This list is not complete and many other drugs can interact with quinine. If you need surgery or medical tests, tell your caregivers ahead of time that you are using quinine. The U.S. Food and Drug Administration has banned the sale of all non-approved brands of quinine. 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. Malaria is common in areas such as Africa, South America, and Southern Asia. Malaria parasites have become somewhat resistant to quinine, and better drugs have become available, yet it is sometimes still used today.”. Quinine is used to treat uncomplicated malaria, a disease caused by parasites. To make sure quinine is safe for you, tell your doctor if you have: heart disease or a heart rhythm disorder; low potassium levels in your blood (hypokalemia); or. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Rifamycins and cigarette smoking increase the elimination of quinine.3, 4, 5, 6, 7 Cimetidine3, 6 and ketoconazole4, 6 decrease the clearance of quinine. Medically reviewed by Drugs.com. 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. While quinine itself does have the ability to kill certain parasites that can trigger illnesses, tonic water is a sugary drink that’s best to avoid in more than small amounts. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. According to the FDA, quinine in tonic water is not harmful as long as it is present in amounts less than than 83 parts per million. 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. This is only a brief summary of general information about this product. headache, blurred vision, changes in color vision; sweating or flushing (warmth, redness, or tingly feeling); mild dizziness, spinning sensation, ringing in your ears; or. Quinine will not treat severe forms of malaria, and it should not be taken to prevent malaria. This Dr. Axe content is medically reviewed or fact checked to ensure factually accurate information. Quinine has been widely studied as an antimalarial, and has been used at doses of 325 mg to 1 g as the sulfate salt. nausea, diarrhea, vomiting and stomach cramps, rarely, serious complications like altered mental status, kidney damage, changes in heart rhythms, bleeding problems, seizures and allergic reactions, increased risk of gaining weight and developing obesity. Avoid using antacids without your doctor's advice. We comply with the HONcode standard for trustworthy health information -. Select one or more newsletters to continue. Several methods are known for its preparation, and production of synthetic quinoline exceeds that from coal tar. For additional information please refer to the "Evidence-Based Herb-Drug Interactions" appendix. There is no report of an interaction occurring with coadministration of quinine and warfarin. A small, in vitro study showed potential of phenobarbital to partially reverse quinine resistance.17 Calcium antagonists and other agents (eg, prochlorperazine) are being studied for reversing P. falciparum resistance to quinine.18 Various antibiotics (ie, artemisinin, artemether, clindamycin, doxycycline, mefloquine) in combination with quinine are being tested and used to treat resistant strains of P. falciparum.19, 20, 21, 22, 23, 24 If the oral route is not available for administration of quinine in children, effective alternate routes (ie, IM, intrarectal, IV) can be used.25, 26, 27, 28 Close monitoring for adverse reactions is advised, especially in young children who are more susceptible to quinine toxicity.26 The combination of quinine and clindamycin has been safely and effectively used in Thailand for the treatment of uncomplicated malaria.29, Quinine has been thought to have antipyretic action.1 Although quinine administered before acetaminophen produces a more rapid drop in temperature than administration after acetaminophen, quinine alone has no effect on fever.30, Another common use of quinine has been for the treatment of leg cramps caused by vascular spasm. According to Dr. Sean O’Keefe, professor in the Department of Food Science at the Virginia Polytechnic Institute and State University, “quinine was the first successful drug used to treat human infectious disease. The latter compound is used for its antiarrhythmic activity. 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. This product may be unsafe when used before surgery or other medical procedures. Believe it or not, one of the oldest cures for malaria, a compound called quinine, is now found in a popular “mixer” used to make cocktails: tonic water. FDA pregnancy category C. It is not known whether quinine will harm an unborn baby. What is tonic water? 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. Last updated on Jan 15, 2020. Before you get excited, here’s some disappointing news: The amount of quinine found in tonic water is very low, meaning it isn’t enough to provide much protection against infections or other symptoms. It is also the same compound used to lend strong, bitter flavors to other products, such as those intended to taste like “bitter lemon.”. Our team aims to be not only thorough with its research, but also objective and unbiased. Quinine can cause serious side effects on your heart, kidneys, or blood cells. 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. Since then it’s become well-known as an ingredient used to make “gin and tonics” and other (mostly alcoholic) beverages. According to this report, quinine should only be considered when cramps are very disabling, no other agents relieve symptoms, and there is careful monitoring of side effects. Uses This medication is used alone or with other medication to treat malaria caused by mosquito bites in countries where malaria is common. Quinine has been used as an abortifacient.11 Extracts of cinchona have a bitter, astringent taste and have been used as flavoring for foods and beverages.
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