Cardiac effects of antimalarial treatment with halofantrine.
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.
Nosten
F
F
Shoklo Malaria Research Unit, Mae Sot, Thailand.
ter Kuile
F O
FO
Luxemburger
C
C
Woodrow
C
C
Kyle
D E
DE
Chongsuphajaisiddhi
T
T
White
N J
NJ
D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000009:adverse effects* / Q000627:therapeutic use; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D006321:Heart / Q000187:drug effects*; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use; D010616:Phenanthrenes / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies
D000962:Antimalarials; D010616:Phenanthrenes; C023768:halofantrine; D015767:Mefloquine