QUININE (Systemic)
Generic name product may be available in the U.S. and Canada.
Category
- Antimyotonic
- antiprotozoal
Description
Quinine (KWYE-nine)is used to treat malaria. This medicine usually is given with one or moreother medicines for malaria.
Quinine may also be used for other problems as determined by your doctor.Do not confuse quinine with quinidine, a differentmedicine that is used for heart problems.
Quinine is available only with your doctor's prescription in the followingdosage forms:
Oral- Capsules (U.S. and Canada)
- Tablets (U.S.)
Before Using This Medicine
In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For quinine, the followingshould be considered:
Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to quinine, quinidine (e.g., Quinidex), or to dietary itemsthat contain quinine, such as tonic water or bitter lemon. Also tell yourhealth care professional if you are allergic to any other substances, suchas foods, preservatives, or dyes.
Pregnancy?Quinine has been used for the treatment of malariain pregnant women. Treatment is important because if a pregnant woman getsmalaria, there is an increased chance of premature births, stillbirths, andabortion. However, quinine has been shown to cause birth defects in rabbitsand guinea pigs and has also been shown to cause rare birth defects, stillbirths,and other problems in humans. In addition, quinine has been shown to causemiscarriage when taken in large amounts.
Breast-feeding?Quinine passes into the breast milk in small amounts.However, this medicine has not been reported to cause problems in nursingbabies.
Children?This medicine has been used to treat malaria in childrenand, in effective doses, has not been shown to cause different side effectsor problems in children than it does in adults.
Older adults?Many medicines have not been studied specificallyin older people. Therefore, it may not be known whether they work exactlythe same way they do in younger adults or if they cause different side effectsor problems in older people. There is no specific information comparing useof quinine in the elderly with use in other age groups.
Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are takingquinine, it is especially important that your health care professional knowif you are taking the following:
- Mefloquine (e.g., Lariam)?Use of mefloquine with quinine mayincrease the chance of side effects
Other medical problems?The presence of other medicalproblems may affect the use of quinine. Make sure you tell your doctor ifyou have any other medical problems, especially:
- Blackwater fever, history of, or
- Glucose-6-phosphate dehydrogenase (G6PD) deficiency or
- Purpura, or history of (purplish or brownish-red discoloration ofskin)?Patients with a history of blackwater fever, G6PD deficiency,or purpura may have an increased risk of side effects affecting the blood
- Heart disease?Quinine can cause side effects affecting theheart, usually at higher doses
- Hypoglycemia?Quinine may cause low blood sugar
- Myasthenia gravis?Quinine may increase muscle weakness in patientswith myasthenia gravis
Proper Use of This Medicine
Take this medicine only as directed. Do not take more of it, do not take itmore often, and do not take it for a longer time than recommended on the label, unless otherwise directed by your doctor. To do so may increase thechance of side effects.
Take this medicine with or after meals to lessenpossible stomach upset, unless otherwise directed by your doctor. If you areto take this medicine at bedtime, take it with a snack or with a glass ofwater, milk, or other beverage.
For patients taking quinine for malaria:
- To help clear up your infection completely, keep taking this medicine for the full time of treatment, even if youbegin to feel better after a few days. If you stop taking this medicine toosoon, your symptoms may return. Do not miss any doses.
Dosing?The dose of quinine will be different for differentpatients. Follow your doctor's orders or the directionson the label. The following information includes only the average doseof quinine. If your dose is different, do not changeit unless your doctor tells you to do so.
The number of capsules or tablets that you take depends on the strengthof the medicine. Also, the number of doses you take eachday, the time allowed between doses, and the length of time you take the medicinedepend on the medical problem for which you are taking quinine.
- For treatment of malaria:
- Adults and teenagers: 600 to 650 mg every eight hours for at leastthree days. This medicine must be taken with other medicine to treat malaria.
- Children: Dose must be determined by the doctor.
Missed dose?If you do miss a dose of this medicine, take itas soon as possible. However, if it is almost time for your next dose, skipthe missed dose and go back to your regular dosing schedule. Do not doubledoses.
Storage?To store this medicine:
- Keep out of the reach of children.
- Store away from heat and direct light.
- Do not store in the bathroom, near the kitchen sink, or in otherdamp places. Heat or moisture may cause the medicine to break down.
- Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.
Precautions While Using This Medicine
Quininemay cause blurred vision or a change in color vision. Make sure you know how you react to this medicine before you drive, use machines,or do anything else that could be dangerous if you are not able to see well. If these reactions are especially bothersome, check with your doctor.
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects.Although not all of these side effects may occur, if they do occur they mayneed medical attention.
Check with your doctor immediately if any ofthe following side effects occur:
Less common
Anxiety; behavior change, similar todrunkenness; black, tarry stools; blood in urine or stools; blurred vision; cold sweats; confusion; convulsions (seizures) or coma; coolpale skin; cough or hoarseness; difficulty in concentrating; drowsiness; excessive hunger; fast heartbeat; fever or chills; headache; lower back or side pain; nervousness; nightmares; painful ordifficult urination; pinpoint red spots on skin; restless sleep; shakiness; slurred speech; sore throat; unusual bleeding or bruising; unusualtiredness or weakness
Rare
Difficulty in breathing and/or swallowing; disturbed color perception; double vision; hives; increased sweating; muscle aches; night blindness; reddening of the skin, especially around ears; ringing or buzzing in ears; swelling of eyes, face,or inside of nose
Signs and symptoms of overdose
Blindness; chest pain; dizziness; double vision; fainting; lightheadedness; rapid or irregular heartbeat; sleepiness
Other side effects may occur that usually do not need medical attention.These side effects may go away during treatment as your body adjusts to themedicine. However, check with your doctor if any of the following side effectsoccur or progress after you stop taking this medicine:
Other side effects notlisted above may also occur in some patients. If you notice any other effects,check with your doctor.
Additional Information
Once a medicine has been approvedfor marketing for a certain use, experience may show that it is also usefulfor other medical problems. Although these uses are not included in productlabeling, quinine is used in certain patients with the following medical conditions:
- Babesiosis (infection caused by parasites)
- Nighttime leg cramps
Other than the above information, there is no additional information relatingto proper use, precautions, or side effects for these uses.
Revised: 05/24/1999
