Quinine: Difference between revisions

Latest revision as of 12:10, 20 March 2026

General

Type: Antimalarial
Dosage Forms: PO 324 (IM and IV formulations available outside US)
Common Trade Names: Qualaquin

Adult Dosing

Indications by Disease

Disease	Dose	Context
Babesiosis	650mg TID	Severe parasitemia with Clindamycin use IV for severe
Malaria	648mg PO q8h x 7 days	Uncomplicated malaria, use with doxycycline or clindamycin

Pediatric Dosing

Indications by Disease

Disease	Dose	Context
Babesiosis	8mg/kg PO q8h x 7-10 days (Max: 648mg/dose)	Severe parasitemia with Clindamycin
Malaria	30mg/kg/day PO q8h x 3-7 days (Max: 648mg/dose)	Uncomplicated malaria, use with clindamycin

Special Populations

Pregnancy Rating: C
Lactation: Probably safe
Renal Dosing
- Adult
  - Severe chronic renal failure: 648mg PO x 1 then 324mg PO q12h
  - If on HD give after dialysis
- Pediatric
  - Not defined
Hepatic Dosing
- Adult and Pediatric
  - No adjustment for Child-Pugh Class A or B
  - Avoid in Child-Pugh Class C

Contraindications

Black Box Warnings

Hematologic Toxicity with use for nocturnal leg cramps
- Thrombocytopenia
- HUS/TTP

General

Allergy to class/drug
Allergy to mefloquine or quinidine
Black water fever
ITP/TTP/HUS
Thrombocytopenia
Glucose-6-Phosphate Deficiency (G6PD)
Myasthenia gravis
Optic neuritis
QT prolongation/Congenital long QT syndrome
Electrolyte abnormalities
Bradycardia
Ventricular arrhythmias
CHF
Recent MI

Caution

Adverse Reactions

Serious

Cinchonism
QT prolongation
Torsades de pointes
Anaphylaxis
Angioedema
Bronchospasm
Thrombocytopenia
TTP/HUS
Hemolytic anemia
Black water fever
Stevens-Johnson syndrome and toxic epidermal necrolysis
Intestinal nephritis
Renal impairment
Hepatitis
Leukopenia
Neutropenia
DIC
Hypoglycemia
Myasthenia gravis exacerbation
Lupus
Optic neuritis
Blindness
Deafness

Common

Cinchonism
Headache
Vasodilation
Diaphoresis
Nausea/Vomiting
Tinnitus
Impaired hearing
Vertigo
Visual impairment
Fever
Flushing
asthenia
Rash
Pruritus
Urticaria
Diarrhea
Abdominal pain
Photosensitivity

Pharmacology

Half-life: 9-12 hours
Metabolism: Liver 80%, CYP450
Excretion: Urine
Mechanism of Action: Unknown

Administration

Give with food

Toxicity

Mild
- Nausea
- Vomiting
- Tinnitus
- Vertigo
- Deafness
Severe
- Ataxia
- Convulsions
- Coma
- QRS/QT prolongation
- Arrhythmia
Retinal Toxicity
- Blurry vision
- Impaired visual fields
- Blindness

References

Epocrates

Authors:

@@ Line 1: / Line 1: @@
 ==General==
-*Type: Antimalarial
+*Type: [[Antimalarial]]
 *Dosage Forms: PO 324 (IM and IV formulations available outside US)
 *Common Trade Names: Qualaquin
 ==Adult Dosing==
-===[[Malaria]]===
+===Indications by Disease===
-*648mg PO Q8h x 7 days
+{{#ask: [[Has DrugName::Quinine]] [[Has Population::Adult]]
-*See [http://www.cdc.gov/malaria/resources/pdf/treatmenttable.pdf CDC Recommendations] for full treatment recommendations
+ |?Treats disease=Disease
+ |?Has Dose=Dose
-===[[Babesiosis]]===
+ |?Has Context=Context
-*648mg PO q6-8h x7-10 days
+ |format=table
-*Use with [[Clindamycin]]
+ |limit=50
+ |mainlabel=-
+ |headers=show
+ |sort=Treats disease
+}}
 ==Pediatric Dosing==
-===[[Malaria]]===
+===Indications by Disease===
-*30mg/kg/day PO q8h x 3-7 days
+{{#ask: [[Has DrugName::Quinine]] [[Has Population::Pediatric]]
-*Max: 648mg/dose
+ |?Treats disease=Disease
-*See [http://www.cdc.gov/malaria/resources/pdf/treatmenttable.pdf CDC Recommendations] for full treatment recommendations
+ |?Has Dose=Dose
+ |?Has Context=Context
-===[[Babesiosis]]===
+ |format=table
-*8mg/kg PO q8h x 7-10 days
+ |limit=50
-*Max: 648mg/dose
+ |mainlabel=-
-*Use with [[Clindamycin]]
+ |headers=show
+ |sort=Treats disease
+}}
 ==Special Populations==
@@ Line 89: / Line 95: @@
 *Blindness
 *Deafness
 ===Common===
 *Cinchonism
@@ Line 106: / Line 111: @@
 *Pruritus
 *Urticaria
-*Diarrhea
+*[[Diarrhea]]
 *Abdominal pain
 *Photosensitivity
@@ Line 114: / Line 119: @@
 *Metabolism: Liver 80%, CYP450
 *Excretion: Urine
-*Mechanism of Action:  Unknown
+*Mechanism of Action: Unknown
 ==Administration==
 *Give with food
+==Toxicity==
+*Mild
+**Nausea
+**Vomiting
+**Tinnitus
+**Vertigo
+**Deafness
+*Severe
+**Ataxia
+**Convulsions
+**Coma
+**QRS/QT prolongation
+**Arrhythmia
+*Retinal Toxicity
+**Blurry vision
+**Impaired visual fields
+**Blindness
 ==See Also==
@@ Line 125: / Line 148: @@
 ==References==
 *Epocrates
+<references/>
-<references/>
 [[Category:Pharmacology]]
+[[Category:ID]]