Quinine (By mouth)

Brand Name(s)

Qualaquin

There may be other brand names for this medicine.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash.
• Blurred vision.
• Chest pain.
• Dark urine, decrease in how much or how often you urinate.
• Fever, chills, cough, sore throat, increased sweating, and body aches.
• Nausea, vomiting, severe itching, or bleeding from your gums or nose.
• Pinpoint red or purple spots under your skin.
• Seizures or tremors.
• Severe stomach cramps.
• Shortness of breath, tiredness, or uneven heartbeat.
• Unusual bleeding, bruising, or weakness.
• Warmth or redness in your face, neck, arms, or upper chest.
• Wheezing or trouble with breathing.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Headache.
• Loss of appetite.
• Ringing in your ears.
• Upset stomach.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Introduction

Quinine (KWYE-nine)

Treats malaria.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to quinine, mefloquine (Lariam®), or a heart medicine called quinidine (Quinaglute®, Quinidex®). Do not use this medicine if you have glucose-6-phosphate dehydrogenase (G6PD) deficiency, a prolonged QT interval (heart rhythm problem), myasthenia gravis (severe muscle weakness), or optic neuritis (swelling of a nerve in the eye). This medicine should not be used to treat or prevent night time leg cramps.

How to Use This Medicine

Capsule, Tablet, Long Acting Tablet

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• Quinine may be taken with food or milk if it upsets your stomach.
• Keep using this medicine for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.
• This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose. If it has been more than 4 hours since you missed a dose, skip the missed dose and take your next dose at the regular time.

How to Store and Dispose of This Medicine

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are taking acetazolamide (Diamox®), aminophylline (Norphyl®), debrisoquine (Declinax®), desipramine (Norpramin®), dextromethorphan, digoxin (Lanoxin®), flecainide (Tambocor®), ketoconazole (Nizoral®), metoprolol (Lopressor®), pancuronium (Pavulon®), paroxetine (Paxil®), rifampin (Rifadin®, Rimactane®), ritonavir (Norvir®), sodium bicarbonate, succinylcholine (Anectine®), tetracycline (Sumycin®), theophylline (Theo-Dur®), troleandomycin (Tao®), or tubocurarine. Tell your doctor if you are also using medicines that may change the heart rhythm such as astemizole (Hismanal®), cisapride (Propulsid®), erythromycin (Ery-Tab®), halofantrine (Halfan®), mefloquine (Lariam®), pimozide (Orap®), or terfenadine (Seldane®).
• Make sure your doctor knows if you are also using medicine for heart rhythm problems (such as amiodarone, disopyramide, dofetilide, procainamide, quinidine, sotalol, Cordarone®, Betapace®, Norpace®, Quinaglute®, or Tikosyn®), medicines to lower cholesterol (such as atorvastatin, fluvastatin, lovastatin, simvastatin, Altoprev®, Lescol®, Lipitor®, Mevacor®, or Zocor®), a blood thinner (such as heparin, warfarin, or Coumadin®), medicine for seizures (such as carbamazepine, phenobarbital, phenytoin, valproic acid, Depakote®, Dilantin®, Keppra?, Luminal®, or Tegretol®), stomach medicines (such as cimetidine, ranitidine, Tagamet®, or Zantac®), or an antacid that contains aluminum and magnesium (such as Maalox®, Mylanta®).

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart disease, a slow heartbeat, heart rhythm problems (such as atrial fibrillation), or a history of low blood sugar (hypoglycemia) or low potassium in the blood. Tell your doctor if you have a history of hemolytic uremic syndrome (a serious kidney disorder), thrombotic thrombocytopenic purpura (a serious blood disorder), or thrombocytopenia (low platelets in the blood).
• This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; lightheadedness, dizziness, or fainting; trouble with breathing; trouble with swallowing; or any swelling of your hands, face, or mouth after you take this medicine.
• This medicine lowers the number of blood cells (platelets) in your body causing serious side effects such as bleeding and kidney problems. Sometimes serious side effects can occur without a warning. However, possible warning signs include black, tarry, stools; bleeding from your gums or nose; coughing or vomiting of blood; dark urine; decrease in how much or how often you urinate; fever or chills; nausea or vomiting; severe itching; pinpoint red or purple spots under your skin; seizures; severe acne or skin rash; unusual bleeding or bruising; or yellow eyes or skin. Stop taking this medicine and check with your doctor immediately if you notice any of these warning signs.
• This medicine can cause changes in the heart rhythm, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting, dizziness, or serious side effects in some patients. Call your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or uneven heartbeats.
• Quinine may cause hypoglycemia (low blood sugar). If your blood sugar gets too low, you may feel weak, drowsy, confused, anxious, or very hungry. You may also sweat, shake, or have blurred vision, a fast heartbeat, or a headache that will not go away. Tell your doctor right away if you have any of these symptoms.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
• Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments.