Generic
Quinine Sulphate
6 brands available in the market
At a glance
Quinine Sulphate is a cinchona alkaloid and 4-methanolquinoline used for uncomplicated, severe, and complicated falciparum malaria, falciparum malaria resistant to other drugs, and prevention of nocturnal muscle cramps.
Description
Quinine is a cinchona alkaloid and 4-methanolquinoline that suppresses the asexual cycle of malaria parasites in erythrocytes by interfering with lysosomal function or nucleic acid synthesis. It is a highly active blood schizonticide and suppresses parasite development.
Indications
- Uncomplicated, severe, and complicated falciparum malaria
- Falciparum malaria resistant to other drugs
- Prevention of nocturnal muscle cramps
Therapeutic class
Anti-malarial drugs
Pharmacological class
Cinchona Alkaloid (4-Methanolquinoline)
Pharmacology
Quinine suppresses the asexual cycle of malaria parasites by interfering with lysosomal function or nucleic acid synthesis in Plasmodia spp. It is a highly active blood schizonticide and prevents parasite development.
Mechanism of action
Interferes with lysosomal function or nucleic acid synthesis in malaria parasites.
Dosage
Adult Dose (Oral):
- Malaria (sulfate): 648 mg every 8 hours for 7 days
- Nocturnal leg cramps: 200-300 mg once at night
Pediatric Dose (Oral):
- Malaria (sulfate): >8 years: 10 mg/kg every 8 hours for 7 days
Pregnancy: Adult treatment doses can be safely used
Severe Renal Impairment: Initially 648 mg, followed after 12 hours by 324 mg every 12 hours
Administration
- Take with food (to minimize GI discomfort)
- Swallow tablet whole; do not chew, crush, or break
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Side Effects (Cinchonism):
- Severe headache
- Nausea
- Vomiting
- Diarrhea
- Blurred vision
- Tinnitus
- Flushing of skin
- Fever
- Rash
- Pruritus
- Hypoglycemia
- Hemolysis in G6PD deficiency
- Thrombocytopenia
- Hepatitis
- Potentially fatal: Sinus arrest, AV block, ventricular fibrillation, sudden death
Precautions & warnings
- Caution in patients with cardiac conduction defects, heart block, or atrial fibrillation
- Monitor for cardiotoxicity, blood glucose, CBC, LFT, ECG
- Caution in prolonged QT interval, tinnitus, optic neuritis, myasthenia gravis
- Caution in pregnancy and lactation
Contraindications
- Hypersensitivity to quinine, mefloquine, or quinidine
- Nocturnal leg cramps
- Prolonged QT interval
- Tinnitus or optic neuritis
- Myasthenia gravis
- G6PD deficiency
- History of black water fever
Drug interactions
- Class IA/III antiarrhythmics (quinidine, procainamide, disopyramide, amiodarone, sotalol): Risk of QT prolongation and torsade de pointes
- Mefloquine: Risk of QT prolongation
- Rifampicin: Decreased plasma levels of quinine
- Ritonavir: Increased serum levels
- Warfarin: Increased anticoagulant effect
- Digoxin: Increased plasma levels
- Atorvastatin: Increased risk of myopathy and rhabdomyolysis
- Al/Mg-containing antacids: Delayed or decreased absorption
Food interactions
Take with food for better absorption; it is not known whether it is safe to consume alcohol.
Use in pregnancy
Use in Pregnancy: Safe in therapeutic doses during pregnancy; limited information on fetal risk.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Excreted in breast milk in insignificant amounts; safe to use.
Pediatric use
Pediatric dose based on weight; >8 years: 10 mg/kg every 8 hours.
Geriatric use
Caution required in elderly patients; dose adjustment may be needed.
Renal / hepatic impairment
Renal Impairment: Severe renal impairment: Initially 648 mg, followed after 12 hours by 324 mg every 12 hours; consult your doctor.
Hepatic Impairment: Mild-moderate: No dose adjustment needed; consult your doctor.
Overdose effects
Overdose: Exacerbation of cinchonism (nausea, vomiting, tinnitus, visual disturbances), cardiac arrhythmias; treatment: symptomatic supportive care, gastric lavage, electrolyte monitoring.
Storage conditions
Store away from light and moisture; keep out of reach of children.
Chemical structure
Quinine Sulphate