Author: Unknown

PATIENT INFORMATION LEAFLET
ON 'HALFAN' TABLETS

Please read this leaflet before you start to take your medicine.

It is essential to follow your doctor's advice. If there is anything you do not
understand, please ask your doctor or pharmacist (chemist).
Keep this leaflet until you have finished all your prescribed course. You may
want to read it again.
If you are helping someone else who has been prescribed 'Halfan' by their
doctor to take their medicine, please read this leaflet before you give the first
dose.

THE NAME OF YOUR MEDICINE IS ‘HALFAN'
What is 'Halfan’?
It is an antimalarial drug. The active ingredient is called halofantrine.

What does 'Halfan' do?
It is used to treat malaria (not to prevent it).

IMPORTANT THINGS TO KNOW ABOUT 'HALFAN'

1.	You should consult your doctor before taking 'Halfan' if you (or any member of your family) have heart problems or if you have taken tablets for your heart, or if you suffer from blackouts or if you are taking any other tablets from a doctor or pharmacist (chemist).
2.	If you think you may have salt depletion as a result of prolonged severe diarrhoea and vomiting (being sick) or usage of diuretics (water tablets) consult your doctor before taking 'Halfan'.
3.	If you are taking the antimalarial mefloquine (Lariam) or have taken it within the last 3 months or if you are taking any other antimalarials, you must inform your doctor before taking 'Halfan'.
4.	You should not take this medicine if you think or have been told that you are allergic to 'Halfan'. If so tell your doctor, you may be given another medicine instead.
5.	Before taking ANY medicines you should tell you doctor if you are pregnant (or think you may be), or if you are breast feeding.
6.	Like all medicines, 'Halfan' can sometimes cause unwanted effects. [You will find more about this later in this leaflet.)
7.	ALWAYS KEEP MEDICINES OUT OF THE REACH OF CHILDREN
For more information on 'Halfan' and malaria, please read the rest of this leaflet.

BEFORE TAKING YOUR MEDICINE
What should I do it I think I am pregnant (or I am breast feeding)?
Do not take 'Halfan' without consulting your doctor. You may be given another medicine instead.

TAKING YOUR MEDICINE
How much should I take and how often?
'HALFAN' SHOULD BE TAKEN ON AN EMPTY STOMACH.
Follow your doctor's directions about how and when to take your medicine. Please read the dispensing label carefully, it will tell you how many 'Halfan' tablets to take for each dose. DO NOT TAKE MORE THAN THE DOSE YOUR DOCTOR HAS RECOMMENDED. Your pharmacist or doctor can help if you are not sure.
The tablets should be swallowed with water
For the first 24 hours of treatment (day one), there are three doses of 'Halfan' to be taken. You must take the first dose immediately, the second dose six hours later and the last dose six hours after that. All doses should be taken on an empty stomach. For example:

The normal adult dose is two tablets three times a day. Children weighing less than 37 kg will be given less than this according to their weight.
Your doctor may also instruct you to take a second course of treatment one week later on day eight. This course will also be three doses taken six hours apart.
It is important to follow your doctor's instructions. Your symptoms may come back if you stop your treatment too early.
What should I do if I forget to take a dose?
It is very important that 'Halfan' doses are taken exactly as instructed. However, if you forget to take a dose at the right time, take it as soon as you remember, but then take the next dose six hours later.
AFTER TAKING YOUR MEDICINE
What unwanted effects might it have?
A few people may find that 'Halfan' gives them diarrhoea, stomach pains, sickness, itching or a rash. If this happens, these symptoms are usually mild. If you suffer badly tell your doctor immediately.
In some patients 'Halfan' could cause serious heart or blood problems. If you develop any unusual problems such as fainting, blackouts, palpitations, irregular heart beats, fits or brown-coloured urine, tell your doctor immediately.
If your doctor decides to stop treatment, return any left-over medicine to your pharmacist.
What if I have taken too much?
If more than the recommended dose has been taken, consult your doctor or local hospital casualty department at once.
continued

STORING YOUR MEDICINE
How should I store 'Halfan' tablets?
Keep the medicine in its original pack; this provides protection from light. Keep 'Halfan' in a dry place and at a temperature below 30°C.

KEEP ALL MEDICINES OUT OF REACH OF CHILDREN - preferably in a locked cupboard or medicine cabinet.

Remember this medicine has been prescribed just for you. Never offer your medicine to other people. It may not be suitable for them even if their symptoms seem the same as yours.

MORE INFORMATION
'Halfan' tablets: each tablet contains 250 mg of halofantrine hydrochloride.
The tablets also contain inactive ingredients to make the medicine acceptable amongst these are starch and cellulose. They do not contain tartrazine or other azo dyes.
Non-proprietary name: Halofantrine Tablets.

Product Licence Holder: Smith Kline & French Laboratories, Welwyn Garden City, Hertfordshire AL7 1EY, England.

Manufacturer: SmithKline Beecham Laboratoires Pharmaceutiques, avenue G. Eiffel, BP 60, 33603 PESSAC Cedex, France.

How can I obtain more information about 'Halfan’?
In this short leaflet, we can give you only the most important information. If you would like to know more, ask your doctor or pharmacist.

Smith Kline & French Laboratories
'Halfan' is a trade mark
Leaflet prepared in June 1994
t1994 Smith Kline 6 French Laboratories

FURTHER INFORMATION ON MALARIA
What is malaria?
Malaria is one of the world's most serious tropical diseases and is spread by mosquitoes carrying the malaria parasite.
The malaria parasite is transferred to man when a mosquito carrying the infection bites its victim. The malaria parasite then enters the bloodstream and is carried to the liver. At that time no symptoms appear, but the malaria parasite multiplies.
Following its stay in the liver, the parasite enters another stage of its life cycle by being released into the bloodstream. Here it penetrates red blood cells multiplies and causes the blood cells to burst, releasing large numbers of parasites. each able to infect a new red blood cell. The release of these parasites coincides with the malaria fever It takes two to three days for newly infected blood cells to release further parasites and this explains the well-known intermittent character of the fever. In some cases. the infection is so severe that the fever is continuous.

There are four different forms of malaria, caused by different Plasmodium species. In general, the severity of the illness is related to the number of parasites in the blood. In three forms of malaria the number of plasmodia in the blood is relatively small. no more than 1% of red blood cells containing parasites. In falciparum malaria however, up to 80% of the red blood cells may be affected, causing severe or even fatal disease.

What are the risks associated with malaria?
Worldwide, at least 1600 million people are constantly at risk from malaria, and about 200 million people are affected by the disease each year with at least two million deaths, mainly in young children.
Malaria can be caught by people living or travelling in or through) most of the tropical or sub-tropical countries in the world (more than 100 countries - see map below). The risks of contracting malaria vary from country to country depending on public health measures.
Former residents of affected areas who migrate to countries where they are no longer exposed to malaria quickly lose any immunity that they may have built up to infection . If they return to these areas for a visit, they will be at high risk of serious illness unless they take full preventative measures.
Pregnant women should avoid travelling to malarial regions. The body's resistance to malaria is decreased during pregnancy so the disease is more frequent and severe in pregnancy.
Other groups at special risk include children and sick or elderly people who can suffer the worst effects if they develop the disease.
REMEMBER any person bitten by a single infected mosquito can be at risk from malaria. For this reason, it is essential to take all possible precautions against malaria when travelling to areas where infection is a possibility.

Geographical distribution of malaria (1988). Note, however, that the exact | distribution varies somewhat from time to time. Taken from: R Dawood (1989). Travellers' Health: How to Stay Healthy Abroad (Second Edition) Oxford University Press.
continued

What are the symptoms of malaria?
The incubation period following the bite of a mosquito bearing the infection is at least five to 10 days - but longer than a year may elapse before the symptoms appear. The principal symptoms are a continuous or intermittent fever with malaise, shivering, headache, tiredness, mental confusion. dizziness or muscle pains. Gastrointestinal symptoms including nausea, vomiting, abdominal pain, loss of appetite or diarrhoea may also be present. Serious cases may involve jaundice, convulsions or coma.

Malaria should always be suspected in any person who has a fever or other worrying symptoms and has recently travelled to a malarial area. YOU MUST CONSULT A DOCTOR IMMEDIATELY.

What steps should be taken BEFORE you travel to a malarial region?
You should always consult your doctor in advance of any travel to or through a malarial region - no matter how often you may have visited the country before. Preventative drugs can be prescribed; these drugs suppress the red blood cell forms of the parasite. They generally must be started one to two weeks before entering a malarial region (to ensure a sufficient blood level of the drug before any possible exposure to malaria). They are taken continuously during the visit and continued for four to eight weeks afterwards. It is important that any preventative drugs are taken exactly as prescribed, for the full course.

NOTE: 'HALFAN' IS NOT A PREVENTATIVE DRUG.

It is also vital that you receive the correct drug for the region to which you are travelling. In many parts of the world, the malaria parasite has become resistant to several of these preventative drugs.

No drugs give long-term protection so a full new course is needed for each journey. Your doctor or health advisory agency can provide you with up-to-date information on the most appropriate form of preventative treatment for your travel requirements. A recorded telephone advice message on malaria prevention is available on 071-636 7921.

What personal measures can be taken to prevent mosquito bites?
In addition to preventative drug therapy, it is important to take all possible measures to avoid mosquito bites. Protection against mosquitoes is also advisable if passing through a malarial region, or even pausing briefly in an airport transit lounge.

Some simple commonsense measures to reduce the risk of mosquito bites can greatly reduce the risk of developing malaria:

•	Mosquitos most commonly bite between dusk and dawn. If possible, avoid going out at these times.
•	Wear a long-sleeved shirt and long trousers if you are going out at night.
•	Use an insect repellent regularly on all exposed skin.
•	Avoid sunbathing when mosquitoes are about.
•	Close all windows at night to keep mosquitoes out. A wire mesh across the windows can also be helpful. Always use air-conditioning, if it is available.
•	Use mosquito nets over the beds. Check that there are no holes in the net through which mosquitoes may gain entry.

What needs to be remembered on return home?

When you have been travelling in areas where malaria can occur, you should remember the following points:

1.	Frequent exposure to mosquitoes is not necessary: just one bite from an infected mosquito can cause malaria.
2.	It could be five days to a year between being bitten by an infected mosquito and developing the symptoms of malaria.
3.	Make sure that you complete the full course of any preventative drugs on your return.
4.	ConsuIt your doctor immediately if you develop any worrying symptoms and identify which countries you have visited.
5.	If you have received treatment for malaria whilst abroad, inform your doctor in case of a recurrence of the disease.