Comprehensive medication guide to Malarone including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$10–$60 copay for generic atovaquone/proguanil on most commercial plans (Tier 2–3); Medicare Part D generally covers it with standard cost-sharing. Some plans specifically exclude travel prophylaxis — verify your plan's formulary. Medicaid coverage varies by state.
Estimated Cash Pricing
$167–$245 retail for generic atovaquone/proguanil (30 tablets, 250 mg/100 mg); as low as $43–$50 with GoodRx or SingleCare coupons. Brand Malarone runs $261–$272 retail. Costco, Walmart, and independent pharmacies typically offer the lowest cash prices.
Medfinder Findability Score
75/100
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Malarone is the brand name for atovaquone/proguanil, a combination antimalarial medication manufactured by GlaxoSmithKline (GSK). It was approved by the FDA in 2000 and is one of the most widely recommended antimalarials for travelers. Generic atovaquone/proguanil has been available in the US since approximately 2011 and is FDA-approved as bioequivalent to the brand-name product.
Malarone comes in two tablet strengths: the adult tablet (250 mg atovaquone / 100 mg proguanil hydrochloride) and the pediatric tablet (62.5 mg / 25 mg). Both are pink, film-coated, round tablets. Malarone must be taken with food or a milky drink for adequate absorption — atovaquone bioavailability increases up to 5-fold when taken with dietary fat.
Malarone is the CDC's first-choice antimalarial for most travelers visiting malaria-endemic regions in Africa, South Asia, Southeast Asia, and South America. Unlike chloroquine, it works effectively against chloroquine-resistant strains of Plasmodium falciparum, which now predominate in most malaria-endemic parts of the world.
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Malarone uses two complementary mechanisms to kill malaria parasites, targeting them from two completely different angles simultaneously. This dual approach is why the combination is more effective than either drug alone.
Atovaquone blocks the cytochrome bc1 complex in the malaria parasite's mitochondria, disrupting the electron transport chain. This collapses the mitochondrial membrane potential — the electrical gradient the parasite needs to generate energy. Without energy, the parasite's cellular machinery shuts down and it dies.
Proguanil is metabolized by CYP2C19 to cycloguanil, which inhibits dihydrofolate reductase (DHFR) in the parasite. This blocks folate synthesis, preventing the parasite from replicating its DNA. Proguanil also acts as a "mitochondrial sensitizer," enhancing atovaquone's ability to collapse the mitochondrial membrane potential.
Malarone is active against both the blood stage and the liver stage of Plasmodium falciparum malaria. This liver-stage activity is why the post-travel course is only 7 days — compared to 4 weeks for medications like doxycycline and mefloquine that only act on the blood stage.
250 mg / 100 mg — tablet (adult)
Standard adult dose for prophylaxis and treatment
62.5 mg / 25 mg — tablet (pediatric)
Pediatric dose; children dosed by body weight starting at 5 kg
As of 2026, Malarone (atovaquone/proguanil) is not in an active FDA shortage. However, it is only stocked at approximately 75% of US retail pharmacies for the adult formulation, and at fewer than 50% for the pediatric formulation. This is significantly lower than most everyday medications, and it means patients are frequently turned away or have to call multiple pharmacies.
Availability is most reliable at travel medicine clinics, Costco Pharmacy, Walmart, and hospital-affiliated pharmacies. Chains like CVS and Walgreens carry it at some — but not all — locations, with higher stocking rates at urban and airport-area stores. Suburban and rural locations are less reliable.
Travelers should start looking for their Malarone prescription at least 2-3 weeks before departure. medfinder calls pharmacies near you to find which ones have Malarone in stock and texts you the results, saving you hours of calling pharmacies on your own.
Malarone (atovaquone/proguanil) is not a controlled substance and does not require any special DEA registration or prescribing authority. Any licensed prescriber in the United States can prescribe it, including:
Telehealth providers are widely available for Malarone prescriptions. Several online travel medicine platforms can provide a same-day or next-day consultation and ship the medication directly to the patient's home, making telehealth ideal for last-minute travelers or those in areas without convenient travel medicine clinic access.
No. Malarone (atovaquone/proguanil) is not a controlled substance. It is not scheduled under the DEA Controlled Substances Act. Any licensed prescriber — including primary care physicians, nurse practitioners, physician assistants, infectious disease specialists, and travel medicine providers — can prescribe Malarone without special DEA registration or controlled substance prescribing authority.
Because Malarone is not a controlled substance, prescriptions can be called in, faxed, or sent electronically (no paper required in most states). Refills are permitted (though typically not needed for a single trip). There are no limits on quantity per prescription beyond clinical need. This makes it relatively easy to prescribe, even through telehealth, which is an increasingly popular option for travelers seeking pre-trip antimalarial prescriptions.
Most patients tolerate Malarone well. Common side effects are primarily gastrointestinal and are significantly reduced when the medication is taken with food or a milky drink:
Serious side effects are rare but require immediate medical attention:
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Doxycycline
Most affordable antimalarial; daily dosing; 4-week post-travel course; causes photosensitivity; not safe in pregnancy or children under 8. Best for budget-conscious travelers on longer trips.
Mefloquine (Lariam)
Weekly dosing; more convenient for long trips; FDA boxed warning for neuropsychiatric side effects; must start 2 weeks before travel; avoid in patients with psychiatric history or seizure disorders.
Chloroquine
Only effective where chloroquine resistance is absent (Central America, Caribbean). Weekly dosing; safest option in pregnancy. Not appropriate for most African or Asian destinations.
Primaquine
Second-line only; requires G6PD testing before use; primarily for P. vivax/P. ovale radical cure. Not first-line for P. falciparum prophylaxis.
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Warfarin / coumarin anticoagulants
majorProguanil may potentiate anticoagulant effect; monitor INR closely when starting or stopping Malarone in patients on warfarin.
Efavirenz
majorSignificantly decreases atovaquone and proguanil plasma levels; avoid combination — choose an alternative antimalarial for patients on efavirenz-based HIV regimens.
Rifampin / rifabutin
majorSubstantially reduces atovaquone concentrations; concomitant use not recommended.
Dapsone
majorRisk of hemolytic reactions when combined with atovaquone or proguanil; avoid coadministration.
Tetracycline
moderateReduces atovaquone plasma concentrations by approximately 40%; monitor parasitemia if combination cannot be avoided.
Indinavir
moderateAtovaquone reduces trough concentrations of indinavir by ~23%; use caution in HIV patients on indinavir-based regimens.
Metoclopramide
minorMay decrease bioavailability of atovaquone; prefer other antiemetics (ondansetron, prochlorperazine) when taking Malarone.
Vivotif (oral typhoid vaccine)
moderateProguanil's antibiotic-like activity can inactivate the live Vivotif vaccine bacteria; complete Vivotif at least 10 days before starting Malarone.
Malarone (atovaquone/proguanil) is the CDC's first-choice antimalarial for most travelers and has an excellent tolerability profile compared to alternatives like mefloquine (neuropsychiatric risks) and doxycycline (long post-travel course and photosensitivity). Its short 7-day post-travel course, ability to work in chloroquine-resistant areas, and availability in a pediatric formulation make it versatile for most travel scenarios.
The main challenges are cost and pharmacy availability. The brand-name version is expensive ($261+), but generic atovaquone/proguanil can be obtained for as little as $43-50 with discount coupons from GoodRx or SingleCare. Always ask for the generic by name when filling your prescription. Malarone is stocked at only about 75% of US pharmacies, so planning ahead is critical — start your prescription search at least 2-3 weeks before departure.
If you're struggling to find Malarone in stock at a pharmacy near you, medfinder can call pharmacies on your behalf and text you a list of locations that can fill your prescription — taking the guesswork and phone marathon out of the equation.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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