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
  • Methadone
  • Methazolamide
  • Mitotane
  • Moxifloxacin
  • 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
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