Shandong Sino Pharmaceutical Technology Co., Ltd.

• Mechanism:

  • Derived from Cinchona bark alkaloids, quinine acts as a blood schizonticide, killing the erythrocytic stage of Plasmodium falciparum.

  • Inhibits parasite heme polymerization, leading to toxic accumulation.

• Additional Effects:

  • Reduces muscle excitability (for nocturnal leg cramps).

• Primary:

  • Treatment of chloroquine-resistant falciparum malaria (combined with antibiotics).

  • Babesiosis (off-label, with azithromycin/clindamycin).

• Secondary:

  • Nocturnal leg cramps (limited to short-term use due to toxicity risks).

• Malaria (uncomplicated):

  • 600 mg (salt) every 8 hours × 7 days with doxycycline/clindamycin.

• Severe Malaria:

  • Initial IV quinine → switch to oral tablets (same dose) when tolerated.

• Leg Cramps:

  • 200-300 mg at bedtime (max 4 weeks; avoid prolonged use).

• Malaria: 10 mg/kg every 8 hours (max adult dose).

 Take with food to reduce GI irritation.
 Avoid grapefruit juice (↑ toxicity risk).
 Never crush/chew (bitter; may cause throat irritation).

• Hypersensitivity to quinine or cinchona alkaloids.

• G6PD deficiency (risk of hemolysis).

• Pregnancy (except for life-threatening malaria).

• Cardiac arrhythmias (QT prolongation risk).

• Common: Tinnitus, headache, nausea ("cinchonism").

• Serious: Hypoglycemia, thrombocytopenia, vision disturbances.

• Antacids: ↓ Quinine absorption (separate by 2 hours).

• CYP3A4 inhibitors (e.g., erythromycin): ↑ Quinine levels.

• Warfarin: ↑ Bleeding risk (monitor INR).

• Temperature: Store below 25°C (77°F).

• Packaging: Keep in original blister/aluminum foil (light-sensitive).

• Stability: Do not use if tablets discolor (oxidation sign).

• FDA Black Box Warning:

  • For malaria only; not approved for leg cramps due to life-threatening side effects.