What is the most important information I should know about quinine?
|You should not take quinine if you have a heart rhythm disorder called Long QT syndrome, G-6-PD (an enzyme deficiency), a blood clotting disorder, myasthenia gravis, or optic neuritis (inflammation of the nerves in your eyes).|
|Some people have used quinine to treat leg cramps, but this is not an FDA-approved use. Using this medication improperly or without the advice of a doctor can result in serious side effects or death. The U.S. Food and Drug Administration has banned the sale of all non-approved brands of quinine. Do not purchase quinine on the Internet or from vendors outside of the United States.|
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, Quin-G).
Before taking quinine, tell your doctor if you have heart disease or a heart rhythm disorder, low potassium levels in your blood (hypokalemia), kidney disease, or liver disease.
|Many drugs can interact with quinine and some should not be used at the same time. Tell your doctor about all medications you use. Do not start a new medication without telling your doctor.|
What is quinine?
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 will not treat severe forms of malaria, and it should not be taken to prevent malaria. Quinine also should not be taken to treat or prevent night-time leg cramps.|
|Using this medication improperly or without the advice of a doctor can result in serious side effects or death. Quinine is approved for use only in treating malaria. Some people have used quinine to treat leg cramps, but this is not an FDA-approved use.|
The U.S. Food and Drug Administration has banned the sale of all non-approved brands of quinine. As of December 2006, Qualaquin is the only brand of quinine that is approved by the FDA.
Quinine may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking quinine?
|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, Quin-G), or if you have:|
- a heart rhythm disorder called Long QT syndrome;
- an enzyme deficiency called glucose-6-phosphate dehydrogenase (G-6-PD) deficiency;
- a blood clotting disorder;
- myasthenia gravis; or
- optic neuritis (inflammation of the optic nerve).
To make sure you can safely take quinine, tell your doctor if you have any of these other conditions:
- heart disease or a heart rhythm disorder;
- low potassium levels in your blood (hypokalemia); or
- kidney or liver disease.
|FDA pregnancy category C. It is not known whether quinine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication..|
|Hypoglycemia (low blood sugar) may be more likely to occur in pregnant women who are taking quinine. Signs of low blood sugar include headache, hunger, weakness, sweating, tremors, irritability, or trouble concentrating. Talk to your doctor about your specific risk for low blood sugar if you take quinine while you are pregnant.|
|Quinine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.|
|Do not give this medication to a child younger than 16 years old.|
How should I take quinine?
Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
|Take with food if quinine upsets your stomach.|
Quinine is usually taken for 7 days. 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. Talk with your doctor if you have fever, vomiting, or diarrhea during your treatment.
|Take this medication for the full prescribed length of time. Your symptoms may get better before your condition is completely cleared. If you stop using the medication early for any reason, talk to your doctor about other forms of malaria prevention.|
If you need 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 unusual results with certain medical tests. Tell any doctor who treats you that you are using quinine.
|Store at room temperature away from moisture and heat.|
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 the missed dose and take the medicine at your next scheduled dose time. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
|Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.|
What should I avoid while taking quinine?
Avoid taking other anti-malaria medications without your doctor's advice. This includes chloroquine (Arelan), halofantrine (Halfan), and mefloquine (Lariam).
Avoid using antacids without your doctor's advice. Use only the type of antacid your doctor recommends. Some antacids can make it harder for your body to absorb quinine.
|Quinine may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.|
|Do not use quinine to treat any medical condition if your doctor did not prescribe quinine for that condition. Do not purchase quinine on the Internet or from vendors outside of the United States.|
What are the possible side effects of quinine?
|Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.|
|Stop using quinine and call your doctor at once if you have any of these serious side effects:|
- fever, chills, confusion, weakness, sweating;
- severe vomiting, stomach pain, diarrhea;
- problems with vision or hearing;
- chest pain, trouble breathing, severe dizziness, fainting, fast or pounding heartbeats;
- severe flushing (warmth, redness, or tingly feeling);
- urinating less than usual or not at all;
- weak or shallow breathing, feeling like you might pass out;
- easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
- blood in your urine or stools;
- fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or
- loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may include:
- headache, blurred vision, changes in color vision;
- mild dizziness, spinning sensation, ringing in your ears;
- upset stomach; or
- muscle weakness.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect quinine?
Many drugs can interact with quinine. Below is just a partial list. Tell your doctor if you are using:
- acetazolamide (Diamox);
- arsenic trioxide (Trisenox);
- atorvastatin (Lipitor);
- bosentan (Tracleer);
- cimetidine (Tagamet) or ranitidine (Zantac);
- dextromethorphan (cough medicine);
- tacrolimus (Prograf);
- St. John's wort;
- aminophylline (Phyllocontin, Truphylline) or theophylline (Elixophyllin, Theo-24, Theochron, Uniphyl);
- an antibiotic, especially clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), levofloxacin (Levaquin), moxifloxacin (Avelox), pentamidine (NebuPent, Pentam), rifampin (Rifadin, Rifater, Rifamate), or tetracycline (Brodspec, Tetracap);
- an antidepressant, especially amitriptylline (Elavil, Vanatrip, Limbitrol), clomipramine (Anafranil), desipramine (Norpramin), or paroxetine (Paxil);
- ADHD medication;
- antifungal medication such as itraconazole (Sporanox) or ketoconazole (Nizoral);
- a blood thinner such as warfarin (Coumadin, Jantoven);
- heart rhythm medicine, especially amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), dronedarone (Multaq), flecainide (Tambocor), ibutilide (Corvert), procainamide (Procan, Pronestyl), propafenone (Rythmol), quinidine (Quin-G), or sotalol (Betapace);
- heart or blood pressure medication, especially digoxin (digitalis, Lanoxin) or metoprolol (Toprol);
- HIV medications, especially ritonavir (Norvir, Kaletra), or saquinavir (Invirase);
- medicine to prevent or treat nausea and vomiting, such as dolasetron (Anzemet) or ondansetron (Zofran);
- cancer medicine (chemotherapy);
- medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (FazaClo, Clozaril), haloperidol (Haldol), pimozide (Orap), thioridazine (Mellaril), or ziprasidone (Geodon);
- migraine headache medicine such as sumatriptan (Imitrex, Treximet) or zolmitriptan (Zomig);
- narcotic medication such as methadone (Methadose, Diskets, Dolophine);
- sedatives or tranquilizers; or
- seizure medication, especially carbamazepine (Carbatrol, Equetro, Tegretol), phenobarbital (Solfoton), or phenytoin (Dilantin).
This list is not complete and there are many other drugs that can interact with quinine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.
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.
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