atovaquone / Generic mfg. - LARVOL DELTA

STK31 enhances gallbladder cancer development by modulating DNA replication machinery. (PubMed, J Biol Chem) - "Atovaquone identified through molecular docking screening, binds STK31 and reduces its expression and kinase activity, demonstrating anti-tumor effects against GBC both in vitro and in vivo. We demonstrate that STK31 facilitates GBC progression through c-Myc/FOXP1-mediated DNA replication dysregulation. Its inhibition triggers lethal polyploidization, with ATO identified as a potential STK31-targeting drug candidate."

Journal • Gallbladder Cancer • Oncology • Solid Tumor • AURKB • FOXP1 • MYC

Distinct performance and ruminal adaptations to ethyl-cellulose rumen-protected methionine and guanidinoacetic acid during a heat stress challenge in lactating Holstein cows. (PubMed, J Dairy Sci) - "The objective was to determine effects of rumen-protected methionine (RPM; Mepron®, Evonik) and GAA (GuanAMINO®, ≥ 97% GAA, ∼1% starch, ∼1% moisture; Evonik), fed alone or in combination during heat stress (HS) on production, thermoregulation, ruminal biopolymer-degrading enzymes and microbiota, ruminal papillae gene expression and cystathionine β-synthase (CBS) activity, and plasma biomarkers...In contrast, RPM-HS and, to a greater extent, MIX-HS induced coordinated molecular remodeling characterized by upregulation of genes involved in polyamine synthesis, antioxidant responses, and tight-junction signaling. Overall, RPM improved milk protein synthesis and metabolic resilience during HS, whereas MIX primarily enhanced epithelial adaptative responses without additional lactational benefits."

Journal

EVALUATION OF ATOVAQUONE AS A SAFE PREVENTIVE STRATEGY FOR HIGH-GRADE SEROUS OVARIAN CARCINOMA (IGCS 2026) - " Mice received either a control diet or an atovaquone -supplemented diet initiated 7 days after tamoxifen -induced recombination (at 6 –8 weeks of age). No disease was detected at 24 weeks. At 30 weeks, atovaquone reduced tumor progression compared to controls, and at later time points, it decreased metastatic spread. Transcriptomic analyses revealed downregulation of pathways related to epithelial prolife ration, extracellular matrix organization, and inflammatory signaling, along with reduced activity of transcription factors linked to tumor progression."

High Grade Serous Ovarian Cancer • Oncology • Ovarian Cancer • Solid Tumor

Redox and structural determinants of mitochondrial complex III inhibition by triphenylphosphonium-conjugated atovaquone analogs. (PubMed, Redox Biol) - "Structure-activity relationship analysis revealed that the intrinsic redox properties of TPP+-conjugated MitoR-ATO analogs alone do not predict biological activity. Instead, accurate prediction of the therapeutic efficacy of mitochondria-targeted complex III inhibitors requires integrating redox properties with computational analyses of ligand-protein interactions at the mitochondrial complex III Qi site."

Journal • Oncology

When Prior Exposure Doesn't Protect: Imported Plasmodium falciparum Malaria in a Returning Traveler With Waning Immunity. (PubMed, Cureus) - "Second, this case underscores the importance of G6PD testing before initiating antimalarial regimens, as many first-line medications carry the risk of oxidative hemolysis in patients with G6PD deficiency. Recognition of these issues is imperative for safe and effective management of malaria in non-endemic settings."

Journal • Fatigue • Hematological Disorders • Infectious Disease • Malaria • Metabolic Disorders

Babesiosis at ultra-low parasitemia presenting as secondary hemophagocytic lymphohistiocytosis in a patient on B cell-depleting therapy. (PubMed, ASM Case Rep) - "Ocrelizumab, an anti-CD20 B-lymphocyte monoclonal antibody used to treat multiple sclerosis, increases the risk of severe or relapsing infections with tick-borne pathogens...The patient improved following treatment with atovaquone and azithromycin, along with corticosteroids for HLH...Additionally, this case underscores the importance of maintaining a broad differential in patients on B cell-depleting agents who present with new pancytopenia and systemic inflammatory symptoms. Early utilization of microbial cell-free DNA next-generation sequencing tests may aid in timely diagnosis and treatment."

Journal • CNS Disorders • Hematological Disorders • Hemophagocytic lymphohistiocytosis • Immunology • Infectious Disease • Inflammation • Multiple Sclerosis • Rare Diseases

Donor-Derived Disseminated Toxoplasmosis After Liver Transplant (ACG 2026) - "He was empirically treated with meropenem and micafungin...Atovaquone should be considered as a second line option for patients at risk of toxoplasmosis who cannot tolerate TMP-SMX due to its activity against both Toxoplasma and Pneumocystis . Figure: Table 1: Infection status of donor and recipient prior to transplant. Figure: Table 2: Results of initial infectious laboratory workup."

Cholestasis • Fibrosis • Hepatology • Immunology • Infectious Disease • Liver Failure • Nephrology • Renal Disease • Septic Shock • Transplantation

The Biopsy Tells the Story: Zone 1 Hepatic Necrosis as the Diagnostic Compass in Seronegative Acute Liver Failure (ACG 2026) - "Case Description/ A 77-year-old male with hereditary hemochromatosis, ILD (on prednisone and atovaquone), CAD, and diabetes presented with syncope after travel to Florida. Biopsy alone established the diagnosis. When the pattern is zone 1, the cause is direct toxicity - not autoimmune, not ischemic, not viral."

Biopsy • Addiction (Opioid and Alcohol) • Autoimmune Hepatitis • Diabetes • Fibrosis • Genetic Disorders • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Failure • Metabolic Disorders

Tick-Borne Double Trouble: Co-Infection of Babesiosis and Anaplasmosis (ACG 2026) - "Case Description/ A 96-year-old woman with a medical history of hyperlipidemia and DVT on apixaban first presented with lethargy and was found to have babesiosis...She was started on atovaquone and azithromycin and discharged home...Over the next two days, her liver enzymes rose to ALT 553, AST 203, ALP 730, and total bilirubin 2.7...She was empirically started on doxycycline given the likelihood of co-infection with Lyme disease...This emphasizes the importance of recognition of both typical and atypical presentations of these infections, and if initial treatment fails, consideration of co-infection. Co-infection complicates disease courses by possibly increasing disease severity, risk of adverse effects, and further convoluting management."

Cardiovascular • Dyslipidemia • Hematological Disorders • Hepatology • Infectious Disease • Inflammatory Arthritis • Liver Failure • Lyme Disease • Pancreatitis

A Vanishing Brain Mass After Liver Transplantation: Disseminated Nocardiosis Mimicking Malignancy (ACG 2026) - "On discharge, immunosuppression included tacrolimus, mycophenolate, and prednisone; TMP-SMX was prescribed for Pneumocystis jirovecii prophylaxis...Four months post-transplant, TMP-SMX was transitioned to atovaquone due to leukopenia and renal dysfunction...Given the prior frontal lobe lesion that resolved on TMP-SMX and meropenem, followed by pulmonary nocardiosis after TMP-SMX cessation, retrospective concern arose for partially treated nocardiosis with intracranial involvement...The patient was discharged on prolonged linezolid and ceftriaxone...Figure: Axial Brain MRI, T2-FLAIR on 9/11/2025. Figure: Axial Brain MRI-T2 FLAIR on 12/11/2025"

Brain Cancer • Chronic Cough • CNS Disorders • Cough • Epilepsy • Fibrosis • Glioma • Hepatology • Immunology • Infectious Disease • Leukopenia • Nephrology • Oncology • Renal Disease • Respiratory Diseases • Solid Tumor • Transplantation

Marked Direct Hyperbilirubinemia From Severe Babesiosis Mimicking Biliary Obstruction (ACG 2026) - "Despite treatment with atovaquone and azithromycin, she developed worsening hemolytic anemia (nadir 6.9 g/dL), thrombocytopenia (nadir 18 K/µL), coagulopathy, hypoxic respiratory failure requiring up to 4 L Oâ, and progressive direct hyperbilirubinemia...Clindamycin and doxycycline were added; however, progressive multiorgan dysfunction necessitated red blood cell exchange transfusion...Figure: Peripheral blood smear demonstrating intraerythrocytic Babesia organisms (Wright-Giemsa stain). Multiple ring-form parasites are visible within erythrocytes, confirming babesiosis."

Diabetes • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Infectious Disease • Liver Failure • Metabolic Disorders • Respiratory Diseases • Thrombocytopenia • Type 1 Diabetes Mellitus • HP

Varicella-Zoster Immune Reconstitution Inflammatory Syndrome in HIV-Infected Patient (ACG 2026) - "The patient was treated with prednisone, N-acetylcysteine, valacyclovir, and atovaquone with improvement in liver enzymes. Diagnosis relies on temporal association with ART, evidence of immune recovery, clinical deterioration from inflammatory response, and exclusion of competing etiologies. This case highlights the importance of monitoring liver enzymes after ART initiation and maintaining suspicion for atypical manifestations of IRIS, particularly in severely immunocompromised patients with concurrent opportunistic infections."

Clinical • Autoimmune Hepatitis • CNS Disorders • Hepatitis B • Hepatology • Herpes Zoster • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Pneumonia • Respiratory Diseases • Septic Shock • Varicella Zoster • CD4

Drug development targeting the mitochondrial respiratory chain of Sparganum proliferum: Initial biochemical and drug discovery insights into the enigmatic helminth parasite. (PubMed, PLoS Negl Trop Dis) - "The antimalarial drug atovaquone inhibited complex III at a very low concentration (IC₅₀ 2.2 nM). IACS-010759 potently inhibited complex I (IC₅₀ 16.1 nM), causing worm body swelling, surface destruction, and mitochondrial morphological changes in culture assays. Further investigation of the mitochondrial respiratory chain of S. proliferum to develop targeted candidate drugs is warranted."

Journal • Infectious Disease

Identifying candidate therapeutic targets in amyotrophic lateral sclerosis through a transcriptome-wide machine-learning consensus approach for drug repurposing. (PubMed, Neuroscience) - "Deferoxamine and disulfiram showed the clearest reversal-compatible profiles in motor cortex, whereas yohimbic acid and atovaquone showed reversal-compatible profiles in blood. Ciprofloxacin, prochlorperazine, and a compound group led by androsterone instead showed concordant connectivity. The results provide transparent, hypothesis-generating gene, pathway, and compound priorities, but they do not establish biomarkers, therapeutic efficacy, or clinical suitability and require validation in independent cohorts and experimental ALS models."

Journal • Amyotrophic Lateral Sclerosis • CNS Disorders

Dihydroorotate Dehydrogenase Inhibitors are Potent Antiviral Agents against Henipaviruses and Arenaviruses. (PubMed, Antiviral Res) - "Among eleven primary hits, five compounds-Farudodstat, Atovaquone, PTC299, hDHODH-IN-7, and Brequinar-were prioritized based on antiviral potency. Notably, PTC299 exhibited a selectivity index exceeding 500. Together, these in vitro findings indicate that DHODH inhibitors have potential as potent broad-spectrum host-directed antivirals, especially against high-consequence and emerging viruses."

Journal

Phosphonic Acid-Enriched Nanogels as High Relaxivity Platforms for Enhanced Magnetic Resonance Imaging and Drug Delivery. (PubMed, Macromol Biosci) - "They also exhibited a loading capacity for clinical hydrophobic drugs, such as atovaquone (ATO), thereby potentially improving the pharmacokinetics. This work highlights the prospect of poly(vinyl phosphonic acid) based nanogels as multifunctional nanoplatforms for diagnostic and therapeutic applications."

Journal • Oncology • Solid Tumor

Retraction Note: Atovaquone inhibits colorectal cancer metastasis by regulating PDGFRβ/NF-κB signaling pathway. (PubMed, BMC Cancer) - No abstract available

Journal • Colorectal Cancer • Oncology • Solid Tumor • PDGFRB

Babesiosis-associated HLH in an immunocompetent adult: Host-driven hyperinflammation at low parasitemia. (PubMed, IDCases) - "Despite appropriate antimicrobial therapy with atovaquone and azithromycin, the patient developed worsening cytopenias, hemolysis, hypertriglyceridemia, and elevated soluble interleukin-2 receptor levels, fulfilling HLH-2004 diagnostic criteria. Pulse-dose intravenous methylprednisolone was initiated, resulting in rapid clinical and laboratory improvement. The patient was discharged on antimicrobial therapy with a prednisone taper and remained clinically stable. This case highlights that babesiosis-associated HLH can occur even in immunocompetent hosts and may present with severe hyperinflammation despite minimal parasitemia. Early recognition of persistent cytopenias and hyperferritinemia, along with timely initiation of immunosuppressive therapy in addition to antimicrobial treatment, is critical to improving outcomes."

Journal • Dyslipidemia • Hematological Disorders • Hemophagocytic lymphohistiocytosis • Hypertriglyceridemia • Immunology • Infectious Disease • Inflammation • Oncology • Rare Diseases • Septic Shock • IL2

Combination of oxidative phosphorylation and platelet-derived growth factor inhibitors for the treatment of ovarian cancers. (PubMed, NPJ Womens Health) - "The combination therapy of FDA approved oxidative phosphorylation inhibitors (metformin and atovaquone) and platelet derived growth factor inhibitors (sunitinib and sorafenib) could target ovarian cancer stem-like cells (CSCs) and carcinoma associated mesenchymal stem cell enrichment of CSCs while reducing off-target effects. Results of a 48-hour drug exposure ovarian cancer-MSC tumoroid model showed additive effects with atovaquone combined with sunitinib or sorafenib being most effective."

Journal • Oncology • Ovarian Cancer • Solid Tumor

Mutations in apicoplast rRNA genes are associated with clindamycin resistance and impair the ability of malaria parasites to infect mosquitoes. (PubMed, Antimicrob Agents Chemother) - "We assessed how well our most vigorously growing 23S rRNA mutant could infect Anopheles mosquitoes and found a modest reduction in vector infectivity, indicating that high-level clindamycin resistance is likely to be transmissible in the field. This is in contrast to atovaquone resistance, which exhibits a total block to transmission (and hence spread), but is more pronounced than P. falciparum azithromycin resistance, which does not significantly impair development in the mosquito."

Journal • Infectious Disease • Malaria

Cascade-Enhanced Chemodynamic Therapy via a Mitochondria-Targeted PEI-Fc-Gox Nanogel with Dual Antihypoxia and ROS Amplification. (PubMed, Biomacromolecules) - "To address this limitation, we developed a mitochondria-targeted PFAGD nanogel, by covalently conjugating ferrocene (Fc) and GOx onto a polyethylenimine (PEI) backbone and encapsulating atovaquone (ATO), a mitochondrial respiration inhibitor...Multiple cellular assays confirmed that the three-step cascade reaction in the PFAGD nanogel enhanced the proliferation inhibition effect on cancer cells, especially under hypoxic conditions. This self-reinforcing nanoplatform mitigates tumor hypoxia and enables sustained, localized ROS generation, offering a promising strategy for catalytic anticancer therapy."

Journal • Oncology

Anti-malarial contact dependent blocking of transmission of Plasmodium vivax by Anopheles darlingi mosquito vector. (PubMed, PLoS Pathog) - "Among the antimalarials evaluated were Atovaquone (ATQ), Tafenoquine (TQ), Chloroquine (CQ), Mefloquine (MQ), Primaquine (PQ), and the compound Nanchangmycin (NCG). In addition, MQ also significantly reduced infection intensity, but there was no difference in infection prevalence. No significant differences were observed for the other antimalarials."

Journal • Infectious Disease • Malaria

Low-dose atovaquone for prophylaxis of Pneumocystis jirovecii pneumonia in patients with connective tissue diseases: an open-label, multicentre, single-arm, phase II trial. (PubMed, EULAR Rheumatol Open) - "Trimethoprim-sulfamethoxazole (TMP-SMX) and atovaquone 1500 mg/d, the first and one of the second-line prophylactic options of PCP, are often difficult to continue the administration due to side effects or the cost. There were 7 nonserious and 2 serious adverse events, including 2 nonserious adverse events possibly related to low-dose atovaquone. Results of this trial suggest that low-dose atovaquone has sufficient efficacy for the prophylaxis of PCP and a good safety profile in patients with connective tissue diseases under glucocorticoid treatments."

Journal • P2 data • Infectious Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases • Rheumatology

Not all trophozoites are malaria: A case of babesiosis in a traveler from the USA. (PubMed, Ticks Tick Borne Dis) - "Oral atovaquone and intravenous azithromycin were administered for 7 days, switched to oral therapy following clinical improvement and parasitemia clearance. In non-endemic regions, the typical clinical features of this case might not raise suspicion. Nevertheless, rapid diagnosis and treatment are key to ensure favorable clinical outcomes, since babesiosis can cause rapidly aggravating illness, particularly in splenectomised patients."

Journal • Infectious Disease • Malaria

Targeting Membrane Transport and Energy Metabolism for the Identification of Repurposed Drug Candidates Against Neisseria gonorrhoeae Using an In Silico Strategy. (PubMed, Antibiotics (Basel)) - "Overall, this preliminary study identifies approved drugs with antimicrobial or adjuvant activity against a single N. gonorrhoeae reference strain, supporting further investigation in clinically relevant and efflux-variant strains."

Journal • Infectious Disease