Pronunciation:

KWYE-nine

Brand Names:

• Qualaquin
• Quinamm
• Quiphile

Dosage Forms:

• Capsule
• Tablet
• Tablet, Extended Release

Classifications:

Therapeutic—

Musculoskeletal Agent

Chemical—

Cinchona Alkaloid

Uses of This Medicine:

Quinine is used to treat malaria. This medicine usually is given with one or more other medicines for malaria.

Quinine may also be used for other problems as determined by your doctor. Do not confuse quinine with quinidine, a different medicine that is used for heart problems.

Quinine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, quinine is used in certain patients with the following medical conditions:

• Babesiosis (infection caused by parasites)

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

This medicine has been used to treat malaria in children and, in effective doses, has not been shown to cause different side effects or problems in children than it does in adults.

Older adults—

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of quinine in the elderly with use in other age groups.

Pregnancy—

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Astemizole
• Aurothioglucose
• Ranolazine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you 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 of skin)—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 the heart, usually at higher doses

• Hypoglycemia—Quinine may cause low blood sugar

• Myasthenia gravis—Quinine may increase muscle weakness in patients with myasthenia gravis

Proper Use of This Medicine:

Take this medicine only as directed. Do not take more of it, do not take it more 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 the chance of side effects.

Take this medicine with or after meals to lessen possible stomach upset, unless otherwise directed by your doctor. If you are to take this medicine at bedtime, take it with a snack or with a glass of water, 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 you begin to feel better after a few days. If you stop taking this medicine too soon, your symptoms may return. Do not miss any doses.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For treatment of malaria:
  • Adults and teenagers: 600 to 650 mg every eight hours for at least three days. This medicine must be taken with other medicine to treat malaria.
  • Children: Dose must be determined by the doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using This Medicine:

Quinine may 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 may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Abdominal or stomach cramps or pain

diarrhea

nausea

vomiting

Less common

Anxiety

behavior change, similar to drunkenness

black, tarry stools

blood in urine or stools

blurred vision

cold sweats

confusion

convulsions (seizures) or coma

cool pale skin

cough or hoarseness

difficulty in concentrating

drowsiness

excessive hunger

fast heartbeat

fever or chills

headache

lower back or side pain

nervousness

nightmares

painful or difficult urination

pinpoint red spots on skin

restless sleep

shakiness

slurred speech

sore throat

unusual bleeding or bruising

unusual tiredness 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

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Blurred vision or change in vision

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.