Halofantrine interactions

Charbit B, Becquemont L, Lepere B, Peytavin G, Funck-Brentano C. Pharmacokinetic and pharmacodynamic interaction between grapefruit juice and halofantrine. Clin Pharmacol Ther 2002 72(5) 514-523. 

Clinically important, potentially hazardous interactions with acitretin, antacids, cholestyramine, dapsone, furazolidone, halofantrine, hydroxychloroquine, methotrexate, methoxsalen, mivacurium, nilotinib, penicillamine, sulfonamides... 

Clinically important, potentially hazardous interactions with halofantrine... 

Clinically important, potentially hazardous interactions with amiodarone, astemizole, bepridil, carbamazepine, chloroquine, cisapride, clarithromycin, dihydroergotamine, disopyramide, ergotamine, grapefruit juice, halofantrine, haloperidol, itraconazole, ketoconazole, methadone, moxifloxacin, phenobarbital, phenytoin, pimozide, procainamide, quinidine, rifampicin, ritonavir, sotalol, St John s wort, telithromycin, terfenadine, voriconazole... 

Clinically important, potentially hazardous interactions with alcohol, amiodarone, amphotericin B, cisapride, clonidine, digitalis, diltiazem, disopyramide, erythromycin, glucocorticoids, halofantrine, haloperidol, hypokalemic diruretics, imipramine antidepressants, levodopa, lithium, pentamidine, pimozide, quinidine, sotalol, stimulant laxatives, tetracosactides, thioridazine... 

Nausea vomiting allergic reactions, including pulmonary infiltration hypotension urticaria fever vesicular rash hypoglycemia headache hemolytic anemia in G-6-PD deficiency and neonates disulfiram-like reaction with alcohol MAO-inhibitor interactions polyneuritis Halofantrine... 

Magnesium carbonate halves the maximum plasma levels of halofantrine, which may be clinically relevant. Aluminium hydroxide and magnesium trisilicate seem less likely to interact. 

The pharmacokinetic interaction between halofantrine and magnesium carbonate appears to be established. Its clinical importance does not seem... 

A study in animals found that ketoconazole roughly doubled the AUC of halofantrine and inhibited its metabolism to the equipotent metabolite, desbutylhalofantrine. In in vitro studies, ketoconazole markedly inhibited the metabolism of halofantrine by CYP3A4. It has been suggested that the rise in halofantrine levels could reasonably be expected to increase toxicity. Other CYP3A4 inhibitors, diltiazem and erythromycin, also inhibited the metabolism of halofantrine in vitro, and might therefore do so clinically. The manufacturer recommended caution with the concurrent use of potent CYP3A4 inhibitors. Further study is needed of these potential pharmacokinetic interactions. Mefloquine, quinine and quinidine may also inhibit the metabolism of halofantrine by CYP3A4, see (b) below. 

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