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Halofantrine
Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Drug Interactions
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Monitoring Parameters
Test Interactions
Mental Health: Effects on Mental Status
Mental Health: Effects on Psychiatric Treatment
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms
References

Pronunciation
(ha loe FAN trin)

U.S. Brand Names
Halfan®

Generic Available

No


Synonyms
Halofantrine Hydrochloride

Pharmacological Index

Antimalarial Agent


Use

Treatment of mild to moderate acute malaria caused by susceptible strains of Plasmodium falciparum and Plasmodium vivax


Pregnancy Risk Factor

X


Contraindications

Family history of congenital Q-Tc prolongation; hypersensitivity to halofantrine


Warnings/Precautions

Monitor closely for decreased hematocrit and hemoglobin, patients with chronic liver disease


Adverse Reactions

>10%: Dermatologic: Pruritus

1% to 10%:

Cardiovascular: Edema

Central nervous system: Malaise, headache

Gastrointestinal: Nausea, vomiting

Hematologic: Leukocytosis

Hepatic: Elevated LFTs

Local: Tenderness

Neuromuscular & skeletal: Myalgia

Respiratory: Cough

Miscellaneous: Lymphadenopathy

<1%: Tachycardia, hypotension, urticaria, hypoglycemia, sterile abscesses, asthma, anaphylactic shock


Drug Interactions

CYP2D6 and 3A3/4 enzyme substrate


Mechanism of Action

Similar to mefloquine; destruction of asexual blood forms, possible inhibition of proton pump


Pharmacodynamics/Kinetics

Mean time to parasite clearance: 40-84 hours

Absorption: Erratic and variable; serum levels are proportional to dose up to 1000 mg; doses greater than this should be divided; may be increased 60% with high fat meals

Distribution: Vd: 570 L/kg; widely distributed in most tissues

Metabolism: To active metabolite in liver

Half-life: 23 hours; metabolite: 82 hours; may be increased in active disease

Elimination: Essentially unchanged in urine


Usual Dosage

Oral:

Adults: 500 mg every 6 hours for 3 doses; repeat in 1 week


Monitoring Parameters

CBC, LFTs, parasite counts


Test Interactions

Increased serum transaminases, bilirubin


Mental Health: Effects on Mental Status

May cause drowsiness


Mental Health: Effects on Psychiatric Treatment

None reported


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

No effects or complications reported


Patient Information

Take on an empty stomach; avoid high fat meals; notify physician of persistent nausea, vomiting, abdominal pain, light stools, dark urine


Nursing Implications

Monitor closely for jaundice, other signs of hepatotoxicity


Dosage Forms

Tablet, as hydrochloride: 250 mg


References

White NJ, "The Treatment of Malaria," N Engl J Med, 1996, 335(11):800-6.


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