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Qualaquin, |quinine Quinine Sulfate

quinine

Generic Name: quinine (KWYE nine)
Brand Names: Qualaquin

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 purposes other than those listed in this medication guide.

What is the most important information I should know about 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.

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).

You should not take quinine if you have a history of "Long QT syndrome", or if you have glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, myasthenia gravis, or optic neuritis (inflammation of the nerves in your eyes).

No medication is 100% effective in treating malaria. For best results, keep using the medication as directed. Talk with your doctor if you have fever, vomiting, or diarrhea during your treatment.

What should I discuss with my healthcare provider before taking quinine?

• a history of "Long QT syndrome";

• glucose-6-phosphate dehydrogenase (G-6-PD) deficiency;

• myasthenia gravis; or

• optic neuritis (inflammation of the optic nerve).

Before taking quinine, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease or a heart rhythm disorder;

• low potassium levels in your blood (hypokalemia); or

• kidney or liver disease.

If you have any of these conditions, you may not be able to use quinine, or you may need a dosage adjustment or special tests during treatment.

How should I take quinine?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Call your doctor if your malaria symptoms do not improve after 2 days of taking quinine, or if your symptoms return after you have finished the medication.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using quinine. You may need to stop using the medicine for a short time.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using quinine.

No medication is 100% effective in treating malaria. For best results, keep using the medication as directed. Talk with your doctor if you have fever, vomiting, or diarrhea during your treatment.

What happens if I miss a dose?

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.

What happens if I overdose?

Symptoms of a quinine overdose 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.

What should I avoid while taking quinine?

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.

Quinine 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.

Continue taking quinine and talk with your doctor if you have any of these less serious side effects:

• hunger, headache, confusion, irritability, sweating;

• drowsiness, weakness, dizziness, tremors; or

• warmth, redness, or tingly feeling under the skin.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect quinine?

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 (Mariam).

If you are using any of these drugs, you may not be able to use quinine, or you may need dosage adjustments or special tests during treatment.

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.

Where can I get more information?

• Your pharmacist has information about quinine written for health professionals that you may read.

What does my medication look like?

Quinine is available with a prescription under the brand name Qualaquin. Other brand or generic forms may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Qualaquin 324 mg--clear capsule

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• 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.