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    DEA Class; Rx

    Common Brand Names; Qualaquin

    • Antimalarials; 

    Antimalarial; occurs naturally in the bark of the cinchona tree; more toxic and potent antimalarial than quinidine; FDA ruled that it lacked evidence of effectiveness for relief of nocturnal muscle cramps; non-prescription forms are no longer available but prescription forms are still available.

    Indicated for the treatment of malaria.

    For the treatment of babesiosis.

    Prolonged QT interval

    Hypersensitivity; cross-sensitivity with mefloquine or quinidine

    G6PD deficiency

    Optic neuritis, tinnitus, history of quinine-associated blackwater fever and thrombocytopenic purpura


    Idiopathic thrombocytopenia purpura (ITP) and thrombotic thrombocytopenic purpura (TTP)

    Hemolytic uremic syndrome

    Blackwater fever

    Myasthenia gravis

    Optic neuritis

    • Flushing of the skin
    • Anginal symptoms
    • Fever
    • Rash
    • Pruritus
    • Hypoglycemia
    • Epigastric pain
    • Hemolysis in G6PD deficiency
    • Thrombocytopenia
    • Hepatitis
    • Nightblindness
    • Diplopia
    • Optic atrophy
    • Impaired hearing
    • Hypersensitivity reaction

    Acute hemolytic anemia reported in patients receiving quinine for treatment of malaria, including patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency; the cause for acute hemolytic anemia in treated patients with malaria and potential relationship with G6PD deficiency not determined; closely monitor hemoglobin and hematocrit during quinine treatment; discontinue therapy if patients develop acute hemolytic anemia

    Use with caution in patients with atrial fibrillation or atrial flutter; a paradoxical increase in ventricular response rate may occur with quinine, similar to that observed with quinidine; if digoxin is used to prevent a rapid ventricular response, serum digoxin levels should be closely monitored, because digoxin levels may be increased with use of quinine

    Quinine stimulates release of insulin from the pancreas, and patients, especially pregnant women, may experience clinically significant hypoglycemia

    No evidence that quinine causes uterine contractions at doses recommended for malaria treatment

    Low levels of quinine in breastmilk; amounts ingested by infant are small and would not be expected to cause any adverse effects


    1,944 mg/day PO.


    1,944 mg/day PO.


    16 to 17 years: 1,944 mg/day PO.
    13 to 15 years: Safety and efficacy have not been established; however, doses up to 30 mg/kg/day PO (Max: 1,944 mg/day) have been used off-label.


    Safety and efficacy have not been established; however, doses up to 30 mg/kg/day PO (Max: 1,944 mg/day) have been used off-label.


    Safety and efficacy have not been established.


    Safety and efficacy have not been established.

    Quinine sulfate


    • 324mg