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Quinidine Pregnancy and Breastfeeding Warnings

Quinidine is also known as: Cardioquin, Quin-G, Quin-Release, Quinaglute Dura-Tabs, Quinidex Extentabs, Quinora

Quinidine Pregnancy Warnings

Quinidine has been assigned to pregnancy category C by the FDA. Animal studies have not been reported. There are no controlled data in human pregnancy. Quinidine should be given during pregnancy only when benefit outweighs risk.

Quinidine crosses the placenta, with umbilical cord blood to maternal serum concentration ratios ranging from 0.2 to 0.8. Quinidine, when compared to many other cardiovascular drugs, is considered relatively safe for the fetus. Quinidine has been used successfully and safely to treat resistant fetal tachyarrhythmias and to treat acute malaria in pregnant women. Neonatal thrombocytopenia has been reported after maternal ingestion of quinidine. Data from the Michigan Medicaid Birth Defects Study has failed to reveal an association between quinidine and congenital abnormalities (written communication, Franz Rosa, MD, Food and Drug Administration, 1994). This was a retrospective study of 229,101 completed pregnancies between 1985 and 1992, of which 17 were exposed to quinidine at some time during the first trimester, and 68 were exposed to the drug at any time during pregnancy. Of these pregnancies, a single birth defect was observed. This observation did not achieve statistical significance. There were no observations of cardiovascular defects, cleft palate, spina bifida, polydactyly, limb reduction, or hypospadias. These data do not support an association between quinidine and birth defects.

See references

Quinidine Breastfeeding Warnings

Quinidine is excreted into human milk. The manufacturer reports that quinidine is present in human milk at levels slightly lower than those in maternal serum. The effects in the nursing infant is unknown. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

See references

References for pregnancy information

  1. Hill LM, Malkasian GD "The use of quinidine sulfate throughout pregnancy." Obstet Gynecol 54 (1979): 366-8
  2. Tamari I, Eldar M, Rabinowitz B, Neufeld HN "Medical treatment of cardiovascular disorders during pregnancy." Am Heart J 104 (1982): 1357-63
  3. Guntheroth WG, Cyr DR, Mack LA, Benedetti T, Lenke RR, Petty CN "Hydrops from reciprocating atrioventricular tachycardia in a 27-week fetus requiring quinidine for conversion." Obstet Gynecol 66 (1985): s29-33
  4. Wong RD, Murthy AR, Mathisen GE, et al "Treatment of severe falciparum malaria during pregnancy with quinidine and exchange transfusion." Am J Med 92 (1992): 561-2
  5. Page RL "Treatment of arrhythmias during pregnancy." Am Heart J 130 (1995): 871-6
  6. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  7. Killeen AA, Bowers LD "Fetal supraventricular tachycardia treated with high-dose quinidine: toxicity associated with marked elevation of the metabolite, 3(S)-3-hydroxyquinidine." Obstet Gynecol 70 (1987): 445-9

References for breastfeeding information

  1. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. Roberts RJ, Blumer JL, Gorman RL, et al "American Academy of Pediatrics Committee on Drugs: Transfer of drugs and other chemicals into human milk." Pediatrics 84 (1989): 924-36
  3. Hill LM, Malkasian GD "The use of quinidine sulfate throughout pregnancy." Obstet Gynecol 54 (1979): 366-8

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