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QUINACRINE (Systemic) *†

Other commonly used names are:

Mepacrine

*† Not commercially available in the U.S. and Canada.

Category

  • Antiprotozoal;
  • antirheumatic;
  • intrapleural sclerosing agent

Description

Quinacrine (KWIN-a-kreen)is used to treat giardiasis((jee-ar-DYE-a-siss)), a protozoal infection of the intestinal tract, and certain types of lupus erythematosus((e-ri-thi-ma-TOE-sus)), an inflammatory disease that affects the joints, tendons, and other connective tissues and organs. Quinacrine may be injected into the space surrounding the lungs to prevent reoccurrence of pneumothorax. This medicine also may be used for other conditions as determined by your doctor.

Quinacrine is available only with your doctor's prescription.

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For Quinacrine], the following should be considered:

Allergies- Tell your doctor if you have ever had any unusual or allergic reaction to quinacrine. Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy- Quinacrine crosses the placenta, and its use in pregnant women is generally not recommended.

Breast-feeding- Quinacrine passes into breast milk. However, quinacrine has not been reported to cause problems in nursing babies.

Children- Children tolerate the oral dosage form of quinacrine less well than do adults, and it may cause vomiting in children due to its bitter taste.

Older adults- Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of quinacrine in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines- Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking quinacrine, it is especially important that your doctor and pharmacist know if you are taking any of the following:

  • Alcohol or alcohol-containing medicines-Use with quinacrine may increase the chance of side effects of alcohol.
  • Primaquine-Use with quinacrine may increase the chance of serious side effects of primaquine; primaquine should not be taken when you are taking quinacrine.

Other medical problems- The presence of other medical problems may affect the use of quinacrine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcoholism (or history of) or
  • Liver disease-Quinacrine may cause additional liver problems
  • Mental illness (severe) (history of)-Quinacrine may cause mood or other mental changes in some patients.
  • Porphyria-Quinacrine may make porphyria worse.
  • Psoriasis-Quinacrine may cause an attack of psoriasis or make psoriasis worse; patients with psoriasis should not take quinacrine.

Proper Use of This Medicine

Quinacrine is best taken after meals with a full glass (8 ounces) of water, tea, or fruit juice, unless directed by your doctor.

For patients unable to swallow tablets or capsules or unable to tolerate bitter taste :

  • The tablets may be crushed and mixed with jam, honey, or chocolate syrup so that you get the full dose of the medicine.

For patients taking quinacrine for giardiasis:

  • To help clear up your infection completely, keep taking quinacrine for the full time of treatment , even if you feel better after a few days. If you stop taking this medicine too soon, you symptoms may return. Do not miss any doses

Dosing- The dose of Quinacrine will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of quinacrine. If your dose is different, do not change it unless your doctor tells you to do so.

  • For oral dosage forms:
    • For giardiasis:
      • Adults and teenagers-100 milligrams (mg) thee times a day for five to seven days.
      • Children- 2 mg per kilogram (0.9 mg per pound) of body weight three times a day for seven days.
    • For lupus erythematosus:
      • Adults and teenagers- 100 milligrams (mg) once a day for one or two months. After this time, the dose may be decreased by your doctor.
      • Children-1 to 2 mg per kilogram (0.45 to 0.9 mg per pound) of body weight once a day.
  • For injection dosage form:
    • For pneumothorax:
      • Adults and teenagers-100 milligrams, injected into the space surrounding the lungs, once a day for three or four days in a row.
      • Children-Use and dose must be determined by your doctor.

Missed dose- If you do miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage- To store this medicine:

  • Keep out of the reach of children.
  • Store away from heat and direct light.
  • Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
  • Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

It is very important that your doctor check your progress at different times. This is to check whether or not the infection is cleared up completely.

If your symptoms do not improve within a few days or if they become worse, check with your doctor.

Quinacrine may cause some people to become dizzy. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert . If this reaction is especially bothersome, check with your doctor.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. When this medicine is used for a short time, side effects are not generally serious. However, if this medicine is used for a long time and/or in high doses, other more serious side effects may occur.

Check with your doctor immediately if any of the following side effects occur:

Less common

Black, tarry stools; blood in urine or stools; cough or hoarseness accompanied by a fever or chills; pinpoint red spots on skin; skin rash, redness, itching or peeling; unusual bleeding or bruising

Rare

Vision changes; yellow discoloration of eyes and skin

Note:

Yellow discoloration of skin, without involvement of the eyes, may be due to the dye characteristics of quinacrine. Check with your doctor if you have questions about yellow discoloration.

Symptoms of Overdose

Get emergency help immediately if any of the following symptoms of overdose occur

Convulsions (seizures); fainting; irregular heartbeat

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome.

More Common

Abdominal or stomach cramps; diarrhea; dizziness; fever; headache; loss of appetite; nausea or vomiting

Quinacrine is a dye-like medicine and commonly causes yellow discoloration of the skin and urine, and darkening of the fingernails and toenails . These side effects are only temporary and will go away when you stop taking this medicine. However, if you notice yellow discoloration of your eyes, check with your doctor as soon as possible because medical attention may be required.

Less common

Chest pain (for injection form only)

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 07/29/2002

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