Dosage of Malanil 250mg/100mg

• For Prophylaxis (Prevention) in Adults (Weight > 40 kg): The adult dose is one tablet (250 mg Atovaquone/100 mg Proguanil) daily. Treatment should start 1-2 days before entering the endemic area, continue daily during the stay, and for 7 full days after leaving.
• For Treatment (Uncomplicated Malaria) in Adults (Weight > 40 kg): The adult dose is four tablets (1000 mg Atovaquone/400 mg Proguanil) taken once daily for three consecutive days.
• Children: Dosage is based on body weight and is typically managed using Malanil Paediatric tablets (62.5 mg/25 mg). Consult a physician for the correct pediatric dosage.

Proper Administration

• Administration: Swallow the tablets whole. They may be crushed and mixed with condensed milk just prior to administration if the patient has difficulty swallowing.
• Best Time to Take It: Take the tablet(s) at the same time each day and always with food or a milky drink to ensure optimal absorption.
• Repeat Vomited Dose: If the dose is vomited within 1 hour of taking it, an entire repeat dose should be taken immediately.

Contraindications of Malanil 250mg/100mg

Do NOT take Malanil if you:

• Drug Allergies: Are allergic to Atovaquone, Proguanil hydrochloride, or any component of the tablet formulation.
• Severe Renal Impairment: Malanil is contraindicated for malaria prophylaxis in patients with severe kidney disease (creatinine clearance $<30\text{ mL/min}$) due to the proguanil component. Use for treatment in this group requires caution and close monitoring.
• Pregnancy & Breastfeeding: Should be avoided in the first trimester. Consult a doctor, as the drug is categorized as Pregnancy Category C. It is not recommended for breastfeeding mothers, as proguanil passes into breast milk.

Side Effects of Malanil

Side effects are generally mild and transient.

• Very Common/Common Side Effects (Mild and Expected): Abdominal pain, nausea, vomiting, diarrhea, headache, dizziness, insomnia (trouble sleeping), loss of appetite, and cough.
• Serious but Rare Side Effects:
  • Severe Allergic Reactions: Hives, swelling of the face, lips, tongue, or throat, or difficulty breathing (anaphylaxis, angioedema).
  • Severe Skin Reactions: Rash, peeling or blistering skin (Stevens-Johnson syndrome).
  • Liver Problems: Yellow eyes or skin (jaundice), dark urine, and pain in the upper right stomach area.
• What to do if side effects occur: If you observe any signs of a serious allergic reaction or liver damage, stop taking the medication and seek immediate medical attention. For common side effects, consult your pharmacist or physician.

Precautions and Warnings of Malanil

• Before Starting Malanil: Inform your doctor if you have kidney or liver disease, as dosage adjustments or alternative therapies may be necessary. Also, disclose any history of uncontrolled vomiting or diarrhea, as this can reduce drug absorption.
• During Use: Be cautious if taking warfarin or other coumarin-based anticoagulants, as proguanil can potentiate their effect; coagulation tests must be monitored closely. If you develop diarrhea or vomiting, continue taking the dose, but be sure to monitor the situation and consider seeking alternative therapy if severe.
• Exposure to Sunlight: Malanil may cause increased sensitivity to sunlight (photosensitivity). Use sun protection (protective clothing, sunscreen).
• Relapse: Taking Malanil for treatment does not always guarantee a radical cure for P. vivax malaria; follow-up treatment may be needed.

Pack Size: Malanil 250mg/100mg is typically supplied in blister packs. The standard treatment course for adults is 12 tablets (4 tablets daily for 3 days). Prophylaxis packs vary in size depending on the expected length of travel.