Doxycycline and atovaquone / proguanil (Malarone?) are both unsuitable for use during pregnancy.
Results of animal studies indicate that tetracyclines cross the placenta, are found in fetal tissues and can have toxic effects on the developing foetus (often related to retardation of skeletal development). Evidence of embryotoxicity has also been noted in animals treated early in pregnancy (SPC). The safety of atovaquone and proguanil hydrochloride when administered concurrently for use in human pregnancy has not been established and the potential risk is unknown. Animal studies showed no evidence for teratogenicity of the combination. The individual components have shown no adverse effects on parturition or pre- and post-natal development (SPC). Women should be reassured that taking Malarone inadvertently prior to or during the first trimester is not an indication to terminate a pregnancy. The data available from studies on the prophylactic use of mefloquine in pregnancy is generally reassuring (see use of Mefloquine in Pregnancy for further information).
