Indications |
Oral Malaria Adult: As sulfate: 648 mg given every 8 hr for 7 days. Child: 10 mg/kg given every 8 hr for 7 days. Renal impairment: Severe chronic renal failure (as sulfate): 648 mg followed 12 hr later by maintenance doses of 324 mg every 12 hr. Oral Nocturnal leg cramps Adult: 200-300 mg once at night. Oral Babesiosis Adult: As sulfate: 650 mg every 6-8 hr. To be taken with clindamycin for 7-10 days. Child: 8 mg/kg (up to 650 mg) every 8 hr. To be taken with clindamycin for 7-10 days. Intravenous Malaria Adult: As dihydrochloride: Initially, 20 mg/kg (max: 1.4 g) given over 4 hr. Start maintenance doses 8 hr after the start of the initial infusion. Maintenance: 10 mg/kg (up to 700 mg) given over 4 hr every 8 hr. Loading dose should not be given if patient has received quinine, quinidine, mefloquine or halofantrine during the previous 24 hr. If parenteral treatment is required for >48 hr, maintenance dose should be reduced to 5-7 mg/kg. |
Contraindications |
Hypersensitivity to quinine or quinidine. Myasthaenia gravis; haemolytic anaemia; quinine-resistant falciparum; patients with tinnitus or optic neuritis; patients who have suffered an attack of blackwater fever. Prolonged QT interval. Pregnancy. |
Warnings / Precautions |
Lactation. CV diseases; G6PD deficient individuals. |
Adverse Reactions |
Cinchonism characterised by tinnitus, impaired hearing, headache, nausea, vomiting, disturbed vision, vertigo, abdominal pain and diarrhoea; urticaria, pruritus, fever, angioedema, asthma, dyspnoea, haemoglobinuria, thrombocytopenic purpura, hypoglycaemia, renal failure, hypoprothrombinaemia, agranulocytosis, Inj site irritation, pain and necrosis. Potentially Fatal: Sinus arrest, AV block, ventricular fibrillation and sudden death especially with IV use. |
Overdose Reactions |
Symptoms include GI effects, oculotoxicity, CNS disturbances and cardiotoxicity. |
Drug Interactions |
Rifampicin accelerates quinine clearance; cimetidine inhibits quinine metabolism; quinine may enhance hypoglycaemic effects of oral antidiabetics. Concurrent admin with aluminium and/or magnesium containing antacids may decrease the absorption of quinine. Potentially Fatal: Increases digitalis toxicity; hypoprothrombinaemic effect of warfarin enhanced by quinine. Increased risk of convulsions with mefloquine. Increased risk of ventricular arrhythmias with halofantrine or other arrhythmogenic drugs e.g., amiodarone, astemizole, terfenadine, cisapride and pimozide. See Below for More quinine Drug Interactions |
Lab Interactions |
Quinine may interfere with some methods of measuring 17-hydroxycorticosteroids, 17-ketogenic steroids and urinary catecholamines. |
Mechanism of Actions |
Quinine is a cinchona alkaloid and a 4-methanol quinoline. It rapidly acts on blood schizontocide by interfering with lysosomal function or nucleic acid synthesis in the Plasmodia spp. It has no activity against exoerythrocytic forms. In the skeletal muscle, quinine increases the refractory period and excitability of the myoneural junction. Absorption: Rapid and almost complete from the GIT; peak plasma concentrations after 1-3 hr (oral). Distribution: Widely distributed; crosses the placenta; enters breast milk. Protein-binding: 70%. Metabolism: Extensively hepatic. Excretion: Urine; 11 hr (elimination half-life). |
Storage Conditions |
Oral: Store at 25-30°C. |
ATC Classification |
P01BC01 - quinine ; Belongs to the class of methanolquinoline antimalarials. |
Storage |
Oral: Store at 25-30°C. |
Available As |
|
Quinine
Post Review about Quinine Click here to cancel reply.
Quinine Containing Brands
Quinine is used in following diseases
Drug - Drug Interactions of Quinine
Latest News
- FDA approves Ruconest for treatment of hereditary angioedema
- FDA recommend against aspirin to prevent First Heart Attacks
- FDA approves Pomalyst (pomalidomide) for advanced multiple myeloma
- FDA approves three new drug treatments for type 2 diabetes
- Long-term consequences of vaginal delivery on the pelvic floor
No comments yet.