when quinine treatment of

Precautions

Quinine is a medicine which has been used to treat cramps for many years. There is conflicting evidence for its ability to reduce cramps. Quinine can cause serious, even fatal adverse events, especially in overdosage. Study characteristics. This review includes 23 trials, with 1586 participants. The trials compared quinine or quinine-based ...

Why you should never take quinine for muscle cramps?

Why was quinine taken off the market? In early 2007, FDA banned all prescription quinine products other than Qualaquin. FDA acted in this manner because of a perception that quinine is not effective for this condition and that its risk potential far exceeds its efficacy potential.

Why was quinine taken off the market?

Quinine can cause serious side effects on your heart, kidneys, or blood cells. 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.

What are the side effects of quinine?

Quinine sulfate, an antimalarial drug, is widely used as an effective therapy for idiopathic leg cramps. Several double-blind, randomized, placebo-controlled studies have questioned the effectiveness of quinine in leg cramps; whereas other studies have shown significantly more benefit with use of quinine in reducing the frequency and severity of cramps compared with placebo or vitamin E.

Is quinine effective and safe in leg cramps?

What is quinine used to treat?

Quinine is used to treat malaria caused by Plasmodium falciparum. Plasmodium falciparum is a parasite that gets into the red blood cells in the body and causes malaria. Quinine works by killing the parasite or preventing it from growing.

When should I take quinine?

This medication is usually taken every 8 hours for 3 to 7 days or as directed by your doctor. Take this medication 2 to 3 hours before or after taking antacids containing aluminum or magnesium. These products bind with quinine, preventing your body from fully absorbing the drug.

What is quinine and why is it important?

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.

Can you take quinine daily?

Adults and children 16 years of age and older—648 milligrams (mg) (2 capsules) every 8 hours for 7 days. Children younger than 16 years of age—Use and dose must be determined by your doctor.

Who should not take quinine?

You should not take quinine if you have a heart rhythm disorder called Long QT syndrome, a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase deficiency (G-6-PD), myasthenia gravis, optic neuritis (inflammation of the nerves in your eyes), if you have taken quinine in the past and it caused a blood cell ...

Does quinine reduce fever?

Quinine alone (n = 7) had no significant effect on fever, whereas paracetamol given 2 h after quinine (n = 7) or 2 h before quinine (n = 7) reduced temperature by a mean of 2.1 degrees C (standard deviation [SD] 0.95) and 2.1 degrees C (SD 0.79) respectively.

Does quinine have health benefits?

Other than its use as an antimalarial drug, quinine doesn't have any health benefits. While quinine in tonic water has been used as a home remedy for nighttime leg cramps and muscle pain, there's no evidence that it works.

What is the best treatment for malaria?

The most common antimalarial drugs include:Chloroquine phosphate. Chloroquine is the preferred treatment for any parasite that is sensitive to the drug. ... Artemisinin-based combination therapies (ACTs). ACT is a combination of two or more drugs that work against the malaria parasite in different ways.

Before Taking This Medicine

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...

How Should I Take quinine?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.Take with f...

What Happens If I Miss A Dose?

Take the missed dose as soon as you remember. If you are more than 4 hours late for your dose, skip the missed dose and take the medicine at your n...

What Should I Avoid While Taking quinine?

Avoid taking other anti-malaria medications without your doctor's advice. This includes chloroquine, halofantrine, and mefloquine.Avoid using antac...

What Other Drugs Will Affect quinine?

Many drugs can interact with quinine. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start...

What is quinine used for?

Quinine is a medication and cutting agent used to cut illicit narcotics such as heroin; it has also been used to treat malaria and babesiosis. This includes the treatment of malaria due to Plasmodium falciparum that is resistant to chloroquine when artesunate is not available. While sometimes used for restless legs syndrome, quinine is not recommended for this purpose due to the risk of serious side effects. It can be taken by mouth or intravenously. Malaria resistance to quinine occurs in certain areas of the world. Quinine is also the ingredient in tonic water that gives it its bitter taste.

What happens if you take quinine?

Quinine can cause unpredictable serious and life-threatening blood and cardiovascular reactions including low platelet count and hemolytic-uremic syndrome / thrombotic thrombocytopenic purpura (HUS/TTP), long QT syndrome and other serious cardiac arrhythmias including torsades de pointes, blackwater fever, disseminated intravascular coagulation, leukopenia, and neutropenia. Some people who have developed TTP due to quinine have gone on to develop kidney failure. It can also cause serious hypersensitivity reactions include anaphylactic shock, urticaria, serious skin rashes, including Stevens–Johnson syndrome and toxic epidermal necrolysis, angioedema, facial edema, bronchospasm, granulomatous hepatitis, and itchiness.

What trees produce quinine?

Cinchona trees remain the only economically practical source of quinine. However, under wartime pressure during World War II, research towards its synthetic production was undertaken. A formal chemical synthesis was accomplished in 1944 by American chemists R.B. Woodward and W.E. Doering. Since then, several more efficient quinine total syntheses have been achieved, but none of them can compete in economic terms with isolation of the alkaloid from natural sources. The first synthetic organic dye, mauveine, was discovered by William Henry Perkin in 1856 while he was attempting to synthesize quinine.

What is the chiral moiety of quinine?

Quinine (and quinidine) are used as the chiral moiety for the ligands used in Sharpless asymmetric dihydroxylation as well as for numerous other chiral catalyst backbones. Because of its relatively constant and well-known fluorescence quantum yield, quinine is used in photochemistry as a common fluorescence standard.

When did quinine stop being sold?

From 1969, to 1992, the US Food and Drug Administration (FDA) received 157 reports of health problems related to quinine use, including 23 which had resulted in death. In 1994, the FDA banned the marketing of over-the-counter quinine as a treatment for nocturnal leg cramps.

Where did Quinine originate?

Quinine was first isolated in 1820 from the bark of a cinchona tree, which is native to Peru. Bark extracts had been used to treat malaria since at least 1632 and it was introduced to Spain as early as 1636 by Jesuit missionaries from the New World. It is on the World Health Organization's List of Essential Medicines.

Is quinine a first line treatment for malaria?

Medical. As of 2006, quinine is no longer recommended by the World Health Organization (WHO) as a first-line treatment for malaria, because there are other substances that are equally effective with fewer side effects. They recommend that it be used only when artemisinins are not available.

Usual Adult Dose for Malaria

648 mg orally every 8 hours for 7 days Comments: -This drug has been effective in geographical regions with documented chloroquine resistance. Use: Only for treatment of uncomplicated Plasmodium falciparum malaria US CDC Recommendations: 542 mg base (650 mg sulfate salt) orally 3 times a day for 3 or 7 days Comments: -With doxycycline, tetracycline, or clindamycin, recommended as a preferred regimen for treatment of uncomplicated malaria due to chloroquine-resistant (or unknown resistance) P falciparum (or species not identified); in pregnant women, this drug should be used with clindamycin. -With (primaquine or tafenoquine [Krintafel]) plus (doxycycline or tetracycline), recommended for treatment of uncomplicated malaria due to chloroquine-resistant P vivax; primaquine and tafenoquine must not be used during pregnancy. -In pregnant women with uncomplicated malaria due to chloroquine-resistant P falciparum or P vivax, doxycycline or tetracycline may be used with this drug if other treatment options are not tolerated/not available and the benefits are deemed to outweigh the risks. -If needed, as interim therapy for severe malaria until IV artesunate arrives -The US manufactured quinine sulfate capsule is available in a 324-mg dosage; therefore, 2 capsules should be sufficient for adult dosing. -Therapy should be continued for 7 days if infection was acquired in Southeast Asia, or for 3 days if acquired elsewhere. -Current guidelines should be consulted for additional information..

Usual Pediatric Dose for Malaria

16 years or older: 648 mg orally every 8 hours for 7 days Comments: -This drug has been effective in geographical regions with documented chloroquine resistance. Use: Only for treatment of uncomplicated P falciparum malaria US CDC Recommendations: 8.3 mg base/kg (10 mg sulfate salt/kg) orally 3 times a day for 3 or 7 days Maximum dose: 542 mg base (650 mg sulfate salt)/dose Comments: -With clindamycin in children younger than 8 years and with doxycycline, tetracycline, or clindamycin in children 8 years or older: Recommended as a preferred regimen for treatment of uncomplicated malaria due to chloroquine-resistant (or unknown resistance) P falciparum (or species not identified) -With primaquine in children younger than 8 years, with primaquine plus (doxycycline or tetracycline) in children 8 to 15 years, and with (primaquine or tafenoquine [Krintafel]) plus (doxycycline or tetracycline) in children 16 years or older: Recommended for treatment of uncomplicated malaria due to chloroquine-resistant P vivax -If needed, as interim therapy for severe malaria until IV artesunate arrives -Pediatric dose should never exceed adult dose. -The US manufactured quinine sulfate capsule is available in a 324-mg dosage; due to the unavailability of non-capsule forms of this drug, pediatric dosing may be difficult. -Therapy should be continued for 7 days if infection was acquired in Southeast Asia, or for 3 days if acquired elsewhere. -Current guidelines should be consulted for additional information..

Renal Dose Adjustments

Mild and moderate renal dysfunction: Data not available Severe chronic renal dysfunction: -Loading dose: 648 mg orally once followed 12 hours later by maintenance dose -Maintenance dose: 324 mg orally every 12 hours

Liver Dose Adjustments

Mild or moderate liver dysfunction (Child-Pugh A or B): No adjustment recommended. Severe liver dysfunction (Child-Pugh C): Not recommended. Comments: -Patients with mild or moderate liver dysfunction should be closely monitored for side effects of this drug. -Alternative therapy recommended for patients with severe liver dysfunction.

Precautions

US BOXED WARNING: -HEMATOLOGIC REACTIONS: Use of this drug for treatment/prevention of nocturnal leg cramps may lead to serious and life-threatening hematologic reactions (including thrombocytopenia and hemolytic uremic syndrome/thrombotic thrombocytopenic purpura [HUS/TTP]); chronic renal dysfunction associated with TTP development reported.

Other Comments

Administration advice: -Do not use to treat severe/complicated P falciparum malaria, to prevent malaria, or to treat/prevent nocturnal leg cramps. -Administer with food to minimize gastric upset. -Do not exceed the prescribed amount. -Consult the manufacturer product information regarding missed doses. Storage requirements: -Store at 20C to 25C (68F to 77F). -Dispense in a tight container. General: -Unless otherwise specified, the dose is expressed as quinine sulfate (i.e., as the salt). -The Medication Guide should be dispensed to each patient. Monitoring: -General: For side effects in patients with liver dysfunction; serum digoxin levels (if used concomitantly) -Metabolic: For signs/symptoms of hypoglycemia Patient advice: -Read the US FDA-approved patient labeling (Medication Guide). -Do not take more than the prescribed amount..

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Why do people drink quinine?

People have consumed quinine in tonic water to help treat cases of malaria for centuries. In this article, learn about what quinine is and what its side effects and possible benefits are.

What are the side effects of quinine?

Some of the possible side effects of taking quinine as a medication include: abnormal heartbeat. kidney damage. severe allergic reaction. electrolyte imbalance. vision or eye issues.

Why is quinine bitter?

As a food additive , quinine offers a bitter taste. Manufacturers usually add it to tonic water.

Does quinine cause nausea?

Side effects. Quinine is very diluted in tonic water. The likelihood of a person experiencing any side effects from drinking tonic water is slim. However, side effects of quinine can include: ringing in the ears. vomiting. stomach cramps. nervousness. nausea.

Can quinine be used for restless legs?

In fact, the FDA have warned doctors against prescribing quinine to treat leg cramps or restless legs syndrome. Tonic water is a carbonated soft drink that may contain sugar and has little nutritional value. The quinine present in tonic water provides a distinctive bitter flavor.

Does tonic water help with leg cramps?

Tonic water does not have any known nutritional benefits. Many people believe that drinking tonic water helps with nighttime leg cramps and restless legs syndrome. However, there is no scientific evidence verifying this belief.

Is quinine in tonic water diluted?

The quinine in tonic water is very diluted. It is unlikely that a person will experience even mild side effects from drinking tonic water, but they should be cautious if they are taking quinine as a medication and try to report any side effects to a doctor. Last medically reviewed on November 14, 2018.

How long is the quinine trial?

A four-week trial of quinine could be an option for fully informed patients experiencing frequent, severe cramps that disrupt their sleep. The trial should be considered only after treatable causes have been ruled out, and nonpharmacologic and potentially less toxic pharmacologic agents have been tried.

Does Quinine help with leg cramps?

Usually idiopathic, these muscle cramps are common, particularly in older patients. Quinine may help by decreasing the excitability of the motor end-plate and increasing the muscle refractory period.2A number of drugs have been proposed for the treatment of nocturnal leg cramps.

What is Quinine used for?

Quinine is a compound derived from the bark of the Cinchona tree, and is typically used to treat mosquito borne diseases, like malaria. It is not used to prevent the disease, but rather to kill the organism responsible for the disease after a person falls ill.

How to protect yourself from quinine?

The best way to protect yourself and others is to practice CDC guidelines including social distancing, wearing a face mask, washing your hands frequently and disinfecting commonly touched surfaces. Here's what you need to know about quinine and why it's been making headlines recently.

How much quinine is in a liter of water?

The way you've probably seen quinine is as an ingredient in tonic water. One liter of tonic water usually has around 83 mg of quinine, much lower than the therapeutic dose found in quinine medication, which is between 500 and 1,000 mg.

Is quinine safe for malaria?

Because quinine is also used to treat malaria, some sources made claims that it, too, could potentially cure the coronavirus.

Is quinine safe for pregnant women?

But, there is no scientific proof that quinine prevents or cures the coronavirus. For many people it can be dangerous, including those with heart conditions or those who are pregnant. For people who are healthy, ingesting the amount of quinine in tonic water is regarded as safe.

Is Quinine a cure all?

As the race to find a cure for COVID-19 continues, scientists are exploring more effective options in numerous clinical trials across the globe. Quinine is not a cure-all and the amount found in tonic water is minimal.

Overview

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