QUININE SULFATE (Generic for QUALAQUIN)

Quinine Sulfate 324mg, Oral capsule

Food

· Severity: Major

· Notes for Consumers: Some food products may contain Quinine (Tonic Water). To avoid additive effects and decrease the potential for side effects while taking medications containing quinine; avoid the use of Tonic Water. Contact your health care provider promptly if you experience side effects such as headache, changes in vision or hearing, or a racing heartbeat while taking Quinine.

· Notes for Professionals: Clinicians should be aware that some food and beverage products contain quinine. Tonic water commonly contains quinine and may have additive effects when taken with quinine medications. One study reported that the concentrations of quinine in tonic water are not significant enough to result in drug interactions with CYP2D6 substrates.

Quinine Sulfate 324mg, Oral capsule

Grapefruit juice

· Severity: Moderate

· Notes for Consumers: These drugs may be taken together only under close supervision from your prescriber. Taking these drugs together can increase the risk of a dangerous change in heartbeat or heart rhythm. Contact your prescriber immediately if you experience chest pain, dizziness, fainting or falling spells, palpitations, shortness of breath, or a change in your heartbeat (such as a fast or irregular heartbeat).

· Notes for Professionals: Quinine pharmacokinetics were not affected by grapefruit juice in a study of 10 healthy volunteers who were administered 5 days of grapefruit juice prior to receiving a single 600 mg quinine dose. However, there is a case report in which a 19 year old patient with known asymptomatic long QT syndrome developed torsade de pointes (TdP) after ingesting excessive amounts of grapefruit juice and quinine-containing tonic water. The TdP stopped 48 hours after discontinuing these drinks. Use of quinine and grapefruit juice should be done with caution, especially with large or multiple doses of quinine or if co-administered in patients with potential cardiac abnormalities.

Quinine Sulfate 324mg, Oral capsule

Tobacco

· Severity: Major

· Notes for Consumers: Do not smoke or use tobacco products while taking this medication. When used together, your medication may not work as well for you.

· Notes for Professionals: Advise patients to avoid smoking tobacco while taking quinine. In healthy male smokers, the single dose AUC of quinine was reduced 44% and the Cmax was 18% lower than in non-smokers. Smoking has been observed to have less of an impact in patients receiving quinine for acute malaria. In malaria patients receiving a 7-day course of quinine, the AUC was reduced by 25% and the Cmax decreased 16.5% in smokers. Cigarette smoking did not appear to influence therapeutic outcomes; therefore, increasing the dose of quinine in smokers is not recommended.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>