Halofantrine

Halofantrine Brand Name– Halfan

What is Halofantrine

Halofantrine is an oral synthetic phenanthrene-methanol antimalarial agent that is related to mefloquine and quinine.

Halofantrine is effective for the treatment of mild to moderate malaria caused by both Plasmodium falciparum and Plasmodium vivax.

Halofantrine is not used for malaria prophylaxis. Because of the rare potential for halofantrine to cause prolongation of QTc, torsade de pointes, and fatal arrhythmias, alternative antimalarial therapy is preferred whenever possible. The use of halofantrine should be limited to uncomplicated chemoresistant Plasmodium falciparum malaria.

Halofantrine is also not recommended for the self-treatment of malaria by traveling patients due to the potential for serious cardiac effects; an ECG is recommended prior to use.

The drug is usually reserved for situations in which no other effective malarial treatment is available.

Halofantrine was FDA-approved in 1992 for use in the US and is marketed internationally; however, the drug has never been marketed in the US.

Halofantrine is available in several countries including: Belgium, France, Germany, Netherlands, Portugal, South Africa, Spain, Switzerland, and the United Kingdom

Indications

1. malaria
2. Plasmodium falciparum
3. Plasmodium vivax

NOTE: Halofantrine is not active against gameocytes or the extraerythrocytic stage.

Side Effects

1. abdominal pain
2. anemia
3. anorexia
4. arthralgia
5. asthenia
6. back pain
7. chest pain (unspecified)
8. confusion
9. constipation
10. depression
11. diarrhea
12. dizziness
13. drowsiness
14. dyspepsia
15. elevated hepatic enzymes
16. fatigue
17. headache
18. hemolysis
19. hemolytic anemia
20. hypertensive crisis
21. impaired cognition
22. leukocytosis
23. leukopenia
24. malaise
25. nausea
26. orthostatic hypotension
27. palpitations
28. paresthesias
29. pruritus
30. pulmonary edema
31. QT prolongation
32. rash
33. seizures
34. stomatitis
35. stroke
36. teratogenesis
37. tetany
38. thrombocytopenia
39. torsade de pointes
40. urticaria
41. vomiting

Monitoring Parameters

• CBC
• ECG

Contraindications

• anorexia nervosa
• AV block
• bradycardia
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• dehydration
• diarrhea
• driving or operating machinery
• electrolyte imbalance
• hepatic disease
• hypocalcemia
• hypokalemia
• hypomagnesemia
• hypovolemia
• malnutrition
• pregnancy
• QT prolongation
• renal disease
• renal failure
• renal impairment
• syncope
• ventricular arrhythmias
• ventricular fibrillation
• ventricular tachycardia
• vomiting

Interactions

• Abarelix
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetazolamide
• Aclidinium; Formoterol
• Albuterol
• Albuterol; Ipratropium
• Alfuzosin
• Aluminum Hydroxide
• Aluminum Hydroxide; Magnesium Carbonate
• Aluminum Hydroxide; Magnesium Hydroxide
• Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
• Aluminum Hydroxide; Magnesium Trisilicate
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amphotericin B
• Amphotericin B cholesteryl sulfate complex (ABCD)
• Amphotericin B lipid complex (ABLC)
• Amphotericin B liposomal (LAmB)
• Antacids
• Apomorphine
• Aprepitant, Fosaprepitant
• Arformoterol
• Aripiprazole
• Arsenic Trioxide
• Asenapine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Bepridil
• Beta-agonists
• Boceprevir
• Budesonide; Formoterol
• Butyrophenone
• Calcium Carbonate; Magnesium Hydroxide
• Carbonic anhydrase inhibitors
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Cimetidine
• Ciprofloxacin
• Cisapride
• Citalopram
• Clarithromycin
• Class IA Antiarrhythmics
• Clomipramine
• Conivaptan
• Corticosteroids
• Danazol
• Dasatinib
• Degarelix
• Delavirdine
• Desipramine
• Dextromethorphan; Quinidine
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Diltiazem
• Disopyramide
• Dolasetron
• Dolutegravir; Rilpivirine
• Doxepin
• Droperidol
• Dutasteride; Tamsulosin
• Emtricitabine; Rilpivirine; Tenofovir alafenamide
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Enflurane
• Erythromycin
• Erythromycin; Sulfisoxazole
• Flecainide
• Fluconazole
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluticasone; Salmeterol
• Fluticasone; Umeclidinium; Vilanterol
• Fluticasone; Vilanterol
• Fluvoxamine
• food
• Formoterol
• Formoterol; Mometasone
• Foscarnet
• Gefitinib
• Gemifloxacin
• Glycopyrrolate; Formoterol
• grapefruit juice
• Haloperidol
• Halothane
• Idelalisib
• Imatinib
• Imipramine
• Indacaterol
• Indacaterol; Glycopyrrolate
• Isoflurane
• Itraconazole
• Ketoconazole
• Lesinurad
• Lesinurad; Allopurinol
• Levalbuterol
• Levofloxacin
• Levomethadyl
• Lomefloxacin
• Loop diuretics
• Magnesium Hydroxide
• Maprotiline
• Mefloquine
• Metaproterenol
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• Methazolamide
• Mitotane
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• Nefazodone
• Nicardipine
• Nilotinib
• Norfloxacin
• Nortriptyline
• Octreotide
• Ofloxacin
• Olanzapine
• Olodaterol
• Omeprazole; Sodium Bicarbonate
• Paliperidone
• Pentamidine
• Perphenazine; Amitriptyline
• Phenothiazines
• Pimozide
• Pirbuterol
• Posaconazole
• Procainamide
• Propafenone
• Protease inhibitors
• Protriptyline
• Quetiapine
• Quinidine
• Quinine
• Ranolazine
• Rilpivirine
• Risperidone
• Salmeterol
• Sevoflurane
• Sodium Bicarbonate
• Sparfloxacin
• Tacrolimus
• Tamsulosin
• Telithromycin
• Telotristat Ethyl
• Terbutaline
• Tetrabenazine
• Thiazide diuretics
• Tiotropium; Olodaterol
• Trandolapril; Verapamil
• Tricyclic antidepressants
• Trimipramine
• Umeclidinium; Vilanterol
• Vardenafil
• Verapamil
• Voriconazole
• Vorinostat
• Zafirlukast
• Zileuton
• Ziprasidone