Quinine Sulfate

Generic Name

quinine-sulfate

Other Names

• Quinine

Drug Class

• Antimalarial

Chemical Formula

C20H24N2O2

Molecular Weight

324.41 g/mol

Mechanism of Action

• Inhibition of nucleic acid synthesis in Plasmodium species

Indications

• Treatment of uncomplicated malaria caused by Plasmodium falciparum
• Treatment of nocturnal leg cramps

Common Dosage Forms

• Tablet
• Injection

Typical Dosage

• 200-300 mg every 8 hours for malaria
• 200-300 mg at bedtime for leg cramps

Pediatric Dosage

• Dosage adjustment required based on body weight and age for malaria treatment

Geriatric Dosage

• Dosage adjustment may be necessary due to decreased renal function in the elderly

Side Effects

• Cinchonism (nausea, vomiting, tinnitus, visual disturbances)
• Hypersensitivity reactions
• Cardiac arrhythmias
• Hypoglycemia

Contraindications

• Hypersensitivity to quinine or quinidine
• Glucose-6-phosphate dehydrogenase (G6PD) deficiency

Pregnancy Category

• C - Risk cannot be ruled out

Lactation Safety

• Moderate risk - caution advised

Drug Interactions

• Enhanced effects with concomitant use of quinidine or mefloquine
• Decreased quinine levels with enzyme-inducing antiepileptics

Overdose Symptoms

• Severe hypotension
• Cardiotoxicity
• Respiratory depression

Antidote for Overdose

• No specific antidote, manage symptoms and provide supportive care

Storage Conditions

• Store at room temperature (15-30°C)
• Protect from light and moisture

Pharmacokinetics

• Absorption: Well absorbed from the gastrointestinal tract
• Distribution: Widely distributed in body tissues
• Metabolism: Mainly hepatic
• Excretion: Primarily renal excretion of unchanged drug

Precautions

• Monitor for signs of cinchonism
• Monitor glucose levels in patients with diabetes

Warnings

• Risk of serious side effects like QT prolongation and hemolytic reactions

Others

• Avoid use in patients with known long QT syndrome or certain cardiac conduction abnormalities