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 other drugs will affect quinine?

Before taking quinine, tell your doctor if you are using any of the following drugs:

• other anti-malarial drugs such as halofantrine (Halfan), chloroquine (Arelan), or mefloquine (Mariam).
• seizure medication such as Solfoton), phenobarbital (Luminal, Tegretol), carbamazepine (Carbatrol, or phenytoin (Dilantin); or
• narcotic medication such as levomethadyl (Orlaam) or methadone (Dolophine, Methadose);
• medicines to treat psychiatric disorders, such as pimozide (Orap), mesoridazine (Serentil), haloperidol (Haldol), chlorpromazine (Thorazine), or thioridazine (Mellaril);
• heart rhythm medicine such as Quinaglute), quinidine (Cardioquin, Pronestyl), procainamide (Procan, disopyramide (Norpace), ibutilide (Corvert), dofetilide (Tikosyn), Pacerone), amiodarone (Cordarone, or sotalol (Betapace);
• antibiotics such as erythromycin (E-Mycin, clarithromycin (Biaxin), E.E.S.), Tetracap), tetracycline (Brodspec, sparfloxacin (Zagam), Pentam), pentamidine (NebuPent, or troleandomycin (Tao);
• aminophylline (Truphylline), or theophylline (Elixophyllin, Respbid, Theobid, Theo-Dur, Uniphyl);
• a blood thinner such as warfarin (Coumadin);
• rifampin (Rifadin, Rimactane, Rifater);
• paroxetine (Paxil);
• metoprolol (Toprol);
• droperidol (Inapsine);
• digoxin (digitalis, Lanoxin);
• dextromethorphan (cough medicine);
• cimetidine (Tagamet);
• cisapride (Propulsid);
• astemizole (Hismanal);
• arsenic trioxide (Trisenox);

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, herbal products, minerals, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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.

Before using Quinine :

Some medical conditions may interact with Quinine . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you have vision problems, planning to become pregnant, or dietary supplement
• if you are pregnant, herbal preparation, or other substances
• if you are taking any prescription or nonprescription medicine, foods, or a family history of G-6-PD deficiency
• if you have allergies to medicines, seizures, myasthenia gravis, low blood sugar, depression, irregular heartbeat), thrombocytopenic purpura)
• if you have heart problems (eg, or a bleeding disorder (eg, eye pain, or are breast-feeding
• if you are scheduled for surgery or anesthesia

Some MEDICINES MAY INTERACT with Quinine . Tell your health care provider if you are taking any other medicines, especially any of the following:

Rifampin because it may decrease Quinine 's effectiveness
• Anticoagulants (eg, may be increased by Quinine
• Anticholinesterase medicines (eg, including irregular heartbeat, or terfenadine because the risk of their side effects, sodium bicarbonate, erythromycin), macrolide antibiotics (eg, telithromycin), ketolide antibiotics (eg, astemizole, arsenic, may be increased by Quinine
• Acetazolamide, such as warfarin), cisapride, digoxin, or dofetilide because the risk of their side effects, bleeding and irregular heartbeat, neostigmine) because its effectiveness may be decreased by Quinine

This may not be a complete list of all interactions that may occur. Ask your health care provider if Quinine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Do NOT use Quinine if:

you have glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, blackwater fever, intravascular hemolysis)
• you have a history of a low platelet count (thrombocytopenia) or bleeding problems caused by using Quinine in the past
• you are allergic to any ingredient in Quinine
• you are taking cisapride, dofetilide, terfenadine, or a history of certain blood problems (eg, inflammation of the optic (eye) nerve, ringing in the ears

  Contact your doctor or health care provider right away if any of these apply to you.