Our expert says:
Hepatic Impairment: Malarone has not been specifically studied in patients with hepatic impairment.
The metabolic route of elimination of proguanil is via the liver. Atovaquone elimination is substantially liver dependent. Clinically significant accumulation of proguanil and atovaquone is unlikely given the short duration of treatment. To date, no special precautions or dosage adjustment for patients with hepatic impairment have been identified.
HOWEVER, YOU NEED TO DISCUSS THIS WITH YOUR DOCTOR PRIOR TO USE.
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