Medicine Name: quinine
Description to quinine
Quinine is a natural alkaloid derived from the bark of the Cinchona tree. It has been used for centuries as an antimalarial agent and continues to play a significant role in the treatment of malaria caused by Plasmodium falciparum, particularly in regions with drug-resistant strains.
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Use
Quinine is primarily used for the treatment of uncomplicated Plasmodium falciparum malaria, especially in cases where other antimalarial drugs are ineffective or unavailable. It is also occasionally used to treat nocturnal leg cramps, though this use is less common due to safety concerns.
Dosages of quinine
- Malaria (adults): 600 mg of quinine sulfate orally, three times daily for 7 days, often combined with other antimalarial agents like doxycycline or clindamycin.
- Children: 10 mg/kg orally every 8 hours for 7 days.
- Dosages can vary based on patient age, weight, and severity of the disease.
Brand and Company Name, Price (Indian/US)
- India:
- Brand: Quinimax
- Company: Sanofi
- Price: ₹15-20 per tablet (500 mg)
- USA:
- Brand: Qualaquin
- Company: AR Scientific
- Price: Approx. $40-50 per tablet (324 mg)
Mechanism of Action
Quinine works by inhibiting the parasite’s ability to break down hemoglobin in red blood cells. It interferes with the parasite’s digestion of hemoglobin and causes toxic buildup within the parasite, leading to its death.
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Side Effects -quinine
- Common: Nausea, vomiting, diarrhea, dizziness, headache, blurred vision.
- Serious: Cinchonism (tinnitus, deafness, vision disturbances), arrhythmias, hemolytic anemia, hypersensitivity reactions, thrombocytopenia.
Contraindications
- Hypersensitivity to quinine or other quinoline derivatives.
- G6PD deficiency (due to the risk of hemolysis).
- Myasthenia gravis (may worsen symptoms).
- Pregnancy (category C – risk-benefit assessment required).
Drug Interactions
- Anticoagulants: Increased risk of bleeding.
- Cardiac medications (e.g., digoxin): Increased risk of arrhythmias.
- Antacids: May reduce quinine absorption.
- CYP3A4 inhibitors/inducers: Affect quinine metabolism.
Precautions
- Monitor patients for signs of hypersensitivity reactions, especially in those with a history of allergic reactions to quinoline drugs.
- Caution in patients with cardiovascular disease due to the risk of arrhythmias.
- Use with caution in patients with liver or kidney impairment as dosage adjustments may be necessary.
Patient Counseling Information
- Take the medication exactly as prescribed, and do not miss doses.
- Quinine should be taken with food to reduce gastrointestinal side effects.
- Report any symptoms of cinchonism (e.g., ringing in the ears, vision disturbances) immediately.
- Avoid driving or operating heavy machinery if you experience dizziness or visual disturbances.
- Women who are pregnant or planning to become pregnant should discuss the risks with their doctor.
Conclusion
Quinine remains an important drug in the treatment of malaria, particularly in areas with resistance to other antimalarials. However, its use requires careful monitoring due to its narrow therapeutic window and potential for serious side effects. With proper use and precautions, quinine is effective in controlling Plasmodium falciparum infections.
References
- WHO Guidelines for the Treatment of Malaria.
- CDC Malaria Treatment Recommendations.
- National Institute for Health and Care Excellence (NICE) guidelines.
Example
A 35-year-old patient diagnosed with Plasmodium falciparum malaria was prescribed quinine sulfate 600 mg three times daily, in combination with doxycycline, for 7 days. The patient reported mild nausea but completed the treatment successfully, resulting in full recovery from malaria.
Brand name
- Albiquin (Tablet, 300 mg) by Albion Laboratories Ltd.
Price: Approx. ₹6.40 per tablet【8†source】. - Jasoquin (Tablet, 300 mg) by Jayson Pharmaceuticals Ltd.
Price: Approx. ₹6.44 per tablet【8†source】. - Kanaquine (Tablet, 300 mg) by Globe Pharmaceuticals Ltd.
Price: Approx. ₹6.40 per tablet【8†source】. - Qualaquin (Capsule, 324 mg)
Price: $85 for a supply of 30 capsules【11†source】. - Zequin (Tablet, 300 mg and 600 mg) by Zee Laboratories Ltd.
Prices vary【9†source】
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice. Consult a healthcare provider for diagnosis and treatment of medical conditions. Always refer to the product’s prescribing information for full detail
