II. Indications
- Non-Severe Malaria Treatment in Chloroquine resistant regions
- Combined with Doxycycline, Tetracycline or Clindamycin
- Alternative when Artemisinin Combination Therapy (ACT) is unavailable
III. Contraindications
- G6PD Deficiency
- Myasthenia Gravis
- Severe hepatic Impairment (Child-Pugh C)
- Do NOT use for Nocturnal Leg Cramps
- Low efficacy and high risk
IV. Dosing
-
Malaria
- Combined with 7 days of Doxycycline, Tetracycline or Clindamycin
- Adult: 648 mg salt (542 mg base) three times daily orally for 3 days (7 days in Southeast Asia)
- In severe Chronic Kidney Disease, after first dose, decrease to 324 mg orally every 12 hours
- Child: 10 mg/kg up to 648 mg salt (8.3 mg/kg up to 542 mg base) three times daily orally
- Severe Babesiosis
- Combined with Clindamycin 7 to 10 mg/kg up to 600 mg IV every 6 hours for 7 to 10 days
- Adult: 650 mg orally every 6 to 8 hours
- Child: 8 mg/kg (up to 650 mg) orally every 8 hours
V. Mechanism
- Quinidine alkaloid extracted from cinchona tree bark
VI. Adverse Effects
- Serious
- Hemolytic Uremic Syndrome
- Thrombotic Thrombocytopenic Purpura
- QTc Prolongation as well as PR and QRS Duration widening
VII. Safety
- Considered safe in pregnancy
- Considered safe in Lactation
- Avoid in infants with G6PD Deficiency
VIII. Drug Interactions
IX. Resources
- Quinine Sulfate (DailyMed)
X. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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Related Studies
| quinine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| QUININE SULFATE 324 MG CAPSULE | Generic | $0.90 each |