MALARONE / ATOVAQUONE
Updated: Oct 21
This is one of many things I have used to treat Babesia. I took Malarone (atovaquone with proguanil) for quite some time along with other things: Zithromax, Alinia and natural products in particular.
Short on time or energy? A quick-view graphic with the key points is at the bottom of this post.
MY EXPERIENCE
-I was told to watch for any deep depression and that I might not notice when it happens, so I told 2 family members so they could help me spot it.
-It did finally hit, but not until 9 months in. I was then told to stop it and add in Sunny Moods and CoQ10. The depression passed quickly.
-I have since switched to a cleaner mood option called Mood Tonic:
-I was told you cannot take CoQ10 while taking atovaquone, though.
-I also personally had lots of nausea.
-Alinia is another one I used for Babesia.
WHAT IS IT?
-Atovaquone on its own is sold as Mepron, a liquid. Malarone is a tablet that combines atovaquone with another drug called proguanil.
-Both were approved for other infections (Mepron for a type of pneumonia and Malarone for malaria). Some Lyme doctors use them for Babesia.
HOW LYME DOCTORS OFTEN USE IT
-The standard treatment for Babesia pairs atovaquone with azithromycin (Zithromax).
-Dr. Marty Ross shares that he combines atovaquone with an antibiotic such as azithromycin, and that he expects to see some improvement in one to two months if a treatment is the right fit.
-Global Lyme Alliance shares that doctors often take breaks and restart these medicines, sometimes for months, as the Babesia load drops.
-Every Lyme doctor has their own approach. What you use is between you and your doctor.
TAKE IT WITH FAT
-Atovaquone is absorbed much better with food. The Mepron label shows that taking it with a meal raised the amount in the blood about 2.6 times compared to an empty stomach.
-Dr. Marty Ross suggests taking it with enough fat to help absorption and to help prevent nausea or diarrhea. Good fats include nuts, nut butter, butter, oils like coconut or flaxseed oil, yogurt, cheese and avocado.
-The Malarone label says to take it at the same time each day with food or a milky drink.
CAUTIONS
-Common side effects on the labels include nausea, vomiting, diarrhea and headache. The Mepron label also lists rash, fever and trouble sleeping. The Malarone label also lists stomach pain, dizziness, weakness and loss of appetite.
-Both labels list depression as a possible side effect. Like I did, you may want to tell someone close to you, so they can help you notice mood changes. Tell your doctor right away if your mood changes.
-Both labels mention liver problems and serious skin reactions. Call your doctor right away if you get any rash.
-Rifampin and rifabutin lower atovaquone levels, so the labels don't recommend taking them together. Tetracycline and metoclopramide can also lower atovaquone levels.
-Malarone may make blood thinners like warfarin stronger.
-If you are pregnant or breastfeeding, talk with your doctor first.
NEWER RESEARCH
-Arakoda (tafenoquine). A small 2024 Yale study looked at 5 people with weakened immune systems whose Babesia kept coming back. All 4 who had tafenoquine added to their treatment were cleared. The one who took it alone was not. Yale notes it isn't safe for people with G6PD deficiency, an inherited condition, so ask your doctor about testing first.
-These patients' Babesia had come back after the standard atovaquone and azithromycin treatment, which is why researchers are looking at new options like this one.
-A 2021 review in the journal Pathogens looked at Babesia treatment then and now. It shares that the standard drugs can cause side effects, and that Babesia can become resistant to them. In some people whose Babesia came back after atovaquone and azithromycin, researchers found changes in the parasite that made it less sensitive to these drugs.
-The review named tafenoquine, clofazimine and a newer group of drugs called ELQs as some of the most promising options being studied. Tafenoquine lasts a long time in the body (it takes about 12 to 17 days for half of it to clear), so only a few doses may be needed, which may help keep resistance from developing. It is not safe for people with G6PD deficiency.
RELATED POSTS
Alinia
Zithromax / Azithromycin
Babesia - Possible Solutions
Babesia (education)
Babesia Directory
Babesia Odocoilei
Babesia Most Common Symptoms
Ivermectin
Antibiotics - Why Using Only One Is Not Recommended in Chronic Lyme
https://www.riseabovelyme.com/post/antibiotics-why-using-only-one-is-not-recommended-in-chronic-lyme
Herx - Possible Solutions
CoQ10
Mood Tonic
Depression and Anxiety - Possible Solutions
Nausea - Possible Solutions
SOURCES
Pathogens - Treatment of human babesiosis: then and now, review (September 2021, older source, still worth reading)
FDA - Malarone (atovaquone and proguanil) prescribing information (June 2026)
FDA - Mepron (atovaquone) prescribing information (March 2026)
Yale School of Public Health - Antimalarial drug is effective against tick-borne infection babesiosis (May 2024)
Global Lyme Alliance - Have you heard of the tick-borne disease babesiosis? (September 2020, older source, still worth reading)
Disclaimer: Rise Above Lyme makes no claims about any possible benefit of using any product mentioned within this site. Always consult with your doctor before adding anything. The information shared is based on personal experience, years of accumulated researched resources from Lyme Literate doctors and polls conducted within Lyme groups from actual patient experience using these solution ideas.
Comments