
2 to 12 years: 30 mg/kg orally once a day
13 years or older: 1500 mg orally once a day

Maximum dose: 1500 mg/day

Usual Pediatric Dose for Babesiosis

1 to 12 years: 20 mg/kg orally twice a day with azithromycin (12 mg/kg once a day) for 7 to 10 days
13 years or older: 750 mg orally twice a day with azithromycin (500 to 600 mg on day 1, followed by 250 to 600 mg once a day thereafter or 1000 mg once a day for 3 days, followed by 500 mg once a day thereafter) for 7 to 10 days

Maximum dose: 1500 mg/day

Renal Dose Adjustments

No data available

Liver Dose Adjustments

Caution and monitoring are advised in patients with severe hepatic insufficiency.

Precautions

Atovaquone treatment failures, due to decreased absorption and inadequate serum levels, have occurred when patients take the drug on an empty stomach. If the patient cannot take atovaquone with meals, it is suggested that alternate treatment be initiated if possible. For similar reasons, atovaquone should be avoided in patients with diarrhea or malabsorption syndrome.

The efficacy of atovaquone has not been established in patients with severe Pneumocystis pneumonia or in patients who are not responding to sulfamethoxazole-trimethoprim therapy.

Rarely, hepatitis, elevated liver function tests, and at least one case of fatal liver failure have been reported with the use of atovaquone. However, causality could not be established due to many confounding medical conditions and concurrent drug treatments.

Caution and monitoring is advised in patients with severe hepatic impairment.

Safety and efficacy have not been established in pediatric patients.

Dialysis

No data available

Other Comments

Atovaquone should be administered with food or a high-fat meal.