Quinine Sulfate Capsules

Generic name: Quinine Sulfate

Drug class: Antiprotozoals

Dosage form: Capsule

Route of administration: Oral

Dose:

• Adults (≥ 16 years of age): 648 mg (two capsules) every 8 hours for 7 days.
• Patients with severe chronic renal impairment: One loading dose of 648 mg (two capsules) followed 12 hours later by 324 mg (one capsule) every 12 hours for 7 days.

Mechanism of action: Quinine sulfate interferes with the growth and reproduction of the malaria parasite by inhibiting the parasite’s ability to digest hemoglobin, leading to its death.

Drug usage cases:

• Treatment of uncomplicated malaria caused by Plasmodium falciparum.

Drug contraindications:

• Known hypersensitivity to quinine, quinidine, or mefloquine.
• Prolonged QT interval or certain heart rhythm problems (e.g., atrial fibrillation).
• Glucose-6-phosphate dehydrogenase (G6PD) deficiency.
• Myasthenia gravis.
• Optic neuritis.

Side effects:

• Thrombocytopenia (low platelet count).
• Hemolytic anemia.
• QT interval prolongation and ventricular arrhythmias.
• Hypoglycemia (low blood sugar).
• Hypersensitivity reactions, including anaphylaxis, urticaria, and skin rashes.
• Gastrointestinal disturbances such as nausea, vomiting, and abdominal pain.
• Headache, dizziness, and tinnitus.
• Visual disturbances, including blurred vision and diplopia.
• Hearing disturbances, including hearing loss and tinnitus.
• Skin reactions such as rash and pruritus.
• Muscle weakness and myalgia.
• Hypotension (low blood pressure).
• Elevated liver enzymes.
• Hemoglobinuria (presence of hemoglobin in urine).
• Renal impairment.

Warnings:

• Quinine sulfate is not approved for the prevention of malaria, treatment of severe or complicated malaria, or treatment or prevention of nocturnal leg cramps.
• Use with caution in patients with a history of cardiac arrhythmias or QT interval prolongation.
• Monitor for signs of thrombocytopenia and hemolytic anemia; discontinue use if these occur.
• Avoid concomitant use with other drugs known to prolong the QT interval.
• Monitor blood glucose levels, especially in patients with diabetes or those at risk for hypoglycemia.
• Use with caution in patients with hepatic or renal impairment; dosage adjustments may be necessary.
• Discontinue use if signs of hypersensitivity reactions occur.
• Use with caution in patients with a history of myasthenia gravis.
• Monitor for visual and auditory disturbances; discontinue use if these occur.
• Use with caution in patients with a history of seizures.
• Monitor for signs of hemolysis, especially in patients with G6PD deficiency.

Use during pregnancy or breastfeeding:

Quinine sulfate should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted into breast milk; caution should be exercised when administering to nursing mothers. Consult a healthcare provider for personalized advice.