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At a glance

Quinine Dihydrochloride is a cinchona alkaloid and 4-methanolquinoline used for the treatment of malaria and nocturnal leg cramps. It rapidly acts on blood schizonticide by interfering with lysosomal function or nucleic acid synthesis in Plasmodia spp.

Indications
  • Uncomplicated, severe, and complicated falciparum malaria
  • Falciparum malaria resistant to other drugs
  • Prevention of nocturnal muscle cramps
Pharmacology

Quinine rapidly acts on blood schizonticide by interfering with lysosomal function or nucleic acid synthesis in Plasmodia spp. It suppresses the asexual cycle of malaria parasites and prevents parasite development in erythrocytes.

Dosage

Adult Dose (IV):

  • Loading dose: 20 mg/kg (max 1.4 g) over 4 hours IV infusion; maintenance started after 8 hours
  • Maintenance infusion: 10 mg/kg (max 700 mg) over 4 hours every 8 hours
  • Do not give loading dose if patient received quinine, quinidine, halofantrine, or mefloquine in previous 12 hours
  • Severe hepatic/renal impairment: Maintenance dose 5-7 mg/kg every 8 hours

Pediatric Dose (IV): <5 mg/kg/hr by slow IV infusion

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 (especially with IV use)
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.

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
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.

Quinine Dihydrochloride — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.