Is halofantrine still advisable in malaria attacks?

• Published in: Annals of tropical medicine and parasitology Vol. 91; no. 7; pp. 867 - 873
• Main Authors: Touze, J. E., Fourcade, L., Peyron, F., Heno, P., Deharo, J. C.
• Format: Journal Article
• Language: English
• Published: Leeds Taylor & Francis 01.10.1997; Maney Publishing
• Subjects: Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimalarials - administration & dosage; Antimalarials - adverse effects; Antimalarials - pharmacology; Antiparasitic agents; Biological and medical sciences; Electrocardiography; Heart Diseases - chemically induced; Heart Diseases - physiopathology; Hemolysis; Human protozoal diseases; Humans; Infectious diseases; Malaria; Malaria, Falciparum - drug therapy; Medical sciences; Parasitic diseases; Pharmacology. Drug treatments; Phenanthrenes - administration & dosage; Phenanthrenes - adverse effects; Phenanthrenes - pharmacology; Prospective Studies; Protozoal diseases; Tropical medicine; Human; Protozoa; Antimalarial; Protozoal disease; Malaria; Toxicity; Parasitosis; Review; Halofantrine; Infection; Plasmodium falciparum; Chemotherapy; Therapeutic protocol; Sporozoa
• ISSN: 0003-4983; 1364-8594
• DOI: 10.1080/00034983.1997.11813213

Halofantrine is an antimalarial drug which is widely prescribed for the treatment of infections with chloroquine-resistant strains of Plasmodium falciparum. Chemically, it is a phenanthrene methanol, belonging to the aryl-amino-alcohol family. It has recently been recognized that this drug may induce rare but serious, cardiotoxic effects, including lengthening of the QTc interval, 'torsade de pointes' and induction of late ventricular potentials. These events are thought to be related to a quinidine-like action of the drug. In addition, severe haemolytic accidents have been reported, mimicking blackwater fever and indicating an immunological process. As a result of these side-effects, new guidelines for prescription and more cautious use of halofantrine, particularly as a stand-by treatment for febrile access among travellers, are required.