Halofantrine adverse effects

Adverse effects. Halofantrine may cause gastrointestinal symptoms pruritis occurs but to a lesser extent than with chloroquine which may be reason for it to be preferred. It prolongs the cardiac QT interval and may predispose to hazardous arrhythmia. The drug should therefore not be taken ... 

Halofantrine is not indicated for prophylactic use. However, of 480 army personnel who took two doses of 1500 mg each on the third and the tenth days after they had returned to a non-malarial area, only one had P. falciparum malaria during the next 5 months (SEDA-13, 820) (1). There were no adverse effects, except for one case of morbilliform rash possibly due to the halofantrine. 

Adverse effects with the dosages originally recommended have in general been mild, no more than nausea, diarrhea, headache, and pruritus (SEDA-13, 820) (2-4). Pruritus occurred markedly less often with halofantrine than with chloroquine (SEDA-16, 306). A comparison between high-dose chloroquine (35 mg/kg total in three daily doses) and halofantrine in the standard dose (total 25 mg/kg given at 6-hour intervals) in patients 4—14 years old showed a fairly similar frequency of adverse effects. Itching was a common adverse effect of chloroquine (4). 

Gastrointestinal adverse effects are more common with halofantrine than with other antimalarial drugs (11). 

Lumefantrine is a synthetic aminoalcohol fluorene derivative, related to halofantrine and mefloquine (1). It was highly effective in uncomplicated chloroquine-resistant malaria tropica in an open, non-comparative trial in 102 patients in China when given in four oral doses over 48 hours (2). No significant adverse effects have been reported. It has also been marketed in a combination of artemether (20 mg) plus lumefantrine (120 mg). 

The adverse effects of some antimalarials can be stereoselective. This could be due to pharmacokinetic and/or pharmacodynamic differences between the enantiomers. For halofantrine, evidence has arisen that the (-I-)... 

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