Generic Name: quinine (KWYE nine)Brand names: Qualaquin, QM-260
The U.S. Food and Drug Administration has banned the sale of all non-approved brands of quinine because of the risk of serious side effects or death. As of December 2006, Qualaquin is the only brand of quinine that is approved by the FDA.
Quinine is used to treat malaria, a disease caused by parasites. Parasites that cause malaria typically enter the body through the bite of a mosquito. Malaria is common in areas such as Africa, South America, and Southern Asia.
Quinine may also be used for other purposes not listed in this medication guide.
The U.S. Food and Drug Administration has banned the sale of all non-approved brands of quinine because of the risk of serious side effects or death. As of December 2006, Qualaquin is the only brand of quinine that is approved by the FDA.Quinine can cause serious or life-threatening side effects, and is approved for use only in treating malaria. Some people have used quinine to treat leg cramps, but this is not an FDA-approved use. Do not use quinine to treat any medical condition if your doctor did not prescribe quinine for that condition. Do not purchase quinine on the Internet or from vendors outside of the United States. Using this medication improperly or without the advice of a doctor can result in serious side effects or death.
Do not use this medication if you have ever had an allergic reaction to quinine or similar medicines such as mefloquine (Lariam) or quinidine (Cardioquin, Quinidex, Quinaglute).
You should not take quinine if you have a history of "Long QT syndrome," or if you have glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, myasthenia gravis, or optic neuritis (inflammation of the nerves in your eyes).
Before taking quinine, tell your doctor if you have heart disease or a heart rhythm disorder, low potassium levels in your blood (hypokalemia), kidney disease, or liver disease.Serious side effects of quinine include fever, chills, confusion weakness, severe vomiting or stomach pain, diarrhea, pale or yellowed skin, dark colored urine, chest pain, pounding or fluttering heartbeats, hearing or vision loss, purple spots under your skin, a blistering or peeling skin rash, or urinating less than usual or not at all.
No medication is 100% effective in treating malaria. For best results, keep using the medication as directed. Talk with your doctor if you have fever, vomiting, or diarrhea during your treatment.
a history of "Long QT syndrome";
glucose-6-phosphate dehydrogenase (G-6-PD) deficiency;
myasthenia gravis; or
optic neuritis (inflammation of the optic nerve).
If you have any of these other conditions, you may need a dose adjustment or special tests to safely take quinine:
heart disease or a heart rhythm disorder;
low potassium levels in your blood (hypokalemia); or
kidney or liver disease.
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.Take quinine with food to lessen stomach upset.
Call your doctor if your malaria symptoms do not improve after 2 days of taking quinine, or if your symptoms return after you have finished the medication.Take this medication for the full prescribed length of time. Your symptoms may get better before your condition is completely treated. If you stop using the medication early for any reason, talk to your doctor about other forms of malaria prevention.
If you need to have any type of surgery, tell the surgeon ahead of time that you are using quinine. You may need to stop using the medicine for a short time.
This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using quinine.
No medication is 100% effective in treating malaria. For best results, keep using the medication as directed. Talk with your doctor if you have fever, vomiting, or diarrhea during your treatment.Store quinine at room temperature away from moisture and heat.
See also: Quinine dosage in more detail
Take the missed dose as soon as you remember. If you are more than 4 hours late for your dose, skip it and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.
Overdose symptoms may include headache, confusion, dizziness, ringing in your ears, vision or hearing loss, severe nausea or vomiting, sweating, uneven heart rate, feeling light-headed, and fainting or collapse.
Avoid using antacids without your doctor's advice. Use only the specific type of antacid your doctor recommends. Antacids contain different medicines and some types can make it harder for your body to absorb quinine.
fever, chills, confusion, weakness;
severe vomiting, stomach pain, diarrhea;
problems with vision or hearing;
urinating less than usual or not at all;
fast, pounding, or fluttering heartbeats;
weak or shallow breathing, feeling like you might pass out;
pale skin, easy bruising, purple or red pinpoint spots under your skin;
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; o
loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may include:
headache, ringing in your ears, blurred vision;
dizziness, spinning sensation;
mild nausea, diarrhea, or stomach pain;
muscle weakness; or
warmth, redness, or tingly feeling under the skin.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Malaria:
Qualaquin (R):Treatment of uncomplicated Plasmodium falciparum malaria: 648 mg orally every 8 hours for 7 daysPer Centers for Disease Control and Prevention (CDC) guidelines:542 mg base (650 mg sulfate salt) orally 3 times a day for 3 to 7 daysTreatment 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. In pregnant women, quinine sulfate plus clindamycin is recommended.Treatment of uncomplicated malaria due to chloroquine-resistant P vivax infection should be in conjunction with either doxycycline or tetracycline plus primaquine phosphate. In pregnant women, quinine sulfate alone for 7 days is recommended.
Usual Pediatric Dose for Malaria:
Qualaquin (R):Treatment of uncomplicated P falciparum malaria:16 years or older: 648 mg orally every 8 hours for 7 daysPer 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 doseLess 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.
Many drugs can interact with quinine. Below is just a partial list. Tell your doctor if you are using:
arsenic trioxide (Trisenox);
cimetidine (Tagamet), cisapride (Propulsid), or ranitidine (Zantac);
dextromethorphan (cough medicine);
digoxin (digitalis, Lanoxin);
rifampin (Rifadin, Rimactane, Rifater);
aminophylline (Truphylline), or theophylline (Elixophyllin, Respbid, Theobid, Theo-Dur, Uniphyl);
a blood thinner such as warfarin (Coumadin);
an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), levofloxacin (Levaquin), moxifloxacin (Avelox), pentamidine (NebuPent, Pentam), or tetracycline (Brodspec, Tetracap);
an antidepressant such as amitriptylline (Elavil, Vanatrip), clomipramine (Anafranil), or desipramine (Norpramin);
other anti-malaria medications such as chloroquine (Arelan), or mefloquine (Lariam);
heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), ibutilide (Corvert), procainamide (Procan, Pronestyl), propafenone (Rythmol), quinidine (Quinidex, Quin-Release Quin-G), or sotalol (Betapace);
medicine to prevent or treat nausea and vomiting, such as dolasetron (Anzemet) or ondansetron (Zofran);
medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (FazaClo, Clozaril), haloperidol (Haldol), pimozide (Orap), thioridazine (Mellaril), or ziprasidone (Geodon);
migraine headache medicine such as sumatriptan (Imitrex) or zolmitriptan (Zomig);
narcotic medication such as levomethadyl (Orlaam), or methadone (Dolophine, Methadose); or
seizure medication such as carbamazepine (Carbatrol, Tegretol), phenobarbital (Luminal, Solfoton), or phenytoin (Dilantin).
This list is not complete and there may be other drugs that can interact with quinine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.