Quinine
Antimalarial · 4-Methanolquinolone
Indications
TABLET: Therapy of falciparum malaria. INJECTION: Only when the patient is seriously ill.
Dosage
ORAL: Adults: Treatment of chloroquine resistant malaria: 650 mg (Quinine sulphate) every 8 hr for 3-7 days with tetracycline. Suppression of malaria: 325 mg (Quinine sulphate) twice daily and continued for 6 wk after exposure. Children: > 8 yr: Treatment of chloroquine resistant malaria: 25-30 mg/kg/day (Quinine sulphate) in divided doses every 8 hr for 3-7 days with tetracycline. Below 8 yr, consider risk versus benefit. INJECTION: Treatment of Falciparum malaria: Adults: By IV infusion: Loading dose 20 mg/kg (Quinine dihydrochloride or hydrochloride), up to max 1.4 gm infused over 4 hr, then 8 hr after the start of the loading dose; maintenance dose of 10 mg/kg (up to max 700 mg) of quinine salt infused over 4 hr every 8 hr (till patient can swallow tablets to complete the 7 day course together with or followed by doxycycline 200 mg once daily for 7 days). Treatment of malaria caused…
Adverse Effects
Hypersensitivity reactions, blood dyscrasias, acute renal failure, hypoglycaemia, bronchospasm, dyspnoea, cardiovascular effects. Cinchonism manifest by tinnitus, headache, nausea, abdominal pain, flushing, rash, visual disturbances, confusion. Reports of thrombocytopenia, Stevens Johnson syndrome.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Contraindicated or not recommended. Contraindications: Haemoglobinuria or haemolysis, optic neuritis, tinnitus, Myasthaenia gravis, history of blackwater fever. Precautions: Atrial fibrillation, conduction defects, heart block. Blood glucose monitoring required during treatment. G6PD deficiency. Risk factors for QT prolongation. Thrombocytopenia.
Interactions
Mefloquine, digoxin, antipsychotics, cimetidine, amiodarone, flecainide, moxifloxacin, pimozide, chloroquine, warfarin, other drugs that prolong QT interval, anticoagulants, phenobarbital, carbamazepine, amantadine.
Advice to Patient
Take with meals with a full glass of water. Do not take any aluminium-containing antacids during therapy. Do not crush sustained release form. Regularly follow-up blood tests during therapy. If there is constant headache, consult prescriber for analgesic. Contact prescriber if there is ringing in ears, change in hearing, difficulty in breathing, seizures, chest pain, change in vision (double vision, blurring, night blindness).
Pharmacokinetics
Absorption: Rapidly and almost completely absorbed from the GI tract. Metabolism: Hepatic. Bioavailability: 76%-88%. Half-life elimination: 11 hrs. Prolonged in patients with malaria. Time to peak, plasma: 1-3 hrs. Excretion: Urine (mainly). Faeces and saliva (small amounts).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.