Medication Guide App

Halfan Side Effects

Generic Name: halofantrine

Note: This page contains information about the side effects of halofantrine. Some of the dosage forms included on this document may not apply to the brand name Halfan.

Not all side effects for Halfan may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to halofantrine: oral tablet

In addition to its needed effects, some unwanted effects may be caused by halofantrine (the active ingredient contained in Halfan). In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking halofantrine:

Less common
  • Coughing
  • noisy, rattling, or troubled breathing
Rare
  • Abdominal pain
  • chest pain
  • confusion
  • convulsions (seizures)
  • diarrhea
  • difficulty in breathing or swallowing
  • hives
  • itching, especially of feet or hands
  • nausea
  • pounding heartbeat
  • reddening of skin, especially around ears
  • swelling of eyes, face or inside of nose
  • unusual tiredness or weakness
  • vomiting

Some of the side effects that can occur with halofantrine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More Common
  • Headache
Less common
  • Aches and pain in joints
  • constipation
  • frequent urination
  • indigestion
  • loss of appetite
  • skin itching or rash

For Healthcare Professionals

Applies to halofantrine: oral tablet

Cardiovascular

Cardiovascular side effects have included QT interval prolongation, torsades de pointes, ventricular arrhythmias, and death. Chest pain and palpitations have been reported less than 1% of patients in clinical trials, and orthostatic hypotension has been reported in less than 1% to 33% of patients. Hypertensive crisis (1/933) and cerebrovascular accident (1/933) have been reported, although causality was not clearly established. Quinidine-like electrocardiographic changes have also been reported.[Ref]

Higher risk may be associated with larger than recommended doses, previous or concurrent mefloquine treatment, preexisting QT interval prolongation, or concurrent administration of other QT interval-prolonging drugs. Prolonged QTc interval has been reported in up to 81% of adults treated with standard halofantrine doses and in 100% of patients treated with high doses (72 mg/kg). Prolonged QTc interval has been reported in 50% of children and prolonged PR interval has been reported in 38% of children (n=21). Females may have a higher risk of adverse cardiovascular effects.

It has been proposed that halofantrine prolongs repolarization by blocking HERG potassium channels.[Ref]

Gastrointestinal

Gastrointestinal (GI) side effects have included abdominal pain (8.5%), diarrhea (6%), vomiting (4.3%), and nausea (3.4%), although these symptoms may also occur with a malarial infection. Abdominal distention, anorexia, constipation, dyspepsia, and stomatitis have been reported in less than 1% of patients. GI upset has also been reported.[Ref]

Hematologic

Hematologic side effects have included decreased hematocrit, decreased or increased white blood cells, decreased platelet counts, hemolysis, and hemolytic anemia. These reactions may also occur with a malaria infection.[Ref]

Hypersensitivity

Hypersensitivity side effects have included allergic and anaphylactic reactions including facial edema and urticaria.[Ref]

Dermatologic

Dermatologic side effects have included pruritus (2.6%) and rash (less than 1%).[Ref]

Musculoskeletal

Musculoskeletal side effects have included rigors (1.7%), myalgia (1.3%), arthralgia (less than 1%), and back pain (less than 1%).[Ref]

Nervous system

Nervous system side effects have included dizziness (4.5%) and headache (3%). Asthenia, confusion, convulsions, depression, paresthesia, and sleep disorder have been reported in less than 1% of patients.[Ref]

Genitourinary

Genitourinary side effects have included urinary frequency (less than 1%).[Ref]

Ocular

Ocular side effects have included abnormal vision (less than 1%).[Ref]

Respiratory

Respiratory side effects have included cough (3%). Pulmonary edema has been reported (1/933); however, causality was not determined.[Ref]

Other

Other side effects have included fatigue, malaise, and tinnitus in less than 1% of patients.[Ref]

Hepatic

Hepatic side effects have included increased hepatic transaminases, which returned to normal within 2 to 3 weeks.[Ref]

Renal

Renal side effects have included blackwater fever (acute intravascular hemolysis with acute renal failure and hemoglobinuria) requiring hemodialysis patients taking halofantrine (the active ingredient contained in Halfan) for Plasmodium falciparum infections (n=2). Causality was not clearly established. One patient had a positive Coombs test.[Ref]

References

1. Toivonen L, Viitasalo M, Siikamaki H, Raatikka M, Pohjola-Sintonen S "Provocation of ventricular tachycardia by antimalarial drug halofantrine in congenital long QT syndrome." Clin Cardiol 17 (1994): 403-4

2. Abernethy DR, Wesche DL, Barbey JT, et al. "Stereoselective halofantrine disposition and effect: concentration-related QTc prolongation." Br J Clin Pharmacol 51 (2001): 231-7

3. Nosten F, ter Kuile FO, Luxemburger C, et al "Cardiac effects of antimalarial treatment with halofantrine." Lancet 341 (1993): 1054-6

4. "From the Centers for Disease Control and Prevention. Sudden death in a traveler following halofantrine administration--Togo, 2000." JAMA 285 (2001): 1836

5. Touze JE, Heno P, Fourcade L, et al. "The effects of antimalarial drugs on ventricular repolarization." Am J Trop Med Hyg 67 (2002): 54-60

6. "Product Information. Lariam (mefloquine)." Roche Laboratories, Nutley, NJ.

7. Piippo K, Holmstrom S, Swan H, et al. "Effect of the antimalarial drug halofantrine in the long QT syndrome due to a mutation of the cardiac sodium channel gene SCN5A." Am J Cardiol 87 (2001): 909-11

8. Mbai M, Rajamani S, January CT "The anti-malarial drug halofantrine and its metabolite N-desbutylhalofantrine block HERG potassium channels." Cardiovasc Res 55 (2002): 799-805

9. White NJ, Pukrittayakamee S "Clinical malaria in the tropics." Med J Aust 159 (1993): 197-203

10. "Sudden death in a traveler following halofantrine administration--Togo, 2000." MMWR Morb Mortal Wkly Rep 50 (2001): 169-70, 179

11. "Product Information. Halfan (halofantrine)." GlaxoSmithKline, Philadelphia, PA.

12. Sahr F, Willoughby VR, Gbakima AA, Bockarie MJ "Apparent drug failure following artesunate treatment of Plasmodium falciparum malaria in Freetown, Sierra Leone: four case reports." Ann Trop Med Parasitol 95 (2001): 445-9

13. Karbwang J, Na Bangchang K "Clinical pharmacokinetics of halofantrine." Clin Pharmacokinet 27 (1994): 104-19

14. Sowunmi A, Fehintola FA, Ogundahunsi OA, Ofi AB, Happi TC, Oduola AM "Comparative cardiac effects of halofantrine and chloroquine plus chlorpheniramine in children with acute uncomplicated falciparum malaria." Trans R Soc Trop Med Hyg 93 (1999): 78-83

15. Winstanley P "Malaria: treatment." J R Coll Physicians Lond 32 (1998): 203-7

16. Ezeamuzie IC, Igbigbi PS, Ambakederemo AW, Abila B, Nwaejike IN "Halofantrine-induced pruritus amongst subjects who itch to chloroquine." J Trop Med Hyg 94 (1991): 184-8

17. Vachon F, Fajac I, Gachot B, Coulaud JP, Charmot G "Halofantrine and acute intravascular haemolysis." Lancet 340 (1992): 909-10

More about Halfan (halofantrine)

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