Qualaquin Side Effects

Generic Name: quinine

Note: This page contains side effects data for the generic drug quinine. It is possible that some of the dosage forms included below may not apply to the brand name Qualaquin.

It is possible that some side effects of Qualaquin may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to quinine: oral capsule, oral tablet, oral tablet extended release

As well as its needed effects, quinine (the active ingredient contained in Qualaquin) may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking quinine, check with your doctor immediately:

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

If any of the following symptoms of overdose occur while taking quinine, get emergency help immediately:

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

For Healthcare Professionals

Applies to quinine: compounding powder, oral capsule, oral tablet

Hematologic

Disseminated intravascular coagulation has been reported in a 79-year-old female within 12 hours following a second dose of quinine (the active ingredient contained in Qualaquin) 300 mg.

Hematologic side effects have included thrombocytopenia, purpura, neutropenia, thrombotic thrombocytopenic purpura-hemolytic uremic syndrome, disseminated intravascular coagulation, petechiae, and ecchymosis. At least 7 cases of immune thrombocytopenia have been reported.

Dermatologic

Fixed drug eruption (nummular skin lesion) has been reported in a 23-year-old female following exposure to quinine (the active ingredient contained in Qualaquin) in tonic water. An open oral challenge, approved by the patient, with 30 mg quinine sulfate triggered the appearance of pruritus, erythema, and edema at the usual sites within 40 minutes of ingestion of the dose.

Dermatologic side effects have included flushing, pruritus, and skin rashes. Fixed drug eruption (nummular skin lesion) and fatal cutaneous vasculitis have been reported.

Gastrointestinal

Gastrointestinal side effects have included abdominal pain, nausea, vomiting, diarrhea, and gastrointestinal upset.

Renal

Renal side effects have included renal failure secondary to thrombotic thrombocytopenic purpura-hemolytic uremic syndrome.

Respiratory

Respiratory side effects have included asthma symptoms, hemoptysis, and a case report of transient bilateral pulmonary infiltrates.

Transient bilateral pulmonary infiltrates have been reported in a 45-year-old woman following a single dose of quinine sulfate 325 mg for nocturnal cramps. Approximately 45 minutes after she took the single dose of quinine the following symptoms were present: sudden onset of dyspnea, wheezing, cough, breathlessness, severe anxiety, dry nonproductive cough, orthopnea, mild fever, chills, and pleuritic chest discomfort.

Ocular

Ocular side effects have included visual disturbances including blurred vision with scotomata, photophobia, diplopia, diminished visual fields, disturbed color vision, and blindness.

Cardiovascular

Cardiovascular side effects have included cardiac dysrhythmias, including prolongation of the QT-interval.

Hepatic

Within 24 hours of taking the first dose of quinine (the active ingredient contained in Qualaquin) 260 mg for leg cramps, a 57-year-old Native American female presented to the hospital with symptoms of nausea, vomiting, generalized myalgia, headache, fever, chills, and rigor. The following liver enzymes were dramatically elevated: alkaline phosphatase, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltranspeptidase. Following discontinuation of quinine, the patient's symptoms resolved within 48 hours and the liver enzyme concentrations declined within 72 hours.

Hepatic side effects have included changes in the hepatic enzyme system that synthesizes vitamin K dependent factors. At least one case report of hepatotoxicity with elevated alkaline phosphatase, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltranspeptidase has been reported.

Nervous system

Tinnitus and impaired hearing may occur at plasma concentrations over 10 mcg/mL.

Nervous system side effects have included apprehension, restlessness, confusion, syncope, dizziness, vertigo, tinnitus, hearing loss, and nystagmus. Cinchonism has been reported with repeated doses or high serum levels in 25% to 100% of patients. Signs and symptoms of cinchonism have been commonly reported. The clinical presentation of cinchonism have included temporary deafness/slight deafness, tinnitus, headache, dizziness, rash, mental dullness, depression, confusion, and nausea. Fatalities have been reported from single oral doses of 2 to 8 grams.

Hypersensitivity

Hypersensitivity side effects have been reported in a few patients who experienced severe side effects after a single dose of quinine (the active ingredient contained in Qualaquin)

Metabolic

Metabolic side effects have included hypoglycemia and electrolyte imbalance.

Other

Other side effects have included mucosal bleeding (gingival, gastrointestinal, epistaxis).

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

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