A Potential Interaction between Warfarin and Atovaquone

Hidalgo, Kathleen; Lyles, Adraine; Dean, S.

doi:10.1345/aph.1p491

Cited by 10 publications

(3 citation statements)

References 4 publications

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“…A case study was recently published that describes a potential interaction between the anticoagulant drug warfarin and atovaquone, where the author suggests that atovaquone caused an increase in free warfarin concentrations to super-therapeutic levels. 68 A separate investigation found that atovaquone did not alter the pharmacokinetics of the antiepileptic drug phenytoin, another highly protein-bound drug, which is susceptible to displacement interactions. 69 The evidence that atovaquone can compete with other drugs for plasma protein binding is lacking, although further investigations are required to fully understand this potential factor in atovaquone pharmacokinetics.…”

Section: Pharmacodynamicsmentioning

confidence: 99%

Antimalarial pharmacology and therapeutics of atovaquone

Nixon

Moss

Shone

et al. 2013

Journal of Antimicrobial Chemotherapy

166

141

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Atovaquone is used as a fixed-dose combination with proguanil (Malarone) for treating children and adults with uncomplicated malaria or as chemoprophylaxis for preventing malaria in travellers. Indeed, in the USA, between 2009 and 2011, Malarone prescriptions accounted for 70% of all antimalarial pre-travel prescriptions. In 2013 the patent for Malarone will expire, potentially resulting in a wave of low-cost generics. Furthermore, the malaria scientific community has a number of antimalarial quinolones with a related pharmacophore to atovaquone at various stages of pre-clinical development. With this in mind, it is timely here to review the current knowledge of atovaquone, with the purpose of aiding the decision making of clinicians and drug developers involved in the future use of atovaquone generics or atovaquone derivatives.

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Section: Pharmacodynamicsmentioning

confidence: 99%

Antimalarial pharmacology and therapeutics of atovaquone

Nixon

Moss

Shone

et al. 2013

Journal of Antimicrobial Chemotherapy

166

141

View full text Add to dashboard Cite

show abstract

“…Aspirin, when combined with warfarin can increase the free fraction of warfarin, thereby predisposing to higher risk of prolonged bleeding (Chan, 1995;Harder and Thürmann, 1996;Zhou et al, 2012). The antimalarial drug, atovaquone has been shown to interact with warfarin probably through the displacement from binding sites (Hidalgo et al, 2011).…”

Section: Changes In Drug Distributionmentioning

confidence: 99%

Drug-drug interactions in ageing HIV-infected individuals

Fasinu¹

2012

Afr. J. Pharm. Pharmacol.

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The effectiveness of antiretroviral therapy has significantly improved life expectancy of HIV-infected individuals. Global campaigns and awareness programmes have led to substantial drop in the rate of new infections. Consequently, the proportion of ageing HIV-infected individuals continues to increase. HIV-associated and age-related comorbidity necessitates polypharmacy in ageing individuals living with HIV/AIDS. The risk of drug-drug interaction increases with the number of administered drugs. Agerelated changes in the body physiology are known to influence pharmacokinetic and pharmacodynamic profile of administered drugs. These changes include reduction in blood flow to major organs, decline in metabolic activities, body mass shrinking and changes in body water and fat proportion. These factors contribute to the perceived and reported higher incidence of drug-drug interaction in this population. The current paper reviews the reported incidence of drug-drug interactions in ageing HIVinfected individuals, providing relative mechanisms and possible factors responsible in comparison to younger population. Health professionals should be aware of the drug interaction risks involved in the management of HIV/AIDS in the ageing population; be able to anticipate them based on concomitant medications and manage them as necessary.

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“…Atovaquone/proguanil may diminish warfarin metabolism. Coagulation parameters must be monitored closely if these drugs used together, and warfarin dosing may need to be reduced (Hidalgo et al, 2011), 2-Antiarrhythmic agents should be used with caution in setting of mefloquine given associated with sinus bradycardia and QT interval prolongation, & 3-Immunosuppressive medications as chloroquine may increase cyclosporine levels, and both doxycycline and mefloquine may increase cyclosporine and tacrolimus levels, Atovaquone-proguanil didn't have known interactions with these medications (Kotton et al, 2005). Now what about Egypt?…”

Section: Introductionmentioning

confidence: 99%

Epidemic Malaria: Is It Threatening to Egypt With the Travelers and Immigrants Through the Southern Borders

MORSY,

EL BAHNASAWY,

DAHESH

et al. 2023

Journal of the Egyptian Society of Parasitology

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Malaria is a serious and sometimes fatal disease caused by Plasmodium species that infects Anopheles mosquito which feeds on humans. But, as malaria parasites live in the RBC, infection also occur by blood transfusion, organ transplantation, shared contaminated needles or stickinjury, and placental transmission with perinatal outcomes such as stillbirth, low birth weight, preterm birth, and small-for-gestational-age neonates. Malaria patients are typically very sick with high fevers, shaking chills, and flu-like illness; but these symptoms may be mild and difficult to diagnose malaria. The severe infection may cause kidney failure, seizures, mental confusion, coma, and death. Man is infected by P. falciparum, P. vivax, P. ovale subspecies, P. malariae, & P. knowlesi, with P. falciparum results in severe infections, which may be miss-diagnosed with zoonotic babesiosis. Although malaria can be a deadly disease, illness and death from malaria can usually be prevented.Nowadays, migrants from endemic countries constitute a high proportion of imported malaria cases in non-endemic countries

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A Potential Interaction between Warfarin and Atovaquone

Cited by 10 publications

References 4 publications

Antimalarial pharmacology and therapeutics of atovaquone

Antimalarial pharmacology and therapeutics of atovaquone

Drug-drug interactions in ageing HIV-infected individuals

Epidemic Malaria: Is It Threatening to Egypt With the Travelers and Immigrants Through the Southern Borders

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