Drug reference

Proguanil hydrochloride

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 676, 677

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Prophylaxis of malaria ▶BY MOUTH ▶Child 4–11 weeks (body-weight up to 6 kg): 25 mg once daily, dose to be started 1 week before entering endemic area and continued for 4 weeks after leaving ▶Child 3–11 months (body-weight 6–9 kg): 50 mg once daily, dose to be started 1 week before entering endemic area and continued for 4 weeks after leaving ▶Child 1–3 years (body-weight 10–15 kg): 75 mg once daily, dose to be started 1 week before entering endemic area and continued for 4 weeks after leaving ▶Child 4–7 years (body-weight 16–24 kg): 100 mg once daily, dose to be started 1 week before entering endemic area and continued for 4 weeks after leaving ▶Child 8–12 years (body-weight 25–44 kg): 150 mg once daily, dose to be started 1 week before entering endemic area and continued for 4 weeks after leaving ▶Child 13–17 years (body-weight 45 kg and above): 200 mg once daily, dose to be started 1 week before entering endemic area and continued for 4 weeks after leaving ▶Adult: 200 mg once daily, dose to be started 1 week before entering endemic area and continued for 4 weeks after leaving l UNLICENSED USE Proguanil doses in BNF Publications may differ from those in product literature.

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National Funding Access Decisions

NHS restrictions Drugs for malaria prophylaxis are not prescribable in NHS primary care; health authorities may investigate circumstances under which antimalarials are prescribed.

PDF page 677

Exceptions To Legal Category

Can be sold to the public provided it is licensed and labelled for the prophylaxis of malaria.

PDF page 677

Safety

Interactions

→Appendix 1: antimalarials

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Side Effects

Alopecia. angioedema. bone marrow disorders. cholestasis. constipation. diarrhoea. fever. gastric disorder. megaloblastic anaemia. oral disorders. skin reactions. vasculitis

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Pregnancy

Beneﬁt of prophylaxis in malaria outweighs risk. Adequate folate supplements should be given to mother.

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Breast Feeding

Amount in milk probably too small to be harmful when used for malaria prophylaxis.

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Renal Impairment

Dose adjustments ▶In children Use half normal dose if estimated glomerular ﬁltration rate 20–60 mL/minute/1.73m2. Use one-quarter normal dose on alternate days if estimated glomerular ﬁltration rate 10–20 mL/minute/1.73m2. Use one-quarter normal dose once weekly if estimated glomerular ﬁltration rate less than 10 mL/minute/1.73m2; increased risk of haematological toxicity in severe impairment. ▶In adults 100 mg once daily if eGFR 20–60 mL/minute/1.73m2. 50 mg on alternate days if eGFR 10–20 mL/minute/1.73m2. 50 mg once weekly if eGFR less than 10 mL/minute/1.73m2; increased risk of haematological toxicity in severe impairment.

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Dose and formulations

Directions For Administration

Tablet may be crushed and mixed with food such as milk, jam, or honey just before administration.

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Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Tablet CAUTIONARY AND ADVISORY LABELS 21 ▶Paludrine (Alliance Pharmaceuticals Ltd) Proguanil hydrochloride 100 mg Paludrine 100mg tablets | 98 tablet p £11.95 DT = £11.95

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Clinical care

Patient And Carer Advice

Warn travellers about importance of avoiding mosquito bites, importance of taking prophylaxis regularly, and importance of immediate visit to doctor if ill within 1 year and especially within 3 months of return.

PDF pages 676, 677

Dose text by age group

Child 4–11 weeks (body-weight up to 6 kg)

25 mg once

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Child 3–11 months (body-weight 6–9 kg)

50 mg once daily,

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Child 1–3 years (body-weight 10–15 kg)

75 mg once daily,

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Child 4–7 years (body-weight 16–24 kg)

100 mg once

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Child 8–12 years (body-weight 25–44 kg)

150 mg once

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Child 13–17 years (body-weight 45 kg and above)

200 mg

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Adult

200 mg once daily, dose to be started 1 week

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Proguanil hydrochloride

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 676, 677

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 676

National Funding Access Decisions

NHS restrictions Drugs for malaria prophylaxis are not prescribable in NHS primary care; health authorities may investigate circumstances under which antimalarials are prescribed.

PDF page 677

Exceptions To Legal Category

Can be sold to the public provided it is licensed and labelled for the prophylaxis of malaria.

PDF page 677

Safety

Interactions

→Appendix 1: antimalarials

PDF page 676

Side Effects

Alopecia. angioedema. bone marrow disorders. cholestasis. constipation. diarrhoea. fever. gastric disorder. megaloblastic anaemia. oral disorders. skin reactions. vasculitis

PDF page 676

Pregnancy

Beneﬁt of prophylaxis in malaria outweighs risk. Adequate folate supplements should be given to mother.

PDF page 676

Breast Feeding

Amount in milk probably too small to be harmful when used for malaria prophylaxis.

PDF page 676

Renal Impairment

PDF page 676

Dose and formulations

Directions For Administration

Tablet may be crushed and mixed with food such as milk, jam, or honey just before administration.

PDF page 676

Medicinal Forms

PDF page 677

Clinical care

Patient And Carer Advice

PDF pages 676, 677

Dose text by age group

Child 4–11 weeks (body-weight up to 6 kg)

25 mg once

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Child 3–11 months (body-weight 6–9 kg)

50 mg once daily,

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Child 1–3 years (body-weight 10–15 kg)

75 mg once daily,

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Child 4–7 years (body-weight 16–24 kg)

100 mg once

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Child 8–12 years (body-weight 25–44 kg)

150 mg once

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Child 13–17 years (body-weight 45 kg and above)

200 mg

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Adult

200 mg once daily, dose to be started 1 week

First-line fragment. Read the complete Indications and Dose section above.

PDF page 676

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.