Cardiac complications of halofantrine: a prospective study of 20 patients.
Halofantrine, increasingly used for treatment of Plasmodium falciparum malaria, is a normally well-tolerated amino-alcohol with very few side-effects, but torsades de pointes ventricular tachycardia due to halofantrine has been reported in a few patients with a congenital long QT interval (Romano-Ward syndrome). We performed a prospective study of the cardiac effect of halofantrine in 20 patients with 48 h ambulatory electrocardiographic (ECG) monitoring; the halofantrine levels in their serum were also determined. Minimal ECG changes were noted, with lengthening of the QT interval without clinical symptoms. This effect was dose-dependent and can be very severe in cases of pre-existing cardiopathy; it also occurs in patients without any pre-existing cardiopathy. In order to reduce the likelihood of such incidents, which are admittedly rare, we suggest performing electrocardiography on all patients before initiating treatment with halofantrine.
Monlun
E
E
Department of Internal Medicine, Hôpital Saint André, Bordeaux, France.
Le Metayer
P
P
Szwandt
S
S
Neau
D
D
Longy-Boursier
M
M
Horton
J
J
Le Bras
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000962:Antimalarials / Q000009:adverse effects* / Q000097:blood; D015716:Electrocardiography, Ambulatory / Q000187:drug effects; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000097:blood / Q000188:drug therapy*; D016780:Malaria, Vivax / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010616:Phenanthrenes / Q000009:adverse effects* / Q000097:blood; D011446:Prospective Studies
D000962:Antimalarials; D010616:Phenanthrenes; C023768:halofantrine