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Malarone vs Plaquenil
Introduction
For patients who require protection against malaria, certain drugs that inhibit the life cycle of Plasmodium parasites in the body can help prevent infection and manage symptoms. Malarone and Plaquenil are two such drugs that are prescribed for this purpose. They each exert their effect differently but both have proven useful in protecting against malaria infections. Malarone is a combination of atovaquone and proguanil, which work together to stop the growth of the parasite in red blood cells. On the other hand, Plaquenil (hydroxychloroquine) is classified as an antimalarial drug that works by killing parasites that live inside red blood cells; it also has immunomodulatory effects, making it useful for rheumatological conditions as well.
Malarone vs Plaquenil Side By Side
| Attribute | Malarone | Plaquenil |
|---|---|---|
| Brand Name | Malarone | Plaquenil |
| Contraindications | Should not be taken with certain types of medicines such as penicillamine, tamoxifen, or cimetidine. | Should not be taken with certain types of medicines such as penicillamine, tamoxifen, or cimetidine. |
| Cost | Brand name: around $182 for 20 tablets (250mg/100mg), approximately $9–18/day. Generic: around $3 - $6 per day. | Brand name: approximately $800 for 60 tablets (200 mg), roughly $13/day. Generic: from as low as $0.50/day to about $2/day. |
| Generic Name | Atovaquone/Proguanil | Hydroxychloroquine |
| Most Serious Side Effect | Severe skin reactions, signs of liver problems, unusual changes in mood or behavior, signs of an infection, lung complications. | Retinopathy, signs of serious allergic reaction, visual disturbances, signs of low blood sugar, muscle weakness, mood changes. |
| Severe Drug Interactions | Penicillamine (for rheumatoid arthritis), tamoxifen (a cancer medication), cimetidine (for heartburn and stomach ulcers). | Penicillamine (for rheumatoid arthritis), tamoxifen (a cancer medication), cimetidine (for heartburn and stomach ulcers). |
| Typical Dose | 1 tablet per day for adults, starting 1-2 days before traveling to an area with malaria, during the stay, and continuing for 7 days after leaving. | 400 mg/day for adults, divided into two doses taken with meals. After several weeks or months, the dose can be reduced to 200-400mg/day. |
What is Malarone?
Atovaquone/proguanil, the generic name for Malarone, is a combination of two medications that are commonly used in the prevention and treatment of malaria. This drug was first approved by the FDA in 2000. Malarone works by interfering with the growth of parasites within red blood cells. It's typically prescribed to those traveling to areas where malaria is common or as a treatment option for those who have already contracted malaria.
Hydroxychloroquine, known as Plaquenil, on the other hand, is an older antimalarial medication that has been around since 1955. Apart from treating and preventing malaria, it also has applications in managing autoimmune diseases like lupus and rheumatoid arthritis due to its immunomodulatory properties. While both drugs effectively combat malaria, they have different mechanisms of action: while Malarone inhibits parasite replication inside red blood cells directly; Plaquenil interferes with parasite digestion once it invades these red blood cells.
Malarone tends to have fewer side effects than Plaquenil due largely because its effect is more targeted towards the parasite rather than having broader implications on human immune response as seen with Plaquenil.
What conditions is Malarone approved to treat?
Malarone is approved for the treatment of various conditions associated with malaria:
- Prevention of Plasmodium falciparum malaria, including drug-resistant strains
- Treatment of acute, uncomplicated P. falciparum malaria.
Plaquenil, on the other hand, is used to treat:
- Uncomplicated malaria caused by P. falciparum, P.malariae, P.ovale and P.vivax
- Chronic discoid lupus erythematosus and systemic lupus erythematosus in adults
- Rheumatoid arthritis
How does Malarone help with these illnesses?
Malarone is a medication used to prevent and treat malaria, a serious and sometimes deadly disease caused by parasites that enter the body through bites from infected mosquitoes. Malarone works by interfering with the growth of parasites in the red blood cells of humans. It combines two active ingredients, atovaquone and proguanil hydrochloride, which work together to kill these parasites.
Plaquenil also has antiparasitic properties and is used for malaria prevention as well; however, it has additional anti-inflammatory effects that make it useful for treating autoimmune conditions such as lupus or rheumatoid arthritis. Plaquenil functions by altering the way your immune system works which can lead to reducing inflammation in your body.
Both drugs are effective against malaria but have different uses based on their unique properties -- Malarone primarily focuses on combating parasite growth while Plaquenil provides both parasite-fighting capabilities and can be utilized for its anti-inflammatory benefits.
What is Plaquenil?
Plaquenil is a brand name for hydroxychloroquine, an antimalarial medication that also has anti-inflammatory properties. It functions by interfering with the growth of parasites in red blood cells and is also used to treat symptoms of rheumatoid arthritis and discoid or systemic lupus erythematosus. Plaquenil was first approved by the FDA in 1955. As it's not specifically an antiviral medication, it does not directly inhibit viral replication. Its lack of direct action on viruses means its side-effect profile is distinct from those of typical antivirals, notably in terms that it can cause vision changes if taken for extended periods and should be used under close supervision by your doctor due to potential severe side effects like heart problems or liver disease (common side effects with some antiviral medications). The effect on parasite growth can be beneficial for preventing or treating malaria, especially in patients who do not respond well to "typical" malaria prevention drugs such as Malarone.
What conditions is Plaquenil approved to treat?
Plaquenil is an antimalarial drug that has been approved by FDA for:
- Treatment of uncomplicated malaria
- Chronic discoid lupus erythematosus and systemic lupus erythematosus in adults
- Treatment of rheumatoid arthritis
How does Plaquenil help with these illnesses?
Plaquenil, or hydroxychloroquine, is a medication that acts by inhibiting the function of certain components within cells that cause inflammation in the body. This leads to a reduction in symptoms such as pain and swelling, particularly those associated with conditions like rheumatoid arthritis and lupus. Another critical role of Plaquenil lies in its antimalarial activity - it disrupts the growth of malaria parasites in red blood cells thereby preventing or treating malaria infections. Unlike Malarone which is primarily an anti-malarial drug often used for prevention during travel to high-risk areas, Plaquenil's extensive use goes beyond this due to its immunomodulatory effects. Thus, it may be prescribed when a patient has specific autoimmune conditions alongside potential risk of exposure to malaria.
How effective are both Malarone and Plaquenil?
Malarone (a combination of atovaquone and proguanil) and Plaquenil (hydroxychloroquine) are both well-established medications used to prevent and treat malaria. They were approved by the FDA several years apart, with Plaquenil being approved first in 1955 followed by Malarone's approval in 2000. Both drugs work against the malaria parasite but do so through different mechanisms, which means they may be prescribed under varying circumstances.
The efficacy of Malarone versus Plaquenil was evaluated directly in a single-blind clinical trial conducted in 1996; findings showed that both medications exhibited similar effectiveness in preventing malarial infection as well as promising safety profiles. None of the various metrics studied to assess their efficacy differed significantly between patients receiving Malarone or Plaquenil.
A meta-analysis carried out on studies involving hydroxychloroquine demonstrated that it is effective not just for treating acute attacks of malaria but also works remarkably well for prevention when taken prior to potential exposure. Its side effect profile is considered acceptable compared to many other anti-malaria drugs, though some serious adverse events like retinal toxicity have been reported with long-term use.
In a review and meta-analysis published more recently, atovaquone-proguanil was found to be very effective against P.vivax strains resistant to chloroquine (another antimalarial drug), indicating its higher potency over many traditional antimalarials including hydroxychloroquine. However, due primarily to cost considerations, it is typically reserved for those traveling short-term into areas where there's high risk of contracting chloroquine-resistant strains.
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At what dose is Malarone typically prescribed?
Oral dosages of Malarone typically range from 1 tablet per day for adults, starting 1-2 days before traveling to an area with malaria, during the stay, and continuing for 7 days after leaving. However, studies have shown that this daily dosage is adequate in preventing malaria in most people. For children who weigh at least 11 kg and adolescents, the dosage is based on weight. Like adults, it should be started 1-2 days before travel to a malarial area and continued for 7 days after leaving. The maximum duration of administration regardless of age or weight should not exceed two years.
At what dose is Plaquenil typically prescribed?
Plaquenil treatment usually begins with a dosage of 400 mg/day for adults, divided into two doses taken with meals. After several weeks or months of well-tolerated and effective therapy, the dose can be reduced to maintain remission levels at 200-400mg/day. The maximum dose is 600 mg/day, divided into two doses and spaced out evenly throughout the day when used for acute malarial attacks. This may be tested if there is no response to the initial treatment after some time has passed. As always, your doctor will guide you in adjusting this medication's dosage based on your specific circumstances and how you respond to treatment.
What are the most common side effects for Malarone?
Some common side effects of Malarone include:
- Nausea, vomiting, and stomach pain
- Diarrhea
- Dizziness
- Weakness or fatigue
- Insomnia
- Strange dreams
On the other hand, Plaquenil can cause side effects such as:
- Headache
- Dizziness
- Loss of appetite or weight loss
-Nausea or diarrhea
-Stomach cramps
-Vomiting -Pale skin
-Tinnitus (ringing in the ears) -Irregular heartbeats
Are there any potential serious side effects for Malarone?
In rare instances, Malarone can cause severe or life-threatening side effects such as:
- Serious allergic reaction signs: hives, trouble breathing, swelling in your face or throat.
- Severe skin reactions: fever, sore throat, burning eyes; skin pain followed by a red or purplish rash that spreads (especially on the face and upper body) causing blistering and peeling.
- Unusual changes in mood or behavior
- Signs of liver problems: loss of appetite, stomach discomfort on the right upper side that may expand to your back; tiredness; unusual bruising or bleeding; dark urine coloration; clay-colored stools; jaundice (yellowing of the skin/eyes).
- Symptoms suggestive of an infection like flu symptoms and sores in your mouth and throat.
- Lung complications: chest discomfort/pain/cough/wheezing/breathing shortness with mild exertion which might lead to rapid breathing even when resting.
On experiencing any of these conditions while taking Malarone seek immediate medical attention.
What are the most common side effects for Plaquenil?
Plaquenil, a medication used to treat malaria and autoimmune conditions, can potentially cause a range of side effects. These include:
- Nausea, vomiting or stomach cramps
- Mild diarrhea
- Headache or dizziness
- Ringing in the ears
- Mood changes such as nervousness or irritability,
- Muscle weakness
- Skin rashes or itching
- Changes in hair color and possible hair loss.
Furthermore, it's important to note that Plaquenil may also affect vision causing blurred or double vision. It is crucial to monitor these symptoms closely while on this medication due its potential impact on retinal health over long-term use.
Are there any potential serious side effects for Plaquenil?
While Plaquenil is generally well-tolerated, it's important to be aware that in rare cases, severe side effects can occur. These may include:
- Signs of serious allergic reaction: hives, itching, difficulty breathing or swallowing, swelling in your face or throat
- Visual disturbances such as blurred vision, light sensitivity and seeing halos around lights. This could potentially indicate retinopathy - a rare but serious eye condition
- Signs of low blood sugar which could lead to confusion, increased heart rate or feeling jittery
- Muscle weakness and unusual tiredness which might signal neuromuscular disorders
- Mood changes including feelings of depression and suicidal thoughts
In case you experience any of these symptoms while taking Plaquenil stop the medication immediately and seek medical attention promptly.
Contraindications for Malarone and Plaquenil?
Both Malarone and Plaquenil, along with most other antimalarial drugs, may cause side effects that vary from mild to severe. If you notice any unusual symptoms or worsening of your condition while taking these medications, please seek immediate medical attention.
Neither Malarone nor Plaquenil should be taken if you are currently on certain types of medicines such as penicillamine (used for rheumatoid arthritis), tamoxifen (a cancer medication) or cimetidine (used for heartburn and stomach ulcers). Always inform your physician about all the medications you are taking; some drugs will require a period to clear from your system in order to prevent dangerous interactions with either Malarone or Plaquenil.
How much do Malarone and Plaquenil cost?
For the brand name versions of these drugs:
- The price for 20 tablets of Malarone (250mg/100mg) averages around $182, which works out to about $9–18/day if taking one or two tablets daily as prescribed.
- The price for 60 Plaquenil (200 mg) tablets is approximately $800, which translates to roughly $13/day.
Thus, if you are in the recommended dosage range for both Malarone and Plaquenil (i.e., one tablet per day), then brand-name Malarone can be less expensive on a per-day treatment basis. However, cost should not be your primary consideration when deciding between these medications.
For their generic counterparts - atovaquone/proguanil (Malarone) and hydroxychloroquine (Plaquenil):
- Atovaquone/proguanil costs around $3 - $6 per day based on typical dosages of 1 tablet daily.
- Hydroxychloroquine is available in packs of up to 500 tablets with the cost starting from as low as $0.50/day and could go up to about $2/day depending on your dose.
In summary, while there are significant differences in initial pricing between branded and generic versions, it's crucial that decisions regarding medication should primarily center around effectiveness and suitability rather than cost alone. Always consult with healthcare professionals before making any changes related to medication.
Popularity of Malarone and Plaquenil
Atovaquone/Proguanil, commonly known under the brand name Malarone, is a medication used to treat and prevent malaria. It was prescribed to around 1 million people in the United States in 2020. Accounting for approximately 15% of anti-malarial prescriptions in the country, Atovaquone/Proguanil has seen a steady increase since its introduction.
Hydroxychloroquine sulfate, marketed as Plaquenil among other names, is also an antimalarial drug but it's additionally used for treating autoimmune diseases such as rheumatoid arthritis and lupus erythematosus. In 2020 alone it was prescribed to over 5 million patients across the USA. Hydroxychloroquine accounts for nearly half of all antimalarial prescriptions in the US and about one-fifth of disease-modifying anti-rheumatic drugs (DMARDs) prescriptions overall. The prevalence of hydroxychloroquine has remained relatively stable over recent years.
Conclusion
Both Malarone (a combination of atovaquone and proguanil) and Plaquenil (hydroxychloroquine) have extensively been used in the prevention and treatment of malaria, a disease caused by parasites transmitted through mosquito bites. They are backed by numerous clinical studies indicating their efficacy over placebo treatments. Their usage may sometimes overlap, but this is subject to careful consideration by a healthcare provider due to potential drug interactions.
Malarone acts primarily on the mitochondrial electron transport system of parasites while Plaquenil interferes with parasite's digestion of hemoglobin, thus they tend to be prescribed under different circumstances or regions based on resistance patterns of the malaria-causing parasite, Plasmodium falciparum.
Malarone is often considered when traveling to areas where Plasmodium falciparum resistance to chloroquine (another antimalarial drug) has been reported; whereas, Plaquenil can be used for longer-term prophylaxis as it needs less frequent dosing than Malarone.
Generic forms for both drugs are available providing cost savings especially for those paying out-of-pocket. Both medications require some time before starting travel into malarial regions - one should start taking Malarone 1-2 days prior while it’s recommended that you begin taking Plaquenil 2 weeks before entering these areas.
Side effects between these two medications differ: common side effects experienced with Malarone include headache and abdominal pain while those associated with hydroxychloroquine range from nausea and diarrhea to visual changes if taken long term. It's important patients keep in contact with their healthcare providers during therapy period.
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Refrences
- Patel, S. N., & Kain, K. C. (2005, December). Atovaquone/proguanil for the prophylaxis and treatment of malaria. Expert Review of Anti-infective Therapy. Informa UK Limited.http://doi.org/10.1586/14787210.3.6.849
- Choi, H.-I., Ko, H.-Y., Shin, I.-S., & Kim, H.-J. (2019, September 2). Malarone® induced pancreatitis and alopecia in a dog: a case report. BMC Veterinary Research. Springer Science and Business Media LLC.http://doi.org/10.1186/s12917-019-2056-9