Quinine Oral: Malaria Dosing and Precautions
Quinine guidance for uncomplicated falciparum malaria and completion treatment after severe malaria when artemisinin combinations cannot be used.
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Guide category
Oral drugs
Safety boundary
Prescription medicine information for clinician-guided use.
Kenza Health Hub presents this medicine page as structured health education. Check dose, route, interactions, pregnancy or breast-feeding considerations, and local protocol with a qualified clinician or pharmacist. Read our medical editorial policy.
Therapeutic action
Antimalarial.
Indications
- Treatment of uncomplicated falciparum malaria when artemisinin-based combinations cannot be used.
- Completion treatment following parenteral therapy with quinine for severe falciparum malaria when artemisinin-based combinations cannot be used.
Forms and strengths
- 300 mg quinine sulfate tablet.
Dose and duration
Dosage is expressed in terms of salt. Except for quinine bisulfate, the dosage is the same for all quinine salts including sulfate, hydrochloride, and dihydrochloride.
- Child and adult under 50 kg: 10 mg/kg 3 times daily at 8-hour intervals for 7 days.
- Adult 50 kg and over: 600 mg 3 times daily at 8-hour intervals for 7 days.
Contra-indications, adverse effects, precautions
- May cause headache, skin rash, visual disturbances, auditory disturbances, and gastrointestinal disturbances.
- Do not exceed indicated doses because of the risk of toxicity in the event of overdose.
- Avoid combination with drugs that prolong the QT interval, including amiodarone, other antimalarials, antipsychotics, fluconazole, fluoroquinolones, hydroxyzine, macrolides, and ondansetron.
- If the patient vomits within 30 minutes after administration, re-administer the full dose. If the patient vomits between 30 minutes and 1 hour after administration, re-administer half of the dose.
- Pregnancy: no contra-indication; if possible administer quinine in combination with clindamycin.
- Breast-feeding: no contra-indication.
Dosage and duration
| Age | Weight | 300 mg tablet |
|---|---|---|
| 5 months to < 2 years | 7 to < 12 kg | ¼ tab x 3 |
| 2 to < 8 years | 12 to < 25 kg | ½ tab x 3 |
| 8 to < 11 years | 25 to < 35 kg | 1 tab x 3 |
| 11 to < 14 years | 35 to < 50 kg | 1½ tab x 3 |
| ≥ 14 years | ≥ 50 kg | 2 tab x 3 |
Source
MSF Essential drugs practical guidelines (January 2026)
This page combines source-derived medicine reference sections with Kenza editorial context, while leaving out the Storage and Remarks sections from the source batch.
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