Quinine

Should be taken with food. Take w/ food to minimise GI discomfort.

Hypersensitivity to quinine, quinidine or mefloquine. History of possible hypersensitivity reactions (including blackwater fever), immune thrombocytopenia, thrombotic thrombocytopenic purpura, haemolytic uraemic syndrome; haemolysis or haemoglobinuria, prolonged QT interval, tinnitus, optic neuritis, myasthenia gravis.

Patient with conditions predisposing to QT-interval prolongation, atrioventricular block, atrial fibrillation or flutter, heart block, other cardiac conduction defects or serious heart disease; G6PD deficiency. Renal and hepatic impairment. Children. Pregnancy and lactation. Patient Counselling This drug may cause visual disturbances and vertigo, if affected, do not drive or operate machinery. Monitoring Parameters Monitor CBC with platelet count, LFTs, blood glucose, and ECG. Perform ophthalmologic exam.

Significant: Cinchonism, haemolytic anaemia, blackwater fever, hypoglycaemia. Blood and lymphatic system disorders: Agranulocytosis, pancytopenia, intravascular coagulation. Cardiac disorders: Atrioventricular conduction disturbances, T wave flattening. Ear and labyrinth disorders: Tinnitus, impaired hearing. Eye disorders: Blurred vision, defective colour perception, visual field constriction. Gastrointestinal disorders: Diarrhoea, nausea, vomiting, abdominal pain. General disorders and administration site conditions: Oedema. Musculoskeletal and connective tissue disorders: Muscle weakness. Nervous system disorders: Headache, vertigo, excitement, loss of consciousness. Psychiatric disorders: Agitation, confusion. Renal and urinary disorders: Renal insufficiency, renal failure, oliguria. Respiratory, thoracic and mediastinal disorders: Bronchospasm, dyspnoea. Skin and subcutaneous tissue disorders: Photosensitivity, erythema, pruritus, urticaria.
Potentially Fatal: Severe hypersensitivity reactions, thrombocytopenia, immune thrombocytopenia, haemolytic uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TTP), QT-interval prolongation, torsade de pointes, ventricular fibrillation.

Increased risk of inducing ventricular arrhythmia with halofantrine or other drugs known to prolong QT interval (e.g. amiodarone, astemizole, terfenadine, cisapride, moxifloxacin, pimozide, thioridazine). Increased risk of convulsion with mefloquine. May potentiate the effects of anticoagulants, neuromascular blocking agents and oral hypoglycaemic. Reduced renal clearance of amantadine. Decreased plasma concentrations with carbamazepine, phenobarbital, phenytoin, rifampicin. Increased plasma concentration with ritonavir. May delay or decrease absorption with Al- and/or Mg-containing antacids. Reduced plasma levels of ciclosporin. Increased plasma levels of digoxin. Increased risk of myopathy and rhabdomyolysis with atorvastatin.

Antimalarials / Neuromuscular Disorder Drugs

P01BC01 - quinine ; Belongs to the class of methanolquinoline antimalarials.