• Prevention and treatment of malaria, especially Plasmodium falciparum.
  • Often combined with atovaquone (e.g., in Malarone) or chloroquine for improved efficacy and resistance management.

Malaria Prophylaxis (Prevention):

  • Adults: 200 mg once daily.
  • Children: Dosage depends on body weight (consult pediatric dosing guidelines).
  • Start 1–2 days before travel to endemic area, continue daily during stay, and for 7 days after leaving.
  • Malaria Treatment (with Atovaquone):
  • Adult dose (in combination): 250 mg atovaquone + 100 mg proguanil, four tablets once daily for 3 days.
  • Proguanil 100 mg and 200 mg tablets.
  • Malarone (combination):
  • Adult: 250 mg atovaquone + 100 mg proguanil
  • Pediatric: 62.5 mg atovaquone + 25 mg proguanil
  • Take with food or a milky drink to improve absorption.
  • Take at the same time each day.
  • Do not skip doses—maintaining blood levels is key for efficacy.
  • Class: Antifolate antimalarial (biguanide class)
  • Mechanism: Proguanil is a prodrug, converted in the liver to cycloguanil, which inhibits dihydrofolate reductase in parasites, blocking DNA synthesis and replication.
  • Half-life: ~12–21 hours
  • Excretion: Primarily via kidneys

Common:

  • Nausea
  • Vomiting
  • Abdominal pain
  • Diarrhea
  • Headache
  • Mouth ulcers

Rare/severe:

  • Hair loss (reversible)
  • Allergic reactions (rash, itching, swelling)
  • Hypersensitivity to proguanil or any component of the formulation
  • Severe renal impairment (especially when CrCl <30 mL/min)
  • Not recommended in children <5 kg (when in combination with atovaquone)
  • Warfarin and other anticoagulants – may enhance effects; monitor INR.
  • Metoclopramide – may reduce atovaquone absorption when combined.
  • Rifampicin and tetracyclines – may decrease effectiveness of combination therapy.
  • Live vaccines – effectiveness might be reduced.

                                   Drug Status

Availability
Pregnancy
Breastfeeding
Schedule
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Proguanil 100mg Tablet 56’s Cosmos Ltd Cosmos Ltd