What is quinine?

The U.S. Food and Drug Administration has banned the sale of all non-approved brands of quinine because of the risk of serious side effects or death. As of December 2006, Qualaquin is the only brand of quinine that is approved by the FDA.

Quinine is used to treat malaria, a disease caused by parasites. Parasites that cause malaria typically enter the body through the bite of a mosquito. Malaria is common in areas such as Africa, South America, and Southern Asia.

Quinine may also be used for other purposes not listed in this medication guide.

Precautions

Quinine can cause serious or life-threatening side effects, and is approved for use only in treating malaria. Some people have used quinine to treat leg cramps, but this is not an FDA-approved use.

Quinine will not treat severe forms of malaria, and it should not be taken to prevent malaria. Quinine also should not be taken to treat or prevent night-time leg cramps.

Do not use this medication if you have ever had an allergic reaction to quinine or similar medicines such as mefloquine (Lariam) or quinidine (Cardioquin, Quinidex, Quinaglute), or if you have:

  • a history of "Long QT syndrome";
  • glucose-6-phosphate dehydrogenase (G-6-PD) deficiency;
  • myasthenia gravis; or
  • optic neuritis (inflammation of the optic nerve).

If you have certain conditions, you may need a dose adjustment or special tests to safely take this medication. Before taking quinine, tell your doctor if you have:

  • heart disease or a heart rhythm disorder;
  • low potassium levels in your blood (hypokalemia); or
  • kidney or liver disease.

FDA pregnancy category C. It is not known whether quinine is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

Hypoglycemia (low blood sugar) may be more likely to occur in pregnant women who are taking quinine. Signs of low blood sugar include hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, and fast heartbeat. Talk to your doctor about your specific risk for low blood sugar if you take quinine while you are pregnant.

Quinine may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medication to a child younger than 16 years old.

Do not use quinine to treat any medical condition if your doctor did not prescribe quinine for that condition. Do not purchase quinine on the Internet or from vendors outside of the United States. Using this medication improperly or without the advice of a doctor can result in serious side effects or death.

Quinine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid using antacids without your doctor’s advice. Use only the specific type of antacid your doctor recommends. Antacids contain different medicines and some types can make it harder for your body to absorb quinine.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include headache, confusion, dizziness, ringing in your ears, vision or hearing loss, severe nausea or vomiting, sweating, uneven heart rate, feeling light-headed, and fainting or collapse.

Take the missed dose as soon as you remember. If you are more than 4 hours late for your dose, skip it and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using quinine and call your doctor at once if you have any of these serious side effects:

  • uneven heart rhythm;
  • weak pulse, fainting or collapse;
  • fever, confusion, weakness;
  • pale or yellowed skin, dark colored urine;
  • unusual muscle weakness;
  • purple spots under the skin, urinating less than usual or not at all;
  • severe blistering, peeling, and red skin rash with a sore throat, fever, and headache;
  • severe nausea, vomiting, stomach pain, diarrhea; or
  • problems with hearing or vision.

Less serious side effects may include:

  • hunger, headache, confusion, irritability, sweating;
  • drowsiness, weakness, dizziness, tremors; or
  • warmth, redness, or tingly feeling under the skin.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may report side effects to FDA at 1-800-FDA-1088.

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Interactions

Before taking quinine, tell your doctor if you are using any of the following drugs:

  • arsenic trioxide (Trisenox);
  • astemizole (Hismanal);
  • cisapride (Propulsid);
  • cimetidine (Tagamet);
  • dextromethorphan (cough medicine);
  • digoxin (digitalis, Lanoxin);
  • droperidol (Inapsine);
  • metoprolol (Toprol);
  • paroxetine (Paxil);
  • rifampin (Rifadin, Rimactane, Rifater);
  • a blood thinner such as warfarin (Coumadin);
  • aminophylline (Truphylline), or theophylline (Elixophyllin, Respbid, Theobid, Theo-Dur, Uniphyl);
  • antibiotics such as clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S.), pentamidine (NebuPent, Pentam), sparfloxacin (Zagam), tetracycline (Brodspec, Tetracap), or troleandomycin (Tao);
  • heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), ibutilide (Corvert), disopyramide (Norpace), procainamide (Procan, Pronestyl), quinidine (Cardioquin, Quinaglute), or sotalol (Betapace);
  • medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), mesoridazine (Serentil), pimozide (Orap), or thioridazine (Mellaril);
  • narcotic medication such as levomethadyl (Orlaam) or methadone (Dolophine, Methadose);
  • seizure medication such as carbamazepine (Carbatrol, Tegretol), phenobarbital (Luminal, Solfoton), or phenytoin (Dilantin); or
  • other anti-malarial drugs such as chloroquine (Arelan), halofantrine (Halfan), or mefloquine (Lariam).

This list is not complete and there may be other drugs not listed that can affect quinine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Other Names

Qualaquin, quinine, and QM-260

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. 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 drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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