Generic Name: quinine (KWYE-nine)
Brand Name: Qualaquin
Quinine may cause serious and life-threatening bleeding problems. In some cases, kidney injury can also occur. Tell your doctor immediately if you experience unusual bleeding or bruising (eg, bleeding gums; severe nose bleed; dark urine; black, tarry, or bloody stools; unusual purple, brown, or red spots on the skin).
Quinine is not approved to treat or prevent nighttime leg cramps. The risk of taking quinine for nighttime leg cramps may be greater than the possible benefits. Talk with your doctor if you have questions about this information.
Quinine is used for:
Treating malaria. It is usually used with other antimalarial medicines. It may also be used for other conditions as determined by your doctor.
Quinine is an antimalarial. It works by killing the malaria parasite.
Do NOT use quinine if:
- you are allergic to any ingredient in quinine, or to mefloquine or quinidine
- you have a history of a low platelet count (thrombocytopenia), certain blood problems (eg, blackwater fever, intravascular hemolysis), or bleeding problems (eg, hemolytic-uremic syndrome/thrombotic thrombocytopenic purpura [HUS/TTP]) caused by using quinine in the past
- you have glucose-6-phosphate dehydrogenase (G6PD) deficiency, inflammation of the optic (eye) nerve (optic neuritis), or myasthenia gravis
- you have a certain type of irregular heartbeat (eg, QT prolongation), a slow heartbeat, or uncorrected low blood potassium levels
- you are taking astemizole, atorvastatin, cisapride, a class IA antiarrhythmic (eg, disopyramide, procainamide, quinidine), a class III antiarrhythmic (eg, amiodarone, dofetilide, sotalol), halofantrine, a macrolide antibiotic (eg, erythromycin, troleandomycin), mefloquine, pimozide, rifampin, ritonavir, or terfenadine
Contact your doctor or health care provider right away if any of these apply to you.
Before using quinine:
Some medical conditions may interact with quinine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have heart problems (eg, slow or irregular heartbeat), liver or kidney problems, nerve or muscle problems, depression, low blood sugar, low blood potassium levels, seizures, or a family history of G6PD deficiency
- if you have had an abnormal electrocardiogram (ECG)
- if you have vision or hearing problems (eg, ringing in the ears), eye pain, or a bleeding disorder (eg, thrombocytopenic purpura)
- if you are scheduled for surgery or anesthesia
Some MEDICINES MAY INTERACT with quinine. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Astemizole, cisapride, class IA antiarrhythmics (eg, disopyramide, procainamide, quinidine), class III antiarrhythmics (eg, amiodarone, dofetilide, sotalol), halofantrine, macrolide antibiotics (eg, erythromycin, troleandomycin), mefloquine, pimozide, or terfenadine because the risk of their side effects, including irregular heartbeat, may be increased by quinine
- Heparin or oral anticoagulants (eg, warfarin) because the risk of their side effects, such as bleeding, may be increased by quinine
- Azole antifungals (eg, ketoconazole), H2 antagonists (eg, cimetidine), mefloquine, ritonavir, tetracycline antibiotics (eg, doxycycline), or urinary alkalinizers (eg, acetazolamide, sodium bicarbonate) because they may increase the risk of quinine's side effects
- Rifamycins (eg, rifampin) because it may decrease quinine's effectiveness
- Carbamazepine, debrisoquine, desipramine, dextromethorphan, digoxin, certain HMG-CoA reductase inhibitors (eg, atorvastatin, lovastatin, simvastatin), metoprolol, paroxetine, phenobarbital, or phenytoin because the risk of their side effects may be increased by quinine
- Anticholinesterase medicines (eg, neostigmine) or theophyllines (eg, aminophylline) because their effectiveness may be decreased by quinine
This may not be a complete list of all interactions that may occur. Ask your health care provider if quinine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use quinine:
Use quinine as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Quinine comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get quinine refilled.
- Take quinine by mouth with food to reduce the risk of stomach upset.
- Do not take an antacid that has aluminum or magnesium in it within 1 hour before or 2 hours after you take quinine.
- Take quinine for the full course of treatment. Keep taking it even if you feel better in a few days. Do not miss any doses.
- If you miss a dose of quinine, take it as soon as possible. If it has been more than 4 hours since the missed dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use quinine.
Important safety information:
- Quinine may cause dizziness, light-headedness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use quinine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Tell your doctor or dentist that you take quinine before you receive any medical or dental care, emergency care, or surgery.
- If your symptoms do not get better within 1 to 2 days or if they get worse, or if your fever comes back after finishing treatment with quinine, check with your doctor.
- Quinine may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to quinine. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
- Quinine may cause low blood sugar. Pregnant women may be at higher risk of low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens.
- Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
- Quinine may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury.
- Serious and life-threatening bleeding problems may occur with quinine. This could also lead to severe kidney problems. Tell your doctor right away if you notice symptoms of unusual bleeding or bruising (eg, bleeding gums; severe nose bleed; dark urine; black, tarry, or bloody stools; unusual purple, brown, or red spots on the skin).
- Quinine should NOT be used to treat or prevent nighttime leg cramps. It should also NOT be used to prevent malaria. Talk with your doctor about other ways to treat nighttime leg cramps or to prevent malaria.
- Quinine may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking quinine.
- Use quinine with caution in the ELDERLY; they may be more sensitive to its effects.
- Quinine should be used with extreme caution in CHILDREN younger than 16 years; safety and effectiveness in these children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking quinine while you are pregnant. Quinine is found in breast milk. If you are or will be breast-feeding while you take quinine, check with your doctor. Discuss any possible risks to your baby.
Possible side effects of quinine:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Dizziness; flushing; headache; nausea; sweating.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue, unusual hoarseness); black, tarry, or bloody stools; blurred vision, changes in how you see color, double vision, light sensitivity, blindness, or other unusual vision changes; chest pain; confusion; dark or bloody urine; decreased amount of urine or trouble urinating; decreased hearing, hearing loss, or ringing in the ears; fainting; fast or irregular heartbeat; fatigue; fever, chills, or sore throat; loss of appetite; low blood sugar symptoms (eg, anxiety, dizziness, fast heartbeat, headache, tremors, unusual sweating); mood or mental problems; muscle weakness; nervousness; pale skin; personality changes; red, swollen, blistered, or peeling skin; seizures; severe dizziness, light-headedness, or flushing; severe nosebleed; severe or persistent nausea, vomiting, or diarrhea; speech problems; stomach or back pain; sudden onset of cold sweat; unusual purple, brown, or red spots on your skin; unusual bleeding or bruising; unusual tiredness or weakness; yellowing of the eyes or skin.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include confusion; dilated pupils; fainting; hearing problems; increased hunger; increased sweating; loss of consciousness; nausea and vomiting; rash; ringing in the ears; seizures; severe diarrhea, dizziness, drowsiness, headache, or weakness; slow, fast, or irregular heartbeat; slow or shallow breathing; stomach cramping or pain; urine discoloration; vision problems (eg, blurred vision, vision loss).Proper storage of quinine:
Store quinine at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep quinine out of the reach of children and away from pets.
- If you have any questions about quinine, please talk with your doctor, pharmacist, or other health care provider.
- Quinine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take quinine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about quinine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to quinine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using quinine.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.