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Pregnancy Category: C
ClassificationTherapeutic: anti infectives
Treatment of mild to moderate Pneumocystis jirovecii pneumonia (PJP) in patients who are unable to tolerate trimethoprim/sulfamethoxazole.Prophylaxis of PJP.
Inhibits the action of enzymes necessary to nucleic acid and ATP synthesis.
Active against P. jirovecii.
Absorption: Absorption is poor but is increased by food, particularly fat.
Distribution: Enters CSF in very low concentrations (<1% of plasma levels).
Protein Binding: >99.9%.
Metabolism and Excretion: Undergoes enterohepatic recycling; elimination occurs in feces.
Half-life: 2.2–2.9 days.
Time/action profile (blood levels)
|PO||unknown||1–8 hr; 24–96 hr†||12 hr|
Contraindicated in: Hypersensitivity; Lactation: May appear in breast milk.
Use Cautiously in: ↓ hepatic, renal, or cardiac function (dose modification may be necessary);GI disorders (absorption may be limited); Obstetric: Safety not established; Pediatric: Safety not established.
Adverse Reactions/Side Effects
Central nervous system
- headache (most frequent)
- insomnia (most frequent)
- cough (most frequent)
- diarrhea (most frequent)
- nausea (most frequent)
- vomiting (most frequent)
- rash (most frequent)
- fever (most frequent)
Drug-Drug interactionMay interact with drugs that are highly bound to plasma proteins (does not appear to interact with phenytoin).Food ↑ absorption.
Oral (Adults) 750 mg twice daily for 21 days.
Oral (Children) 40 mg/kg/day (unlabeled).Prevention
Oral (Adults and Adolescents 13–16 yr) 1500 mg once daily.
Suspension: 750 mg/5 mLIn combination with: proguanil (Malarone). See combination drugs.
- Assess patient for signs of infection (vital signs, lung sounds, sputum, WBCs) at beginning of and throughout therapy.
- Obtain specimens prior to initiating therapy. First dose may be given before receiving results.
- Lab Test Considerations: Monitor hematologic and hepatic functions. May cause mild, transient anemia and neutropenia. May also cause ↑ serum amylase, AST, ALT, and alkaline phosphatase.
- Monitor electrolytes. May cause hyponatremia.
Potential Nursing DiagnosesRisk for infection (Indications, Side Effects)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)
- Oral: Administer with food twice daily for 21 days for treatment and once daily for prevention.
- Instruct patient to take atovaquone exactly as directed around the clock for the full course of therapy, even if feeling better. Emphasize the importance of taking atovaquone with food, especially foods high in fat; taking without food may decrease plasma concentrations and effectiveness.
- Advise patient to notify health care professional if rash occurs.
- Resolution of the signs and symptoms of infection.
A trademark for the drug atovaquone.