Atovaquone (Wellvone)

Atovaquone (Wellvone) is an anti-protozoal drug, which is approved for the treatment of mild to moderate Pneumocystis pneumonia (PCP) in people who cannot take standard therapies such as cotrimoxazole (Septrin / Bactrim).1 Atovaquone is less effective but better tolerated than cotrimoxazole.2 Atovaquone is also an alternative prophylaxis for PCP, being as effective as dapsone and pentamidine (Pentacarinat).3 4 5

Atovaquone is also active against toxoplasmosis, particularly when combined with pyrimethamine (Daraprim) or sulfadiazene.6 7

When treating PCP, the recommended dose is 750mg twice daily times daily for between 14 and 21 days. It is also available on a named patient basis for the treatment of toxoplasmosis in people who are intolerant of or have not responded to standard treatments. Tablets used during atovaquone trials were poorly absorbed and less effective than the suspension, thus the tablets are no longer available.8

Preliminary results indicate that atovaquone may decrease diarrhoea and increase weight in people with microsporidiosis, although it does not eradicate the organisms from the gut.9

Side-effects can include rash, diarrhoea, nausea and fever.

Taking the anti-tuberculosis drug rifampicin (Rifadin / Rimactane) at the same time as atovaquone dramatically reduces blood levels of atovaquone, as does the anti-nausea drug metoclopramide (Maxolon). The protease inhibitors atazanavir (Reyataz), lopinavir, ritonavir (Norvir) and tipranavir (Aptivus) may reduce the levels of atovaquone, so that a dose increase may be necessary.


  1. Dohn MN et al. Oral atovaquone compared with intravenous pentamidine for Pneumocystis carinii pneumonia in patients with AIDS. Ann Intern Med 121: 174-180, 1994
  2. Hughes WT et al. Comparison of 566C80 and trimethoprim-sulfamethoxazole to treat Pneumocystis carinii pneumonia in patients with AIDS. N Engl J Med 328: 1521-1527, 1993
  3. Chan C et al. Atovaquone suspension compared with aerosolized pentamidine for prevention of pneumocystis carinii pneumonia in human immunodeficiency virus-infected subjects intolerant of trimethoprim or sulfonamides. J Infect Dis 180: 369-376, 1999
  4. El-Sadr W et al. Atovaquone compared with dapsone in the prevention of Pneumocystis carinii pneumonia in patients with HIV infection who cannot tolerate trimethoprim, sulphonamides, or both. N Engl J Med 339: 1889-1895, 1998
  5. Horowitz HW et al. Atovaquone compared with dapsone to prevent Pneumocystis carinii pneumonia. N Engl J Med 340: 1512-1513, 1999
  6. Torres RA et al. Atovaquone for salvage treatment and suppression of toxoplasmic encephalitis in patients with AIDS. Atovaquone / Toxoplasmic Encephalitis Study Group. Clin Infect Dis 24: 422-429, 1997
  7. Chirgwin K et al. Randomized phase II trial of atovaquone with pyrimethamine or sulfadiazine for treatment of toxoplasmic encephalitis in patients with acquired immunodeficiency syndrome: ACTG 237 / ANRS 039 Study. AIDS Clinical Trials Group 237 / Agence Nationale de Recherche sur le SIDA, Essai 039. Clin Infect Dis 34: 1243-1250, 2002
  8. Rosenberg DM et al. Atovaquone suspension for treatment of Pneumocystis carinii pneumonia in HIV-infected patients. AIDS 15: 211-214, 2001
  9. Anwar-Bruni DM et al. Atovaquone is effective treatment for the symptoms of gastrointestinal microsporidiosis in HIV-1-infected patients. AIDS 10: 619-623, 1996

Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.