Be careful if you drive or do anything that requires you to be alert and able to see clearly. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Serum levels of amantadine, carbamazepine, digoxin, phenobarbital, and warfarin may be elevated by quinine.3, 6, 8, 9 Quinine may enhance the effects of nondepolarizing muscle relaxants and succinylcholine. The bark of this … 2. One liter of tonic water usually contains no more than 83 mg of quinine. Scientific Name(s): Cinchona calisya Wedd., Cinchona ledgeriana Moens ex Trim. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Although the use of quinine for the treatment of malaria has been largely supplanted by semisynthetic antimalarials, its use persists in some regions of the world. The cinchonas are evergreen shrubs and trees that grow to heights of 15 to 31 m.10 They are native to the mountainous areas of tropical Central and South America, including regions of Bolivia, Costa Rica, and Peru. It can also be consumed orally to help in the treatment of babesiosis, a parasite that is spread by ticks. Capsules are usually available in 324mg doses. tuberculosis medication--rifabutin, rifampin, rifapentine. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Take this medication for the full prescribed length of time. Although a higher incidence of side effects occurred, this combination has potential in treating acute leukemias.6, 38, In a randomized crossover study, administration of a single oral 200 mg dose of quinine decreased the renal clearance of a single oral dose of amantadine (3 mg/kg), increasing the plasma concentrations, in men but not women.39. 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); optic neuritis (inflammation of the optic nerve); or. It would also aggravate millions of people who like gin and tonic…or just plain tonic. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. Your symptoms may get better before your condition is completely cleared. Do not take quinine in larger or smaller amounts or for longer than recommended. Some antacids can make it harder for your body to absorb quinine. It is known as an anti-malarial treatment and has also been used to treat arthritis and lupus. A liter normally has 83 mg of quinine. Today, people sometimes drink tonic water to treat nighttime leg cramps associated with circulatory or nervous system problems. The primary component of this mixture is quinine. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. Tonic water contains about 15 mg of quinine per bottle.14 Quinine may have tumor necrosis factor (TNF)-suppressive activity as demonstrated in one small study.8, Quinine is eliminated mainly by hepatic metabolism with very little excreted unchanged in the urine.4, 5, 15 Cytochrome P450 3A4 has been shown to be important in the metabolism of quinine. Quinine is a compound derived from the bark of the Cinchona tree, and is typically used to treat mosquito borne diseases, like malaria. Moreover, it can help alleviate leg pain and lower back. Quinine will not treat severe forms of malaria, and it should not be taken to prevent malaria. Stop taking quinine and call your doctor at once if you have headache with chest pain and severe dizziness, fast or pounding heartbeats, unusual bruising or bleeding (nosebleeds, bleeding gums, purple or red spots under your skin), signs of infection (fever, chills, mouth sores), severe lower back pain, or blood in your urine. Do not give this medication to a child younger than 16 years old. Some people have used quinine to treat leg cramps, but this is not an FDA-approved use. Take with food if quinine upsets your stomach. Do not purchase quinine on the Internet or from vendors outside of the United States. If you need surgery or medical tests, tell your caregivers ahead of time that you are using quinine. Formal use of the bark to treat malaria was established in the mid-1800s when the British began the worldwide cultivation of the plant11 in order to assure the continuing availability because the plant was in danger of extinction in some regions because of the harvesting of wild populations.13. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with quinine, especially: an antibiotic--azithromycin, clarithromycin, erythromycin, levofloxacin, moxifloxacin, pentamidine, telithromycin, tetracycline; an antidepressant--amitriptyline, citalopram, clomipramine, desipramine, nefazodone, venlafaxine; antifungal medication--itraconazole, ketoconazole, posaconazole, voriconazole; cholesterol-lowering medicine--atorvastatin, simvastatin, lovastatin; cough medicine that contains dextromethorphan; heart medication--amiodarone, digoxin, dofetilide, disopyramide, dronedarone, flecainide, ibutilide, metoprolol, procainamide, propafenone, quinidine, sotalol, verapamil; hepatitis C medications--boceprevir, telaprevir; HIV/AIDS medication--atazanavir, delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, nevirapine, ritonavir, saquinavir; medicine to prevent or treat nausea and vomiting--dolasetron, droperidol, ondansetron; medicine to treat a psychiatric disorder--chlorpromazine, clozapine, haloperidol, mesoridazine, pimozide, thioridazine, ziprasidone; seizure medication--carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone; stomach acid reducers--cimetidine, ranitidine; or. Quinine is a medication used to treat malaria and babesiosis. It gained popularity for it s ability to ward off malaria back then. This includes chloroquine, halofantrine, and mefloquine. According to MedilinePlus.gov: Quinine comes as capsules in the form of Quinine sulfate. Urinary acidification can be employed if necessary.1 Quinine is not eliminated by hemofiltration or hemodialysis.15. doxycycline, clindamycin, hydroxychloroquine, Plaquenil, Cleocin. This is only a brief summary of general information about this product. Cinchona Tree Bark. Quinine and related alkaloids are rapidly absorbed from the GI tract; a single 2 to 8 g oral dose of quinine may be fatal to an adult.3, 11, 12 Treatment of an overdose is generally supportive. Take the missed dose as soon as you remember. Quinine is used to treat uncomplicated malaria, a disease caused by parasites. Quinine can cause cinchonism, hypoglycemia, serious hematologic disorders, urticaria, contact dermatitis, and other hypersensitivity reactions. A high cure rate and better survival were shown in patients treated with combined quinine and chemotherapy when compared with chemotherapy alone. Quinine is an effective muscle relaxant and can be mixed with medicine for a cramps treatment of muscle injuries. The effect of a single 600 mg oral dose of quinine on the pharmacokinetics of a 120 mg oral dose of phenobarbital was studied in 6 healthy volunteers.40 Compared with giving phenobarbital alone, quinine administration increased the phenobarbital AUC and peak plasma concentration 45% and 35%, respectively. Clearly, quinine can be dangerous for some individuals, but the FDA has not banned quinine from tonic water. Select one or more newsletters to continue. In the present time, quinine is used to treat arthritis and lupus in the form of hydroxychloroquine. However, high doses of quinine can cause uterine stimulation in pregnant women and deafness and optic nerve hypoplasia in children.2. Quinine was originally used as a malaria treatment during the days of colonial India. Quinine has been widely studied as an antimalarial, and has been used at doses of 325 mg to 1 g as the sulfate salt. Neither the U.S. Centers for Disease Control (CDC) nor the World Health Organization (WHO) currently recommend its use in COVID-19 patients. Parasites that cause malaria typically enter the body through the bite of a mosquito. These days, drinking tonic water might seem like a natural way to treat RLS. Concentrations in the 100 to 300 ppm range are used to flavor beverages such as tonic water. Adverse effects are dose-related.43. Quinine may cause blurred vision and may impair your thinking or reactions. The way you've probably seen quinine is as an ingredient in tonic water. Naturally found in the bark of the cinchona tree found in the Peruvian Andes, one legend of its discovery claims that a South American Indian suffering from malaria took a drink from a pool of water contaminated with cinchona tree and it cured his fever. Quinine has been used for the treatment of malaria and associated febrile states, leg cramps caused by vascular spasm, internal hemorrhoids, varicose veins, and pleural cavities after thoracoplasty. If you are more than 4 hours late for your dose, skip the missed dose and take the medicine at your next scheduled dose time. Doctors used to prescribe quinine pills to prevent leg cramps. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Quinine has been shown to be secreted into breast milk, but insignificant amounts are ingested by the infant. However, quinine by itself is very bitter, so the British officials, in the 19 th century, from these regions, mixed it with soda water and sugar, giving rise to tonic—a prophylactic agent as well as an interestingly flavored drink. This information should not be used to decide whether or not to take this product. Typical cinchona bark contains about 16% of quinoline alkaloids consisting mainly of quinine, quinidine, cinchonine, and cinchonidine. Treatment of babesiosis. Quinines primary benefit is for the treatment of malaria. Let’s get some quinine. severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. Plasmodium falciparum is a parasite that gets into the red blood cells in the body and causes malaria. Medically reviewed by Drugs.com. This information is not specific medical advice and does not replace information you receive from your health care provider. Give a list of all your medicines to any healthcare provider who treats you. People who are hypersensitive to these alkaloids also may develop the syndrome, which is characterized by severe headache, abdominal pain, convulsions, visual disturbances and blindness, auditory disturbances such as ringing in the ears, paralysis, and collapse.10, Therapeutic doses of quinine have resulted in acute hemolytic anemia12 a limitation for its use in patients who are glucose-6-phosphate dehydrogenase deficient.3 Quinine also has been associated with other serious hematologic disorders such as agranulocytosis, disseminated intravascular coagulation44, 45 hemolytic uremic syndrome (HUS)16, 44, 46, 47, 48, 49 neutropenia (leukopenia)50 pancytopenia with coagulopathy51, 52 and thrombocytopenia (the most common hematologic adverse effect).50, 53, 54, 55 Patients may present with one or several concomitant hematologic adverse events. Quinine has been used for the treatment of malaria and associated febrile states, leg cramps caused by vascular spasm, internal hemorrhoids, varicose veins, and pleural cavities after thoracoplasty. We comply with the HONcode standard for trustworthy health information -. Copyright 1996-2018 Cerner Multum, Inc. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Another shocking condition as a result of quinine is the hearing impairment. Quinine will not treat severe forms of malaria, and it should not be taken to prevent malaria. Call your doctor if your symptoms do not improve after 2 days of treatment, or if your symptoms return after you have finished the medicine. Data sources include IBM Watson Micromedex (updated 7 Dec 2020), Cerner Multum™ (updated 4 Dec 2020), ASHP (updated 3 Dec 2020) and others. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Follow all directions on your prescription label. Quinine is extracted from the bark of a seven or eight-year-old tree, when the yield is highest. Quinine has been previously listed as being contraindicated during pregnancy because of fetal and abortifacient effects.1 A review of the safety of antimalarial drugs in pregnancy state that standard (antimalarial) doses of quinine showed no evidence of increased risk of abortion or preterm delivery. Quinine use in drugs, extrapolation of a safe dosage Dosage of Quinine capsules. Generic Name: quinine (KWYE nine)Brand Name: Qualaquin, QM-260, QuinammDosage Forms: oral capsule (324 mg), Medically reviewed by Drugs.com on Mar 25, 2020 – Written by Cerner Multum. This information relates to an herbal, vitamin, mineral or other dietary supplement. Seven metabolites have been identified with 3-hydroxyquinine being the major metabolite.3, 4, 5, 16 In patients with acute renal failure who are infected with Plasmodium falciparum, up to 12% of antimalarial activity is due to the 3-hydroxyquinine metabolite.16, Quinine is among the most potent of the cinchona alkaloids with respect to antimalarial activity.10 Resistant strains of Plasmodium have been identified. Available for Android and iOS devices. The quinine has medicinal significance. Quinine, drug obtained from cinchona bark that is used chiefly in the treatment of malaria, an infection caused by the protozoan parasite Plasmodium, which is transmitted to humans by the bite of various species of mosquitoes. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. There is no report of an interaction occurring with coadministration of quinine and warfarin. The oblong seed capsule is about 3 cm long and, when ripe, splits open at the base. Quinine can pass through the placenta from mother to fetus and there is some limited evidence that it can cause birth defects, so pregnant women should avoid the … In addition to quinine, over 35 alkaloids have been isolated from the … FDA pregnancy category C. It is not known whether quinine will harm an unborn baby. Malaria.Cinchona bark contains quinine and related chemicals. Quinine is a great muscle relaxant ant can reduce the severity caused by leg cramps. The effect of a single 600 mg oral dose of quinine on the pharmacokinetics of a 200 mg oral dose of carbamazepine was studied in 6 healthy volunteers.40 Compared with giving carbamazepine alone, quinine administration increased the carbamazepine area under the plasma concentration-time curve (AUC) and peak plasma concentration 51% and 36.5%, respectively. For additional information please refer to the "Evidence-Based Herb-Drug Interactions" appendix. This includes prescription and over-the-counter medicines, vitamins, and herbal products. They should only be used after informing the patient of the potentially serious side effects.61, Quinine is bacteriostatic, highly active in vitro against protozoa, and inhibits the fermentation of yeast.11. Avoid taking other anti-malaria medications without your doctor's advice. While sometimes used for restless legs syndrome, quinine is not recommended for this purpose due to the risk of serious side effects. Because quinine is related to quinidine, ventricular fibrillation, prolongation of the QTc interval, and other adverse cardiac events can occur.18 Administration of IV quinine within 72 hours of mefloquine may cause QTc prolongation.22 Closely monitor patients with a cardiac history if quinine is given. 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