title: Cardiac complications of halofantrine: a prospective study of 20 patients.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Hôpital Saint André, Bordeaux, France.
authors.forename: E
authors.initials: E
authors.lastname: Monlun
authors.forename: P
authors.initials: P
authors.lastname: Le Metayer
authors.forename: S
authors.initials: S
authors.lastname: Szwandt
authors.forename: D
authors.initials: D
authors.lastname: Neau
authors.forename: M
authors.initials: M
authors.lastname: Longy-Boursier
authors.forename: J
authors.initials: J
authors.lastname: Horton
authors.forename: M
authors.initials: M
authors.lastname: Le Bras
mesh_terms: 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
chemical_list: D000962:Antimalarials; D010616:Phenanthrenes; C023768:halofantrine