If malaria is suspected in the infant, appropriate evaluation and treatment should be provided. Clinical studies of quinine sulfate did not include sufficient numbers of subjects aged 65 and over to determine whether they respond to treatment differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients.
Clearance of quinine is decreased in patients with severe chronic renal failure. The dosage and dosing frequency should be reduced. Therefore, quinine is not indicated in patients with severe hepatic impairment and alternate therapy should be administered. Close monitoring is recommended for patients with mild Child-Pugh A or moderate Child-Pugh B hepatic impairment, as exposure to quinine may be increased relative to subjects with normal liver function.
Quinine can adversely affect almost every body system. Symptoms of mild cinchonism include headache, vasodilation and sweating, nausea, tinnitus, hearing impairment, vertigo or dizziness, blurred vision, and disturbance in color perception. More severe symptoms of cinchonism are vomiting, diarrhea, abdominal pain, deafness, blindness, and disturbances in cardiac rhythm or conduction.
Most symptoms of cinchonism are reversible and resolve with discontinuation of quinine. Because these reactions have been reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
General: fever, chills, sweating, flushing, asthenia, lupus-like syndrome, and hypersensitivity reactions. Hematologic: agranulocytosis, hypoprothrombinemia, thrombocytopenia, disseminated intravascular coagulation, hemolytic anemia; hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, idiopathic thrombocytopenic purpura, petechiae, ecchymosis, hemorrhage, coagulopathy, blackwater fever, leukopenia, neutropenia, pancytopenia, aplastic anemia, and lupus anticoagulant.
Neuropsychiatric: headache, diplopia, confusion, altered mental status, seizures, coma, disorientation, tremors, restlessness, ataxia, acute dystonic reaction, aphasia, and suicide. Dermatologic: cutaneous rashes, including urticarial, papular, or scarlatinal rashes, pruritus, bullous dermatitis, exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, fixed drug eruption, photosensitivity reactions, allergic contact dermatitis, acral necrosis, and cutaneous vasculitis.
Cardiovascular: chest pain, vasodilatation, hypotension, postural hypotension, tachycardia, bradycardia, palpitations, syncope, atrioventricular block, atrial fibrillation, irregular rhythm, unifocal premature ventricular contractions, nodal escape beats, U waves, QT prolongation, ventricular fibrillation, ventricular tachycardia, torsades de pointes, and cardiac arrest.
Gastrointestinal: nausea, vomiting, diarrhea, abdominal pain, gastric irritation, and esophagitis. Hepatobiliary: granulomatous hepatitis, hepatitis, jaundice, and abnormal liver function tests. Special Senses: visual disturbances, including blurred vision with scotomata, sudden loss of vision, photophobia, diplopia, night blindness, diminished visual fields, fixed pupillary dilatation, disturbed color vision, optic neuritis, blindness, vertigo, tinnitus, hearing impairment, and deafness.
Quinine overdose can be associated with serious complications, including visual impairment, hypoglycemia, cardiac arrhythmias, and death. Visual impairment can range from blurred vision and defective color perception, to visual field constriction and permanent blindness.
Cinchonism occurs in virtually all patients with quinine overdose. Symptoms range from headache, nausea, vomiting, abdominal pain, diarrhea, tinnitus, vertigo, hearing impairment, sweating, flushing, and blurred vision, to deafness, blindness, serious cardiac arrhythmias, hypotension, and circulatory collapse.
Central nervous system toxicity drowsiness, disturbances of consciousness, ataxia, convulsions, respiratory depression and coma has also been reported with quinine overdose, as well as pulmonary edema and adult respiratory distress syndrome.
Most toxic reactions are dose-related; however, some reactions may be idiosyncratic because of the variable sensitivity of patients to the toxic effects of quinine. A lethal dose of quinine has not been clearly defined, but fatalities have been reported after the ingestion of 2 to 8 grams in adults. Quinine, like quinidine, has Class I antiarrhythmic properties.
The cardiotoxicity of quinine is due to its negative inotropic action, and to its effect on cardiac conduction, resulting in decreased rates of depolarization and conduction, and increased action potential and effective refractory period. ECG changes observed with quinine overdose include sinus tachycardia, PR prolongation, T wave inversion, bundle branch block, an increased QT interval, and a widening of the QRS complex. Quinine's alpha-blocking properties may result in hypotension and further exacerbate myocardial depression by decreasing coronary perfusion.
Quinine overdose has been also associated with hypotension, cardiogenic shock, and circulatory collapse, ventricular arrhythmias, including ventricular tachycardia, ventricular fibrillation, idioventricular rhythm, and torsades de pointes, as well as bradycardia, and atrioventricular block.
Quinine is rapidly absorbed, and attempts to remove residual quinine sulfate from the stomach by gastric lavage may not be effective. Multiple-dose activated charcoal has been shown to decrease plasma quinine concentrations.
Forced acid diuresis, hemodialysis, charcoal column hemoperfusion, and plasma exchange were not found to be effective in significantly increasing quinine elimination in a series of 16 patients. In 8 healthy subjects who received quinine sulfate mg with or without 8 grams of cholestyramine resin, no significant difference in quinine pharmacokinetic parameters was seen.
Because smoking did not appear to influence the therapeutic outcome in malaria patients, it is not necessary to increase the dose of quinine in the treatment of acute malaria in heavy cigarette smokers. In a pharmacokinetic study involving 10 healthy subjects, the administration of a single mg dose of quinine sulfate with grapefruit juice full-strength or half-strength did not significantly alter the pharmacokinetic parameters of quinine.
In healthy subjects who were given a single oral mg dose of quinine sulfate after pretreatment with cimetidine mg three times daily and mg at bedtime for 7 days or ranitidine mg twice daily for 7 days , the apparent oral clearance of quinine decreased and the mean elimination half-life increased significantly when given with cimetidine but not with ranitidine.
When quinine is to be given concomitantly with a histamine H2-receptor blocker, the use of ranitidine is preferred over cimetidine. Although no change in the QUALAQUIN dosage regimen is necessary with concomitant ketoconazole, patients should be monitored closely for adverse reactions associated with quinine. Erythromycin was shown to inhibit the in vitro metabolism of quinine in human liver microsomes, an observation confirmed by an in vivo interaction study.
In 7 healthy females who were using single-ingredient progestin or combination estrogen-containing oral contraceptives, the pharmacokinetic parameters of a single mg dose of quinine sulfate were not altered in comparison to those observed in 7 age-matched female control subjects not using oral contraceptives.
In patients with uncomplicated P. In healthy subjects who received a single oral mg dose of quinine sulfate with the 15 th dose of ritonavir mg every 12 hours for 9 days , there were 4-fold increases in the mean quinine AUC and Cmax, and an increase in the mean elimination half-life In 8 patients with acute uncomplicated P. Although no change in the QUALAQUIN dosage regimen is necessary with concomitant theophylline or aminophylline, patients should be monitored closely for adverse reactions associated with quinine.
Quinine-Odan Print. Name of the medicinal product Qualitative and quantitative composition Therapeutic indications Dosage Posology and method of administration Contraindications Special warnings and precautions for use Undesirable effects Overdose Pharmacodynamic properties Pharmacokinetic properties Prices. Components: Quinine. Method of action: Antiprotozoal , Musculoskeletal Agent.
Name of the medicinal product. The information provided in Name of the medicinal product of Quinine-Odan is based on data of another medicine with exactly the same composition as the Quinine-Odan. Be careful and be sure to specify the information on the section Name of the medicinal product in the instructions to the drug Quinine-Odan directly from the package or from the pharmacist at the pharmacy.
Qualitative and quantitative composition. The information provided in Qualitative and quantitative composition of Quinine-Odan is based on data of another medicine with exactly the same composition as the Quinine-Odan. Be careful and be sure to specify the information on the section Qualitative and quantitative composition in the instructions to the drug Quinine-Odan directly from the package or from the pharmacist at the pharmacy.
Therapeutic indications. The information provided in Therapeutic indications of Quinine-Odan is based on data of another medicine with exactly the same composition as the Quinine-Odan. Qualaquin Capsule Odan - Quinine mg. Check Generic Equivalent Of Qualaquin. Prescription Required. Quantity: Manufacturer: Odan. Please Select It is available in the quantity of capsules.
Qualaquin Information: Qualaquin Quinine sulfate is a medication used to treat uncomplicated malaria. Malaria parasites can enter the body through these mosquito bites, and then live in body tissues such as red blood cells or the liver. This medication is used to kill the malaria parasites living inside red blood cells. This medication may also sometimes be prescribed by doctors to treat leg cramps.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. Take the missed dose as soon as you remember it. However, if it has been more than 4 hours since the time you should have taken the missed dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Quinine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture not in the bathroom. Do not refrigerate or freeze the medication. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them.
However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program.
It is important to keep all medication out of sight and reach of children as many containers such as weekly pill minders and those for eye drops, creams, patches, and inhalers are not child-resistant and young children can open them easily.
To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach.
In case of overdose, call the poison control helpline at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking quinine.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.
You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Quinine pronounced as kwye' nine. Why is this medication prescribed? How should this medicine be used?
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