WARNING

Quinine is a medication that has been historically used to treat malaria, a potentially life-threatening tropical disease caused by parasites. While it can be effective in treating malaria, it is associated with various risks and side effects. Here are some of the potential risks of taking quinine:

• Side Effects: Common side effects of quinine include nausea, vomiting, diarrhea, headache, and dizziness. Some individuals may also experience ringing in the ears (tinnitus) or changes in vision.
• Allergic Reactions: In some cases, people may be allergic to quinine, leading to symptoms such as rash, itching, swelling, severe dizziness, or difficulty breathing. Allergic reactions can be serious and require immediate medical attention.
• Cardiovascular Effects: Quinine can affect the heart’s rhythm, leading to conditions such as QT prolongation. This can be particularly problematic for individuals with pre-existing heart conditions.
• Hypoglycemia (Low Blood Sugar): Quinine can cause low blood sugar levels, which may be of concern for individuals with diabetes or those at risk of hypoglycemia.
• Hematologic Effects: Quinine may have adverse effects on the blood, including thrombocytopenia (low platelet count), which can lead to increased bleeding risk.
• Cinchonism: Prolonged or high-dose use of quinine may lead to a condition known as cinchonism, characterized by symptoms such as headache, nausea, blurred vision, and hearing loss.
• Pregnancy Risks: Quinine is generally not recommended for use during pregnancy, especially in the first trimester, as it may be associated with an increased risk of birth defects.
• Drug Interactions: Quinine can interact with various medications, including certain antibiotics, anticoagulants, and drugs that affect the heart’s rhythm. These interactions can lead to serious health problems.

It’s crucial to use quinine under the supervision of a healthcare professional, and the benefits of its use should be carefully weighed against the potential risks. If you are prescribed quinine or any medication, it’s important to communicate openly with your healthcare provider about your medical history, existing conditions, and any other medications or supplements you are taking to minimize potential risks and complications.

Why is this medication prescribed?

Quinine is a medication that has been used to treat and prevent malaria, a potentially life-threatening mosquito-borne infectious disease caused by the Plasmodium parasite. It has been one of the primary drugs for malaria treatment for many years. Quinine works by interfering with the growth and reproduction of the Plasmodium parasite in the red blood cells, which helps to control and eventually eliminate the infection.

How should this medicine be used?

If prescribed by a healthcare professional for malaria treatment, it is crucial to follow their instructions closely. Here are some general guidelines:

• Dosage: Take the medication exactly as prescribed by your healthcare provider. The dosage and duration of treatment can vary depending on factors such as the type of malaria and your overall health.
• Timing: Take quinine with food to minimize stomach upset unless directed otherwise by your healthcare provider.
• Completing the Course: Complete the entire course of treatment even if your symptoms improve before the medication is finished. This helps to ensure that the infection is fully treated.
• Monitoring for Side Effects: Be aware of potential side effects, and contact your healthcare provider if you experience any unusual symptoms. Common side effects may include nausea, vomiting, abdominal pain, headache, and changes in vision.
• Avoiding Certain Foods and Medications: Quinine may interact with certain foods, beverages (such as tonic water), and medications. Inform your healthcare provider about all the medications and supplements you are taking to prevent potential interactions.
• Pregnancy and Breastfeeding: If you are pregnant or breastfeeding, inform your healthcare provider before taking quinine, as it may not be suitable for use during these periods.

It is essential to note that the use of quinine for conditions other than malaria treatment is generally discouraged due to its potential for serious side effects. If you have any concerns or questions about the use of quinine, it’s crucial to consult with a healthcare professional who can provide personalized advice based on your specific health situation.

Other uses for this medicine

Quinine has been used for other purposes, but these uses are generally not recommended due to potential side effects and the availability of safer alternatives.

What special precautions should I follow?

Quinine is a medication that is primarily used to treat malaria. It is important to follow your healthcare provider’s instructions and guidelines when taking quinine. Here are some general precautions associated with quinine use:

Precautions:

• Medical History: Inform your healthcare provider about your complete medical history, especially if you have a history of certain medical conditions such as heart rhythm disorders (arrhythmias), glucose-6-phosphate dehydrogenase (G6PD) deficiency, myasthenia gravis, or optic neuritis.
• Allergies: Inform your healthcare provider if you are allergic to quinine or any other medications.
• Pregnancy and Breastfeeding: Inform your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. The use of quinine during pregnancy and breastfeeding should be carefully considered and discussed with your healthcare provider.
• Interactions: Inform your healthcare provider about all medications, vitamins, and herbal supplements you are taking, as quinine can interact with certain drugs.
• Heart Rhythm Disturbances: Quinine can cause serious heart rhythm disturbances (arrhythmias). If you experience symptoms such as rapid or irregular heartbeat, dizziness, or fainting, seek medical attention immediately.
• Hemolytic Uremic Syndrome (HUS): Quinine has been associated with an increased risk of hemolytic uremic syndrome, a serious condition that involves the breakdown of red blood cells. Report any unusual bleeding, bruising, or signs of hemolysis to your healthcare provider.
• Monitoring: Regular monitoring of blood cell counts, kidney function, and cardiac function may be necessary during quinine treatment.

Always follow the specific instructions provided by your healthcare provider and read the medication guide that comes with the prescription. If you have any questions or concerns about quinine or its potential interactions, consult with your healthcare professional.

What special dietary instructions should I follow?

• Grapefruit Interaction: Avoid consuming grapefruit or grapefruit juice while taking quinine, as it can interfere with the metabolism of the drug and increase the risk of side effects.
• Alcohol: Limit alcohol intake while taking quinine, as alcohol may increase the risk of certain side effects such as dizziness or impairment of judgment.
• Food: Quinine can be taken with or without food. However, if stomach upset occurs, taking it with food or milk may help.
• Caffeine: Quinine may increase the sensitivity to caffeine. Limiting caffeine intake, especially in the evening, may help reduce the risk of insomnia or other sleep disturbances.

What should I do if I forget a dose?

If you forget to take a dose of your medication, the general advice is as follows:

• Take as Soon as Possible: If you forget to take a dose of quinine, take it as soon as you remember. However, if it’s almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule.
• Do Not Double Dose: Do not take a double dose to make up for a missed one. Taking too much quinine at once can increase the risk of side effects.
• Consult Your Healthcare Provider: If you are unsure about what to do or if you miss doses frequently, consult your healthcare provider. They can provide guidance on how to manage missed doses and may adjust your treatment plan if necessary.

What side effects can this medication cause?

Quinine, like many medications, can cause side effects. It’s important to note that the following list is not exhaustive, and individuals may experience side effects to varying degrees. If you are prescribed quinine, it’s essential to report any unusual or severe side effects to your healthcare provider. Common side effects of quinine may include:

• Nausea and Vomiting: Gastrointestinal upset, including nausea and vomiting, is a common side effect.
• Diarrhea: Some individuals may experience diarrhea while taking quinine.
• Dizziness or Lightheadedness: Quinine can cause dizziness or lightheadedness, especially when getting up from a sitting or lying position.
• Headache: Headaches are reported by some individuals taking quinine.
• Changes in Vision: Quinine has been associated with visual disturbances, including changes in color vision and visual acuity. In rare cases, it can lead to more serious visual problems. If you experience any changes in vision, it’s crucial to inform your healthcare provider promptly.
• Ringing in the Ears (Tinnitus): Tinnitus, or ringing in the ears, can occur as a side effect of quinine.
• Sweating: Increased sweating has been reported in some individuals taking quinine.
• Irregular Heartbeat (Arrhythmias): Quinine can affect the electrical activity of the heart and may lead to irregular heart rhythms (arrhythmias). It’s important for individuals with pre-existing heart conditions to be monitored closely.
• Low Platelet Count (Thrombocytopenia): Quinine has been associated with a decrease in platelet count, which can lead to an increased risk of bleeding.
• Hypoglycemia: Quinine can lower blood sugar levels, and individuals with diabetes should monitor their blood sugar levels closely.
• Allergic Reactions: While rare, some individuals may experience allergic reactions to quinine, such as skin rash, itching, or swelling.

It’s crucial to take quinine as prescribed and to report any side effects promptly to your healthcare provider. If you experience severe or persistent side effects, seek medical attention immediately. Additionally, quinine use for treating leg cramps is discouraged due to the risk of serious side effects. Always consult with your healthcare provider for personalized advice based on your health status and medical history.

What should I know about storage and disposal of this medication?

Storage and Disposal of quinine:

Storage:

• Store quinine tablets at room temperature, away from excessive heat and moisture.
• Keep the medication in its original container, tightly closed, and out of reach of children.

Disposal

• Dispose of quinine according to local guidelines and regulations.
• Do not flush medications down the toilet unless specifically instructed to do so. Instead, use a drug take-back program or follow local regulations for proper disposal.
• If you have questions about how to dispose of quinine or any other medication, consult with your pharmacist or healthcare provider.

In case of emergency/overdose

• Emergency Assistance: In case of suspected overdose or a medical emergency, call your local emergency services (such as 911 in the United States) immediately.
• Overdose Symptoms: Symptoms of quinine overdose may include severe vomiting, severe stomach cramps, confusion, seizures, and disturbances in heart rhythm. Seek immediate medical attention if you suspect an overdose.

What other information should I know?

• Missed Dose: If you miss a dose, take it as soon as you remember. However, if it’s almost time for the next dose, skip the missed dose and continue with your regular dosing schedule. Do not double up to make up for a missed dose.
• Follow Instructions: Take quinine exactly as prescribed by your healthcare provider. Do not change the dosage or stop taking it without consulting your doctor.
• Regular Check-ups: Attend regular follow-up appointments with your healthcare provider to monitor your response to the medication and to address any concerns.
• Inform Healthcare Providers: Inform all healthcare providers, including dentists and surgeons, about your use of quinine. This includes over-the-counter medications, herbal supplements, and vitamins.
• Allergies: Inform your healthcare provider if you have a history of allergies to medications, especially quinine or related compounds.
• Drug Interactions: Discuss potential drug interactions with your healthcare provider, especially if you are taking other medications.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of quinine with your healthcare provider.
• Tonic Water and Quinine: If you are consuming tonic water for its quinine content, be aware that the concentration of quinine in tonic water is generally much lower than therapeutic doses used for malaria treatment. However, it’s advisable to consult with your healthcare provider regarding dietary choices and potential interactions.

Always follow your healthcare provider’s advice and instructions regarding the use, storage, and disposal of quinine. If you have specific questions or concerns, discuss them with your healthcare provider for personalized guidance based on your health status and medical history.