Classes
DEA Class; Rx
Common Brand Names; Qualaquin
- Antimalarials;
Description
Antimalarial; occurs naturally in the bark of the cinchona tree; more toxic and potent antimalarial than quinidine; FDA ruled that it lacked evidence of effectiveness for relief of nocturnal muscle cramps; non-prescription forms are no longer available but prescription forms are still available.
Indications
Indicated for the treatment of malaria.
Contraindications
Prolonged QT interval
Hypersensitivity; cross-sensitivity with mefloquine or quinidine
G6PD deficiency
Optic neuritis, tinnitus, history of quinine-associated blackwater fever and thrombocytopenic purpura
Thrombocytopenia
Idiopathic thrombocytopenia purpura (ITP) and thrombotic thrombocytopenic purpura (TTP)
Hemolytic uremic syndrome
Blackwater fever
Myasthenia gravis
Optic neuritis
Adverse Effects
- Flushing of the skin
- Anginal symptoms
- Fever
- Rash
- Pruritus
- Hypoglycemia
- Epigastric pain
- Hemolysis in G6PD deficiency
- Thrombocytopenia
- Hepatitis
- Nightblindness
- Diplopia
- Optic atrophy
- Impaired hearing
- Hypersensitivity reaction
Warnings
Acute hemolytic anemia reported in patients receiving quinine for treatment of malaria, including patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency; the cause for acute hemolytic anemia in treated patients with malaria and potential relationship with G6PD deficiency not determined; closely monitor hemoglobin and hematocrit during quinine treatment; discontinue therapy if patients develop acute hemolytic anemia
Use with caution in patients with atrial fibrillation or atrial flutter; a paradoxical increase in ventricular response rate may occur with quinine, similar to that observed with quinidine; if digoxin is used to prevent a rapid ventricular response, serum digoxin levels should be closely monitored, because digoxin levels may be increased with use of quinine
Quinine stimulates release of insulin from the pancreas, and patients, especially pregnant women, may experience clinically significant hypoglycemia
Pregnancy and Lactation
No evidence that quinine causes uterine contractions at doses recommended for malaria treatment
Low levels of quinine in breastmilk; amounts ingested by infant are small and would not be expected to cause any adverse effects
Maximum Dosage
1,944 mg/day PO.
1,944 mg/day PO.
16 to 17 years: 1,944 mg/day PO.
13 to 15 years: Safety and efficacy have not been established; however, doses up to 30 mg/kg/day PO (Max: 1,944 mg/day) have been used off-label.
Safety and efficacy have not been established; however, doses up to 30 mg/kg/day PO (Max: 1,944 mg/day) have been used off-label.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Quinine sulfate
capsule
- 324mg
