Cardiac effects of antimalarial treatment with halofantrine

Lancet. 1993 Apr 24;341(8852):1054-6. doi: 10.1016/0140-6736(93)92412-m.

Abstract

In a prospective electrocardiographic study of Karen patients with acute uncomplicated falciparum malaria, mefloquine (25 mg/kg) had no cardiac effects (n = 53), but halofantrine (72 mg/kg) induced consistent dose-related lengthening of the PR and QT intervals in all 61 patients treated. The likelihood of significant QTc prolongation (by more than 25% or a QTc of 0.55 s1/2 or more) was greater after halofantrine as retreatment following mefloquine failure than as primary treatment (7/10 vs 18/51; relative risk 2.0 [95% Cl 1.1-3.4], p = 0.04). More than 60% of the effect occurred with three doses of halofantrine (24 mg/kg). The arrhythmogenic potential of halofantrine should now be investigated.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antimalarials / adverse effects*
  • Antimalarials / therapeutic use
  • Electrocardiography / drug effects*
  • Female
  • Heart / drug effects*
  • Humans
  • Malaria, Falciparum / drug therapy*
  • Malaria, Falciparum / physiopathology
  • Male
  • Mefloquine / therapeutic use
  • Phenanthrenes / adverse effects*
  • Phenanthrenes / therapeutic use
  • Prospective Studies

Substances

  • Antimalarials
  • Phenanthrenes
  • halofantrine
  • Mefloquine