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(a-toe-va-kwone) ,


(trade name)


Therapeutic: anti infectives
Pregnancy Category: C


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.

Therapeutic effects

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)

POunknown1–8 hr; 24–96 hr†12 hr
†Two peaks are due to enterohepatic recycling.


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 interaction

May 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).
Oral (Adults and Adolescents 13–16 yr) 1500 mg once daily.


Suspension: 750 mg/5 mL
In combination with: proguanil (Malarone). See combination drugs.

Nursing implications

Nursing assessment

  • 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 Diagnoses

Risk 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.

Patient/Family Teaching

  • 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.

Evaluation/Desired Outcomes

  • Resolution of the signs and symptoms of infection.


A trademark for the drug atovaquone.


An antiprotozoal agent used to treat and prevent Pneumocystis jiroveci (carinii) in patients who are allergic to trimethoprim-sulfamethoxazole.


Atovaquone Infectious disease An antiprotozoal agent used to treat and prevent PCP in Pts who are allergic to trimethoprim-sulfamethoxazole. See AIDS, Pneumocystis carinii pneumonia.
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The Unites States is our most important sales market for Mepron," explains Dr.
In contrast, the use of Mepron in dairy cow rations allows the amount of crude protein in feeds to be reduced, with no loss of output.
The new plant for Mepron will give us a direct presence in the important US dairy cow market," says Dr.
Get them through four months of cipro treatment or six months of Mepron and zithro treatment.
Adding Mepron to a dairy cow ration allows the crude protein content in the diet to be reduced without any loss in performance," explains Dr.
If my patients have both Babesia and Borrelia infections, and their medications are covered by insurance, after starting them on a cyst-busting drug, I may add Zithromax (azithromycin) to their protocol, with the idea of adding Mepron (atovaquone) a few weeks later.
Mepron (atovaquone), one of the primary Babesia medications, costs over $1000 per month, and Malarone (atovaquone plus proguanil) isn't much cheaper.
Or if patients have Babesia, then Zithromax combines well with Mepron (which is used for treating Babesia).
For Babesia, Mepron, macrolides, Plaquenil, Artemisinin, or Bactrim may be helpful.
Babesia usually responds to treatment with a macrolide, Mepron, and artemisinin.
The most common treatment for Babesia is 750 mg/teaspoon of Mepron taken twice a day.
A patient is given at least two Babesia-killing medications such as Mepron, artesunate at a high useful dose, or Malarone (for the proguanil).