Adedapo ADA, Ojji DB, Adedapo KS, Kolade Y, Babalola CP. Comparative cardiac effects of antimalarial drug halofantrine with or without concomitant administration of
kolanut or fluconazole in healthy volunteers.
Afr Health Sci 2023;
23:262-269. [PMID:
37545974 PMCID:
PMC10398509 DOI:
10.4314/ahs.v23i1.28]
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Abstract
BACKGROUND
There is rekindled interest in the cardiotoxicity of antimalarial medicines. Halofantrine is associated with QT interval prolongation. Fluconazole and kolanut alter the pharmacokinetics of halofantrine.
OBJECTIVES
The study assessed the electrocardiographic changes of concomitant administration of kolanut or fluconazole with halofantrine and the effects on the QTc interval.
METHODS
Eighteen healthy volunteers received a single oral dose of halofantrine, halofantrine with kolanut or halofantrine with fluconazole in a crossover study. Twelve lead electrocardiography (ECG) was performed to measure the PR and QT interval (QTc). Statistical analysis was with SPSS at 5% level of significance.
RESULTS
PR intervals were shortened by halofantrine alone and halofantrine with kolanut (169.29 28.67 to 165.29 28.007 and 172.73 29.843 to 163.00 18.336ms) but was prolonged by halofantrine with fluconazole (177.70 27.394 to 186.59 44.434ms). There was prolongation of QTc (384.76 21.727 to 394.12 21.525; 381.36 22.29 to 388.30 17.26 and 382.35 20.08 to 390.84 21.97) in all the three treatment groups at 6 hours, p>0.05. One subject on halofantrine and fluconazole had QTc >440ms. Pre-treatment PR interval (PR0) correlated well with post-treatment PR6, and with PR14 r= 0.519, p= 0.014; r=0.664, p=0.013.
CONCLUSION
Concomitant intake of kolanut with halofantrine was significantly decrease cardiac effect of halofantrine.
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