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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.

Type

Journal article

Journal

Lancet

Publication Date

24/04/1993

Volume

341

Pages

1054 - 1056

Keywords

Adolescent, Adult, Antimalarials, Electrocardiography, Female, Heart, Humans, Malaria, Falciparum, Male, Mefloquine, Phenanthrenes, Prospective Studies