QUININE

• Mild headache
• Flushing
• Unusual sweating
• Nausea
• Ringing in the ears
• Decreased hearing
• Dizziness
• Blurred vision
• Temporary changes in color vision

Hypoglycemia may occur while taking Quinine especially during pregnancy.  Watch out for symptoms of low blood sugar such as sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet.  Quickly eat a candy, table sugar, or fruit juice to restore normal blood glucose level. Consult your physician.

Consult your physician if you experience any of the symptoms mentioned or allergic reaction such as rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Precautions

Inform your physician of your medical history, especially of: previous serious side effects with quinine (such as blood problems), family/personal history of a certain enzyme problem (glucose-6-phosphate dehydrogenase deficiency-G6PD), a certain eye nerve problem (optic neuritis), hearing problems (such as ringing in the ears), a certain nerve/muscle disease (myasthenia gravis), heart rhythm problems (such as atrial fibrillation/flutter), kidney problems, liver problems.

Avoid doing tasks that require alertness or clear vision because this drug causes dizziness and blurred vision.

Quinine may also affect the heart rhythm seen as QT prolongation. It may present as fast irregular heartbeat, dizziness and fainting.  Heart conditions, taking diuretics that could decrease your levels of potassium or magnesium increase the risk of QT prolongation.

This drug is cannot be given to pregnant and lactating women as it crosses the placenta and passes into the breast milk.

Interactions

Taking Quinine with other drugs may cause side effects or may affect the activity of Quinine in the body.  These include: “blood thinners” (such as warfarin), penicillamine, cimetidine, erythromycin, ketoconazole, phenytoin, rifampin, HIV protease inhibitors (such as lopinavir, ritonavir), urinary alkalinizers such as acetazolamide/sodium bicarbonate, desipramine, digoxin, certain “statin” drugs (atorvastatin, lovastatin, simvastatin), certain anticonvulsants (carbamazepine, phenobarbital), among others.

Overdose

Be alert to symptoms of overdose such as sudden vision change, confusion, severe trouble hearing, fast/irregular heartbeat, fainting, slow/shallow breathing, seizures, inability to wake up (coma).  Get emergency medical help right away.

Missed Dose: Take as soon as you remember. However, if more than 4 hours, skip the dose.  Do not double up the dose to catch up.

Storage: Store at room temperature.  Discard properly.

Brands

Available Brands

• Rhea Quinine Sulfate [ Philusa ]

Also marketed as

• Malarin [ Duopharma (M) Sdn Bhd ]