Quinine | Quinidine |Antimalarial

Quinine | Quinidine |Antimalarial

Quinine Sulfate Tablets contain the anti-malarial drug quinine sulfate and are used to treat a type of malaria known as falciparum malaria (malignant malaria). Malaria is a disease caused by infection with a malaria parasite.

This is carried by mosquitoes, which flourish in tropical and subtropical countries. Human beings become infected as a result of being bitten by malaria carrying mosquitoes. Quinine sulfate has a relaxant action on skeletal muscle.

Quinine | Quinidine |Antimalarial

Qualaquin (quinine sulfate) is an antimalarial drug chemically described as cinchonan-9-ol, 6’methoxy-, (8α, 9R)-, sulfate (2:1) (salt), dihydrate with a molecular formula of (C20H24N2O2)2•H2SO42H2O and a molecular weight of 782.96. Quinine sulfate occurs as a white, crystalline powder that darkens on exposure to light.

It is odorless and has a persistent very bitter taste. It is only slightly soluble in water, alcohol, chloroform, and ether. Qualaquin is supplied for oral administration as capsules containing 324 mg of the active ingredient quinine sulfate USP, equivalent to 269 mg free base. Inactive ingredients: corn starch, magnesium stearate, and talc.

Class: Quinine and quinidine are both arylaminoalcohols (Antimalarial agent)

Indications: In conjunction with other antimalarial agents, treatment of uncomplicated chloroquine-resistant P. falciparum malaria

Do not take Quinine Sulfate Tablets:

• If you are allergic to quinine or any of the other ingredients of this medicine 

• If you have problems with your eye sight

• If you suffer from tinnitus (ringing noises in the ear)

• If you have blood in the urine (or have had during a previous attack of malaria)

• If you have been told you have haemolysis (a disorder affecting the red blood cells)

• If you suffer from myasthenia gravis (a disease characterised by weakness of certain groups of muscles)

• If you are pregnant or breast-feeding, unless the benefits outweigh the risks

Antiparasitic Activity

Quinine acts primarily on the erythrocytic stage of human malarias with little parasiticidal effect on sporozoites, hepatic stages, or gametocytes of P. falciparum. The asexual stages of P. ovale are the most vulnerable to quinine, followed by P. vivax, P. malariae and then P. falciparum. Quinine has some gametocytocidal activity for P. vivax and P. malariae,

Mechanism of Action

The mechanism of action is interference with the parasite’s ability to digest haemoglobin. Quinine and quinidine also inhibit the spontaneous formation of beta-haematin (haemozoin or malaria pigment) which is a toxic product of the digestion of haemoglobin by parasites.

How to take Quinine Sulfate Tablets

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. Do not take more than your doctor has recommended. Your medicine should be taken by mouth as follows:

For the treatment of Falciparum Malaria:

Adults: The recommended dose is 600mg (two 300mg tablets) every eight hours for seven days.
Children: The recommended dose is 10mg quinine sulfate per kg of body weight, given every eight hours for seven days.
For the treatment of Night Cramps: Adults (including the elderly): 300mg (one tablet) at bedtime.
Children: This medicine should not be used for the relief of night leg cramps in children under 10 years of age.

  • If you take too many tablets tell a doctor or hospital casualty department straight away. Take your medicine with you.
  • If you do forget to take a dose of your medicine at the correct time, take as soon as you remember, then carry on as before. Do not take a double dose to make up for a forgotten dose.
  • Do not stop taking it just because you feel better. If you stop taking the medicine, your condition may re-occur or get worse.
  • If you have any further questions on the use of the medicine, ask your doctor, pharmacist or nurse.

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine. You should not take quinine sulfate when you are pregnant or breast-feeding, unless the benefits outweigh the risks.

This medicine should not be used to treat cramps during pregnancy. Large doses of quinine can cause foetal abnormalities or induce abortion. You should not breast-feed a baby that might have glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Driving and using machines

This medicine may cause visual disturbances and vertigo. If affected, do not drive or operate any tools or machines. Quinine Sulfate Tablets contain lactose and methyl hydroxyl benzoate. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. This medicine contains methyl hydroxyl benzoate (E218) which may cause allergic reactions (possibly delayed).


In the USA, quinidine is used to treat severe falciparum malaria. Quinidine should be given in a loading dose (10 mg/kg gluconate in 1 hour) followed by a maintenance infusion of 0.02 mg/kg/minute during the acute phase of severe infection. Conversion to oral quinidine can take place when it is tolerated.

Adverse Effects

Headache, nausea, sweating vasodilatation and diarrhoea are common (15-50%) reactions to oral quinine and quinidine even when drug levels are in the therapeutic range. The most troublesome side effects are due to cinchonism, which includes reversible hearing loss.

Quinine or quinidine-induced cardiotoxicity is the usual cause of death when either in overdoses. Quinine in the potential to cause reversible as well as permanent blindness in overdoses. Hyperinsulinaemic hypoglycaemia can occur in both children and adults.

How to store Quinine Sulfate Tablets

Keep this medicine out of the sight and reach of children. Do not use your medicine after the expiry date shown on the carton. The expiry date refers to the last day of that month. Do not store above 25°C. Do not throw away any medicines wastewater or household waste. Ask your pharmacist how to dispose of medicines you no longer use. These measures will help to protect the environment.


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