What is quinine?

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Generic Name: Quinine Brand Name(s): Generics only. No brands available.

Know the basics

What is quinine used for?

This medication is used alone or with other medication to treat malaria caused by mosquito bites in countries where malaria is common. Malaria parasites can enter the body through these mosquito bites, and then live in body tissues such as red blood cells or the liver. This medication is used to kill the malaria parasites living inside red blood cells. In some cases, you may need to take a different medication (such as primaquine) to kill the malaria parasites living in other body tissues. Both drugs may be needed for a complete cure and to prevent the return of infection (relapse). Quinine belongs to a class of drugs known as antimalarials. It is not used for the prevention of malaria.

The United States Centers for Disease Control provide updated guidelines and travel recommendations for the prevention and treatment of malaria in different parts of the world. Discuss the most recent information with your doctor before traveling to areas where malaria occurs.

How should I take quinine?

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking quinine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth, with food to decrease upset stomach, exactly as prescribed by your doctor. This medication is usually taken every 8 hours for 3 to 7 days or as directed by your doctor.

Take this medication 2 to 3 hours before or after taking antacids containing aluminum or magnesium. These products bind with quinine, preventing your body from fully absorbing the drug.

Dosage and length of treatment are based on your medical condition, country where you were infected, other medications you may be taking for malaria, and your response to treatment.

The dosage in children is also based on weight.

It is very important to continue taking this medication (and other malaria medications) exactly as prescribed by your doctor. Do not take more or less of this drug than prescribed. Do not skip any doses. Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Skipping doses or stopping the medication too early may make the infection more difficult to treat and result in a return of the infection.

This medication works best when the amount of drug in your body is kept at a constant level. Therefore, take this drug at evenly spaced intervals. To help you remember, take it at the same times each day.

Tell your doctor if you do not start feeling better after 1-2 days of starting this medication. If your fever returns after completing this prescription, contact your doctor so that he/she can determine whether the malaria has returned.

How do I store quinine?

Quinine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store quinine in the bathroom or the freezer. There may be different brands of quinine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush quinine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using quinine?

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of quinine in children younger than 16 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of quinine in the elderly.

Is it safe to take quinine during pregnancy or breast-feeding?

There isn’t enough information about the safety of using this medication during pregnancy and breast-feeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication.

Know the side effects

What are the side effects of quinine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using quinine and call your doctor at once if you have any of these serious side effects:

  • fever, chills, confusion, weakness, sweating;
  • severe vomiting, stomach pain, diarrhea;
  • problems with vision or hearing;
  • chest pain, trouble breathing, severe dizziness, fainting, fast or pounding heartbeats;
  • severe flushing (warmth, redness, or tingly feeling);
  • urinating less than usual or not at all;
  • weak or shallow breathing, feeling like you might pass out;
  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
  • blood in your urine or stools;
  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or
  • loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • headache, blurred vision, changes in color vision;
  • mild dizziness, spinning sensation, ringing in your ears;
  • upset stomach; or
  • muscle weakness.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with quinine?

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Astemizole
  • Aurothioglucose
  • Cisapride
  • Dronedarone
  • Fluconazole
  • Ketoconazole
  • Mesoridazine
  • Nelfinavir
  • Pimozide
  • Piperaquine
  • Posaconazole
  • Sparfloxacin
  • Thioridazine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfuzosin
  • Aluminum Carbonate, Basic
  • Aluminum Hydroxide
  • Aluminum Phosphate
  • Amiodarone
  • Amitriptyline
  • Amoxapine
  • Anagrelide
  • Apomorphine
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether
  • Asenapine
  • Azithromycin
  • Buserelin
  • Carbamazepine
  • Ceritinib
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Cobicistat
  • Crizotinib
  • Dabrafenib
  • Dasatinib
  • Delamanid
  • Desipramine
  • Deslorelin
  • Dihydroxyaluminum Aminoacetate
  • Dihydroxyaluminum Sodium Carbonate
  • Disopyramide
  • Dolasetron
  • Domperidone
  • Droperidol
  • Erythromycin
  • Escitalopram
  • Eslicarbazepine Acetate
  • Fingolimod
  • Fluoxetine
  • Gatifloxacin
  • Gemifloxacin
  • Gonadorelin
  • Goserelin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Histrelin
  • Ibutilide
  • Idelalisib
  • Iloperidone
  • Imipramine
  • Ivabradine
  • Lacosamide
  • Lapatinib
  • Leuprolide
  • Levofloxacin
  • Lumefantrine
  • Magaldrate
  • Magnesium Carbonate
  • Magnesium Hydroxide
  • Magnesium Trisilicate
  • Mefloquine
  • Methadone
  • Metronidazole
  • Mifepristone
  • Mitotane
  • Moxifloxacin
  • Nafarelin
  • Nevirapine
  • Nilotinib
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Ondansetron
  • Paliperidone
  • Pancuronium
  • Pazopanib
  • Perflutren Lipid Microsphere
  • Primidone
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Ranolazine
  • Rifampin
  • Ritonavir
  • Salmeterol
  • Sevoflurane
  • Siltuximab
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Succinylcholine
  • Sunitinib
  • Telavancin
  • Telithromycin
  • Terfenadine
  • Tetrabenazine
  • Tizanidine
  • Toremifene
  • Trazodone
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Troleandomycin
  • Tubocurarine
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Vilanterol
  • Vinflunine
  • Voriconazole
  • Ziprasidone

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Atorvastatin
  • Cyclosporine
  • Digoxin
  • Fosphenytoin
  • Phenobarbital
  • Phenytoin
  • Rifapentine
  • Tetracycline

Does food or alcohol interact with quinine?

Quinine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with quinine?

Quinine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Atrial fibrillation or flutter (abnormal heart rhythms) or
  • Bradycardia (slow heartbeat) or
  • Heart disease (eg, myocardial ischemia) or
  • Hypokalemia (low potassium in the blood), uncorrected or
  • Sick sinus syndrome (type of abnormal heart rhythm)—Use with caution. May cause side effects to become worse.
  • Blackwater fever (a blood disorder) or
  • Hemolytic uremic syndrome (a serious kidney disorder) or
  • Idiopathic thrombocytopenia purpura (a serious blood disorder) or
  • Thrombocytopenia (low number of platelets) or
  • Thrombotic thrombocytopenic purpura (a serious blood disorder)—Should not be used in patients who had these serious side effects to quinine.
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency (a blood disorder) or
  • Heart rhythm problems (eg, prolonged QT interval) or
  • Liver disease, severe or
  • Myasthenia gravis (severe muscle weakness) or
  • Optic neuritis (swelling of a nerve in the eye)—Should not be used in patients with these conditions.
  • Hypoglycemia (low blood sugar)—Use with caution. May make this condition worse.
  • Kidney disease, severe or
  • Liver disease, mild to moderate—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Understand the dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this medication.

What is the dose of quinine for an adult?

Usual Adult Dose for Malaria

Treatment of uncomplicated Plasmodium falciparum malaria: 648 mg orally every 8 hours for 7 days

Per Centers for Disease Control and Prevention (CDC) guidelines:

542 mg base (650 mg sulfate salt) orally 3 times a day for 3 to 7 days

What is the dose of quinine for a child?

Usual Pediatric Dose for Malaria

Treatment of uncomplicated P falciparum malaria:

16 years or older: 648 mg orally every 8 hours for 7 days

Per CDC guidelines:

8.3 mg base/kg (10 mg sulfate salt/kg) orally 3 times a day for 3 to 7 days; pediatric dose should never exceed adult dose

Less than 8 years:

-Treatment of uncomplicated malaria due to chloroquine-resistant (or unknown resistance) P falciparum (or species not identified) infection should be combined with clindamycin.

-Treatment of uncomplicated malaria due to chloroquine-resistant P vivax infection should be combined with primaquine phosphate.

8 years or older:

-Treatment of uncomplicated malaria due to chloroquine-resistant (or unknown resistance) P falciparum (or species not identified) infection should be in conjunction with one of the following: doxycycline, tetracycline, or clindamycin.

-Treatment of uncomplicated malaria due to chloroquine-resistant P vivax infection should be in conjunction with either doxycycline or tetracycline plus primaquine phosphate.

How is quinine available?

Quinine is available in the following dosage forms and strengths:

Capsules: 324 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

Symptoms of overdose may include:

  • blurriness or changes in color vision
  • symptoms of low blood sugar
  • changes in heartbeat
  • headache
  • nausea
  • vomiting
  • stomach pain
  • diarrhea
  • ringing in the ears or difficulty hearing
  • seizures
  • slow or difficult breathing

What should I do if I miss a dose?

If you miss a dose of quinine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

msBahasa Malaysia

Sources

Review Date: May 30, 2016 | Last Modified: January 4, 2017

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