Quinine

Pregnancy Category: X (first trimester)

Lactation: enters breast milk

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• blurriness or changes in color vision
• symptoms of low blood sugar
• changes in heartbeat
• headache
• nausea
• vomiting
• stomach pain
• diarrhea
• ringing in the ears or difficulty hearing
• seizures
• slow or difficult breathing

Mild headache, flushing, unusual sweating, nausea, ringing in the ears, decreased hearing, dizziness, blurred vision, and temporary changes in color vision may occur. If any of these effects persist after your treatment is finished, or if these effects worsen while taking the medication, tell your doctor or pharmacist promptly.Quinine may cause low blood sugar (hypoglycemia), especially during pregnancy. Symptoms of low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. If symptoms of low blood sugar occur, increase your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or drink fruit juice or non-diet soda. Tell your doctor immediately about the reaction and the use of this product.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these rare but very serious side effects occur: easy bruising/bleeding, unusual purple/brown/red spots on the skin, signs of serious infection (such as high fever, severe chills, persistent sore throat), signs of a sudden loss of red blood cells called hemolytic anemia (such as severe tiredness, brown urine, pale lips/nails/skin, rapid breathing at rest), signs of severe liver problems (such as persistent nausea/vomiting, abdominal pain, severe weakness, yellow skin/eyes, unusually dark urine), change in the amount of urine.Seek immediate medical attention if any of these rare but very serious side effects occur: chest pain, severe dizziness, fainting, fast/irregular heartbeat, blindness.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Quinine is part of the drug class:

• Methanolquinolines

You should not use this medication if you have ever had an allergic reaction to quinine or similar medicines such as mefloquine or quinidine, or if you have:

• a heart rhythm disorder called Long QT syndrome;

• an enzyme deficiency called glucose-6-phosphate dehydrogenase deficiency (G-6-PD);

• myasthenia gravis;

• optic neuritis (inflammation of the optic nerve); or

• if you have taken quinine in the past and it caused a blood cell disorder, severe bleeding, or kidney problems.

To make sure quinine is safe for you, tell your doctor if you have:

• heart disease or a heart rhythm disorder;

• low levels of platelets in your blood;

• low potassium levels in your blood (hypokalemia); or

• liver or kidney disease.

FDA pregnancy category C. It is not known whether quinine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Quinine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give this medication to a child younger than 16 years old.

Quinine is used to treat malaria caused by Plasmodium falciparum. Plasmodium falciparum is a parasite that gets into the red blood cells in the body and causes malaria. Quinine works by killing the parasite or preventing it from growing. quinine may be used alone or given together with one or more medicines for malaria.

Quinine should not be used to treat or prevent night time leg cramps. quinine may cause very serious unwanted effects and should only be used for patients with malaria.

quinine is available only with your doctor's prescription.

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

• Qualaquin

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

Avoid use of aluminum- or magnesium-containing antacids because of drug absorption problems. Swallow dose whole to avoid bitter taste. May be administered with food.

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience headache or flushing. Have patient report immediately to prescriber signs of bleeding (vomiting blood or vomit that looks like coffee grounds; coughing up blood; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a reason or that get bigger; or any bleeding that is very bad or that will not stop), signs of liver problems (dark urine, feeling tired, lack of appetite, nausea, abdominal pain, light-colored stools, vomiting, or yellow skin or eyes), signs of kidney problems (urinary retention, blood in urine, change in amount of urine passed, weight gain), signs of low blood sugar (dizziness, headache, fatigue, feeling weak, shaking, a fast heartbeat, confusion, hunger, or sweating), arrhythmia, angina, severe dizziness, passing out, hearing impairment, tinnitus, sudden vision changes, color blindness, blindness, pinpoint red spots on skin, abdominal pain, severe nausea, vomiting, severe diarrhea, illogical thinking, seizures, anxiety, chills, mood changes, muscle weakness, loss of strength and energy, or signs of Stevens-Johnson syndrome/toxic epidermal necrolysis (red, swollen, blistered, or peeling skin [with or without fever]; red or irritated eyes; or sores in mouth, throat, nose, or eyes) (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.