Drug Guide

Generic Name

Halofantrine Hydrochloride

Brand Names Halfan

Classification

Therapeutic: Antimalarial

Pharmacological: Antiprotozoal, erythrocytic schizonticide

FDA Approved Indications

  • Treatment of uncomplicated Plasmodium falciparum malaria

Mechanism of Action

Halofantrine inhibits the parasite's ability to synthesize proteins required for its survival, primarily affecting the erythrocytic stage of malaria by disrupting mitochondrial function and interfering with parasite replication.

Dosage and Administration

Adult: Initial dose of 1.2 g orally, followed by 480 mg every 8 hours for 2 doses, then 480 mg daily for 2 days (total treatment over 4 days).

Pediatric: Not established; use with caution and per specialist guidance.

Geriatric: Adjust dose cautiously; consider age-related hepatic and cardiac function.

Renal Impairment: Use with caution; dosage adjustments may be necessary.

Hepatic Impairment: Use with caution; potential for altered metabolism; monitor liver function.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses the placenta, and is concentrated in tissues.

Metabolism: Primarily hepatic via CYP3A4.

Excretion: Bile and feces; minimal urinary excretion.

Half Life: Approximately 4-5 days.

Contraindications

  • History of arrhythmias, especially QT prolongation, or concomitant use of other QT-prolonging drugs.
  • Hypersensitivity to halofantrine.

Precautions

  • Use with caution in patients with cardiac disease, electrolyte disturbances, or hepatic impairment.
  • Monitor cardiac function during therapy.

Adverse Reactions - Common

  • Nausea, vomiting, abdominal pain (Common)
  • Headache, dizziness (Common)

Adverse Reactions - Serious

  • QT prolongation, torsades de pointes (Rare)
  • Arrhythmias, cardiac arrest (Rare)
  • Hepatotoxicity (Rare)
  • Allergic reactions (Uncommon)

Drug-Drug Interactions

  • Other QT-prolonging drugs (e.g., quinolones, macrolides, certain antipsychotics)
  • CYP3A4 inhibitors or inducers

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Baseline ECG (QT interval), liver function tests, electrolyte levels.

Diagnoses:

  • Risk for arrhythmias related to QT prolongation
  • Risk for hepatotoxicity

Implementation: Administer with food to enhance absorption. Monitor ECG during therapy.

Evaluation: Assess for improvement in malaria symptoms and monitor for adverse effects.

Patient/Family Teaching

  • Report any symptoms of irregular heartbeat or fainting.
  • Notify provider if symptoms such as dizziness, nausea, or chest pain occur.
  • Adhere strictly to prescribed Dosing schedule.

Special Considerations

Black Box Warnings:

  • Potential for QT prolongation and life-threatening arrhythmias.

Genetic Factors: Patients with congenital QT prolongation or familial arrhythmia syndromes are at increased risk.

Lab Test Interference: None significant.

Overdose Management

Signs/Symptoms: Severe cardiac arrhythmias, dizziness, hypotension, nausea.

Treatment: Supportive care; monitor cardiac function; administer activated charcoal if ingestion was recent; correct electrolyte imbalances.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable for 2 years under proper storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.