Quinine – Oral – 1500wds

Quinine is used to treat symptoms caused by Plasmodium falciparum, a malaria-causing parasite. Quinine is also used to treat babesiosis, lupus and arthritis.

Overview

Quinine is a medication derived from the bark of a tree and is used to treat malaria. Quinine has also shown to be effective in treating the symptoms of lupus and arthritis. Specifically, antimalarials such as Quinine have shown to improve muscle and joint pain, skin rashes, and inflammation of the lining of the heart and lungs, along with other lupus symptoms such as fatigue and fever. As an antimalarial, Quinine works by killing the parasite or preventing it from growing. As of 2006, it is no longer recommended as a first-line treatment for malaria but can be used when artemisinins are not available.

Conditions Treated

  • Malaria
  • Babesiosis
  • Lupus
  • Arthritis

Type of Medicine

  • Oral Antimalarial

Side Effects

The most common side effects experienced by patients taking Quinine have been diarrhea, nausea, stomach cramps or pain, and vomiting. Symptoms of a mild headache, unusual sweating, decreased hearing, minor changes in color vision, and blurred vision have also been reported.

If any of the aforementioned side effects persist or worsen in their severity while taking the medication, the patient is urged to follow up with his or her doctor. Many patients do not experience serious side effects.

Other side effects experienced less frequently, but often enough to warrant mentioning, include behavioral changes including anxiety, confusion, drowsiness, difficulty concentrating, nervousness, nightmares, restless sleep, shakiness, and slurred speech.

The occurrence of any of the following rare but serious side effects should warrant the patient contacting their doctor immediately: signs of serious infection (high fever, severe chills, persistent sore throat), signs of hemolytic anemia (severe tiredness, brown urine, pale lips/nails/skin, rapid breathing at rest), severe liver problems (persistent nausea and vomiting, abdominal pain, weakness, unusually dark urine) and kidney problems (large deviation from normal amounts of urine).

The patient should seek immediate medical attention if the following symptoms occur: chest pain, severe dizziness, fainting, fast/irregular heartbeat, and blindness. Very serious allergic reactions to Quinine are rare; however, if any symptoms such as rash, itching, and swelling (especially in the face/tongue/throat), severe dizziness and trouble breathing present themselves, the patient should seek immediate medical attention.

Quinine is intended to alleviate serious medical conditions and, as such, is generally prescribed because the benefit is greater than the risk of experiencing side effects.

Dosage

As with all medications, it's very important to take Quinine only as prescribed by the physician. This means patients should avoid taking more of the drug than advised, either in frequency or in the size of the dose. Additionally, patients should stop taking the medication when advised to do so by their doctor, even if they still have a supply remaining.

Quinine should be taken with food to reduce the risk of stomach upset unless otherwise directed by the physician. The patient may take it before or after the meal, as well. As the required dosage varies with respect to the needs of each patient, it's important that care is taken to ensure the instructions of the prescribing doctor are followed closely at the time of prescription.

Otherwise, the instructions printed on the side of the bottle may also be followed, as they should be similar.

In determining the patient's dosage, the physician takes a number of different factors into account. The strength of the medicine, number of doses per day, the time between doses, and the period of time the patient is to be taking the medicine all play a part in determining dose size. It can also depend on the reason for which the patient was prescribed Quinine.

General dosage instructions have been provided by the manufacturers of Quinine, but adjustments to these dosages may be made by the prescribing physician. When establishing dose size and frequency, factors discussed between the patient and prescribing physician will provide the required insight.

For treating symptoms related to Malaria, the recommended dosage for adults is 648milligrams (mg) every 8 hours.

There are no recommended dosage sizes for children. Instead, the drug manufacturer leaves the dosage size and frequency up to the administering physician.

Patients are strongly recommended not to take double doses. If a patient does not take the dose at the required time, they can simply take the missed dose when this is realized. However, if it is close to the time at which the patient should take the next dose, he or she should skip this dose and take their next dose at the planned time.

If the patient experiences signs of an overdose (blindness, blurred or changes in vision, chest pain, dizziness, double vision, fainting, lightheadedness, rapid or irregular heartbeat, extreme tiredness or coma), they need immediate attention. Either call 911 or the Poison Control Center (1-800-222-1222) immediately.

Interactions

Drugs interact with other drugs in the human body, changing the effects of each medication. This may cause one medication to be ineffective in treating a condition or it may cause a dangerous reaction in the patient. For these reasons, it's important for patients to keep a list of all medications they are currently taking, including the dosage and frequency of each drug they take. Where some patients fail is in assuming that this applies only to prescribed medication. To the contrary, it's important that your doctor knows everything you're taking, including non-prescription, over the counter drugs.

Below is a partial list of the major drugs known to have negatively interacted with Quinine. If the patient is already taking any of these medications, Quinine should not be prescribed and the physician may need to select alternative treatment options:

  • Amifampridine
  • Amisulpride
  • Astemizole
  • Aurothioglucose
  • Bepridil
  • Cisapride
  • Dronedarone
  • Fluconazole
  • Ketoconazole
  • Mesoridazine
  • Nelfinavir
  • Pimozide
  • Piperaquine
  • Posaconazole
  • Saquinavir
  • Sparfloxacin
  • Thioridazine
  • Ziprasidone

If any other medications are being taken by the patient, it is imperative that they disclose which medications are being taken as there are many medications that taken alongside quinine can interact negatively and result in serious side effects. Open and regular communication with the physician is a vital component of any treatment regime with Quinine.

Warnings

During consultation, the patient should disclose any current or historical health problems, and also notify if they suffer from any allergies or are currently taking any other medications. Quinine should not be taken: where the patient suffers or has suffered from glaucoma, a blockage of the stomach, esophagus, bladder, or intestines, or severe ulcerative colitis.

Additionally, the patient should notify his or her doctor of a history of any of the following conditions, as they may affect the patient's ability to take Quinine:

  • Poor heart health, including angina, heart attack, heart failure, or an irregular heartbeat
  • High or low blood pressure
  • Any blood disorders
  • Kidney disease
  • Liver disease
  • Muscle disease
  • Nerve disease
  • Low blood sugar

As this medication can make cause feelings of lightheadedness, dizziness, and drowsiness, they should also be advised not to operate an automobile or use heavy machinery. Furthermore, any activity that relies on an individual having an alert mind or clear vision is not recommended until the patient is confident that these activities can be performed in a safe manner.

Patients should also exercise caution when drinking alcohol while taking Quinine.

The effects of Quinine may present symptoms of intoxication, including loss of balance and blurred vision, so patients are urged to take care when they undertake any above-average level of physical activity.

Storage

Quinine should be stored at room temperature. Freezing temperatures should be avoided at all times. Additionally, the drug's manufacturer recommends that it be kept away from heat, moisture, and direct light. Ideally, it should be kept in a cupboard or medicine cabinet, where children cannot reach it.

Once the doctor and patient determine Quinine is no longer necessary for treatment, they should discuss proper disposal of the remaining supply. Medication that is either expired or no longer used should be disposed of without haste. Healthcare professionals can advise patients on how best to get rid of the remaining supply.

Summary

While Quinine has demonstrable use as a treatment, it can also pose a risk to patients who fail to communicate fully with their physicians. As a treatment designed to alleviate the symptoms of Malaria, Quinine works to kill the responsible parasites, but it also affects how the body reacts to stimuli. As this medication has the potential to induce feelings of dizziness, drowsiness, and sleepiness, the drug can impair a patient's function day to day and place the patient in danger if precautions are not taken. It is for this reason that it is of vital importance the patient tells their physician as much as is known about their own medical history, including any relevant medical history of family members. There are hundreds of medications that can cause adverse reactions with Quinine and dozens of medical conditions that could be worsened by use of the drug. For this reason, it is in the best interest of the patient to discuss truthfully and honestly with their physician. While side effects can occur, when taken correctly, Quinine can provide an effective treatment for malaria and other health problems.

 

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Last Reviewed:
January 31, 2018
Last Updated:
February 10, 2018
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