QUININE SULPHATE

Indications & Dose:

Chloroquine-resistant falciparum malaria (alone or in combination with pyrimethanmine and a sulfonamide or with a tetracycline ), alternative for chloroquine sensitive strains of P. falciparum, P. malariae, P ovale and P. vivax nocturnal leg cramps

• BY MOUTH 

Adults

Malaria: 300-600mg three times daily for 5-7 days.

Leg cramps: 200-300mg at bed time.

Children 25mg/kg/day divided every 8 hour for 7 days. 

•  BY INJECTION

Refer to Manufacturer

Contraindications:

G-6-PD deficiency, optic neuritis, tinnitus, history of bIackwater fever, thrombocytopenic purpura (associated with previous quinine ingestion), pregnancy

Side Effects:

Cautions:

Precautions:

Cardiac dysrhythmias, myasthenia gravis 

Interaction:

Drugs

Digitalis glycosides: Increased digoxin concentrations (especially at high quinine doses)

Smoking: Reduced serum quinine concentrations

Warnings:

Adverse Effects:

Lactations:

Excreted into breast milk; compatible with breast feeding; use caution in infants at risk for G-6-PD deficiency

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Apprehension, confusion, fever, headache, restlessness, vertigo

CV: Anginal symptoms, syncope

EENT: Blurred vision, deafness, diminished visual field, diplopia, disturbed color vision, photophobia, tinnitus, visual disturbances

GI: Epigastric pain, hepatitis, nausea, vomiting

HEME: Acute hemolysis, agranulocytosis, hypoprothrombinemia, thrombocytopenic purpura

RESP: Asthmatic symptoms

SKIN: Cutaneous rashes, edema of the face, flushing, pruritus, sweating

MISC.: Cinchonism (tinnitus, headache, nausea, disturbed vision) 

Patient And Carer Advice: