Medication Guide App

quinine (Oral route)

Pronunciation

KWYE-nine

Oral route(Capsule)

Quinine sulfate use for the treatment or prevention of nocturnal leg cramps may result in serious and life-threatening hematologic reactions, including thrombocytopenia and hemolytic uremic syndrome/thrombotic thrombocytopenic purpura (HUS/TTP). Chronic renal impairment associated with the development of TTP has been reported. The risk associated with quinine sulfate use in the absence of evidence of its effectiveness in the treatment or prevention of nocturnal leg cramps outweighs any potential benefit .

Commonly used brand name(s)

In the U.S.

  • Qualaquin
  • Quinamm
  • Quiphile

Available Dosage Forms:

  • Tablet, Extended Release
  • Tablet
  • Capsule

Therapeutic Class: Musculoskeletal Agent

Chemical Class: Cinchona Alkaloid

Uses For quinine

Quinine is used to treat malaria caused by Plasmodium falciparum. Plasmodium falciparum is a parasite that gets into the red blood cells in the body and causes malaria. Quinine works by killing the parasite or preventing it from growing. quinine may be used alone or given together with one or more medicines for malaria.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Quinine should not be used to treat or prevent night time leg cramps. quinine may cause very serious unwanted effects and should only be used for patients with malaria.

quinine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, quinine is used in certain patients with the following medical conditions:

  • Babesiosis (a parasite infection).

Before Using quinine

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 quinine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to quinine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of quinine in children younger than 16 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of quinine in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with 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 quinine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using quinine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Astemizole
  • Aurothioglucose
  • Cisapride
  • Dronedarone
  • Fluconazole
  • Ketoconazole
  • Mesoridazine
  • Nelfinavir
  • Pimozide
  • Piperaquine
  • Posaconazole
  • Sparfloxacin
  • Thioridazine

Using quinine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfuzosin
  • Aluminum Carbonate, Basic
  • Aluminum Hydroxide
  • Aluminum Phosphate
  • Amiodarone
  • Amitriptyline
  • Amoxapine
  • Apomorphine
  • Arsenic Trioxide
  • Artemether
  • Asenapine
  • Azithromycin
  • Carbamazepine
  • Ceritinib
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Crizotinib
  • Dabrafenib
  • Dasatinib
  • Delamanid
  • Desipramine
  • Dihydroxyaluminum Aminoacetate
  • Dihydroxyaluminum Sodium Carbonate
  • Disopyramide
  • Dolasetron
  • Domperidone
  • Droperidol
  • Erythromycin
  • Escitalopram
  • Eslicarbazepine Acetate
  • Fingolimod
  • Fluoxetine
  • Gatifloxacin
  • Gemifloxacin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Ivabradine
  • Lapatinib
  • Levofloxacin
  • Lumefantrine
  • Magaldrate
  • Magnesium Carbonate
  • Magnesium Hydroxide
  • Magnesium Trisilicate
  • Mefloquine
  • Methadone
  • Mifepristone
  • Mitotane
  • Moxifloxacin
  • Nevirapine
  • Nilotinib
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Ondansetron
  • Paliperidone
  • Pancuronium
  • Pazopanib
  • Perflutren Lipid Microsphere
  • Primidone
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Ranolazine
  • Rifampin
  • Ritonavir
  • Salmeterol
  • Sevoflurane
  • Siltuximab
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Succinylcholine
  • Sunitinib
  • Telavancin
  • Telithromycin
  • Terfenadine
  • Tetrabenazine
  • Tizanidine
  • Toremifene
  • Trazodone
  • Trifluoperazine
  • Trimipramine
  • Troleandomycin
  • Tubocurarine
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Vilanterol
  • Vinflunine
  • Voriconazole
  • Ziprasidone

Using quinine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Atorvastatin
  • Cyclosporine
  • Digoxin
  • Fosphenytoin
  • Phenobarbital
  • Phenytoin
  • Rifapentine
  • Tetracycline

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

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

  • Atrial fibrillation or flutter (abnormal heart rhythms) or
  • Bradycardia (slow heartbeat) or
  • Heart disease (eg, myocardial ischemia) or
  • Hypokalemia (low potassium in the blood), uncorrected or
  • Sick sinus syndrome (type of abnormal heart rhythm)—Use with caution. May cause side effects to become worse.
  • Blackwater fever (a blood disorder) or
  • Hemolytic uremic syndrome (a serious kidney disorder) or
  • Idiopathic thrombocytopenia purpura (a serious blood disorder) or
  • Thrombocytopenia (low number of platelets) or
  • Thrombotic thrombocytopenic purpura (a serious blood disorder)—Should not be used in patients who had these serious side effects to quinine.
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency (a blood disorder) or
  • Heart rhythm problems (eg, prolonged QT interval) or
  • Liver disease, severe or
  • Myasthenia gravis (severe muscle weakness) or
  • Optic neuritis (swelling of a nerve in the eye)—Should not be used in patients with these conditions.
  • Hypoglycemia (low blood sugar)—Use with caution. May make this condition worse.
  • Kidney disease, severe or
  • Liver disease, mild to moderate—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of quinine

Take quinine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance for unwanted effects.

quinine comes with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Quinine may be given together with one or more medicines for malaria. Make sure you take all of the medicines your doctor ordered. If you have any questions about this, talk to your doctor.

Take quinine with food to lessen stomach upset, unless otherwise directed by your doctor. If you are taking quinine at bedtime, take it with a snack, water, milk, or other beverage.

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

Dosing

The dose of quinine 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 quinine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For treatment of malaria:
      • Adults and teenagers 16 years of age and older—648 milligrams (mg) (2 capsules) every 8 hours for 7 days.
      • Children younger than 16 years of age—Use and dose must be determined by the doctor.

Missed Dose

If you miss a dose of quinine, 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.

If it has been more than 4 hours since you missed a dose, skip the missed dose and take your next dose at the regular time.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using quinine

It is very important that your doctor check your progress after you finish taking the medicine. This is to make sure the malaria is cleared up completely, and to allow your doctor to check for any unwanted effects. Blood tests may be needed to check for unwanted effects.

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem such as QT prolongation.

Quinine may cause hypoglycemia (low blood sugar). If your blood sugar gets too low, you may feel weak, drowsy, confused, anxious, or very hungry. You may also sweat, shake, or have blurred vision, a fast heartbeat, or a headache that will not go away. Tell your doctor right away if you have any of these symptoms.

quinine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, lightheadedness, dizziness, or fainting, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after you take quinine.

Quinine may cause blurred vision or a change in color vision. Make sure you know how you react to quinine before you drive, use machines, or do anything else that could be dangerous if you are not able to see well. If these reactions are especially bothersome, check with your doctor.

Before you have any medical tests, tell the medical doctor in charge that you are taking quinine. The results of some tests may be affected by quinine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

quinine Side Effects

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.

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

More common
  • Diarrhea
  • nausea
  • stomach cramps or pain
  • vomiting
Less common
  • Anxiety
  • behavior change, similar to drunkenness
  • black, tarry stools
  • blood in the urine or stools
  • blurred vision or change in vision
  • cold sweats
  • confusion
  • convulsions (seizures) or coma
  • cool pale skin
  • cough or hoarseness
  • difficulty concentrating
  • drowsiness
  • excessive hunger
  • fast heartbeat
  • fever or chills
  • headache
  • lower back or side pain
  • nervousness
  • nightmares
  • painful or difficult urination
  • pinpoint red spots on the skin
  • restless sleep
  • shakiness
  • slurred speech
  • sore throat
  • unusual bleeding or bruising
  • unusual tiredness or weakness
Rare
  • Difficulty breathing or swallowing
  • disturbed color perception
  • double vision
  • hives
  • increased sweating
  • muscle aches
  • night blindness
  • reddening of the skin, especially around ears
  • ringing or buzzing in the ears
  • swelling of the eyes, face, or inside of the nose

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

Symptoms of an overdose
  • Blindness
  • blurred vision or change in vision
  • chest pain
  • dizziness
  • double vision
  • fainting
  • lightheadedness
  • rapid or irregular heartbeat
  • sleepiness

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

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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