Quinine oral

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