{"id":4312,"date":"2025-03-31T18:12:04","date_gmt":"2025-03-31T18:12:04","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/quinine-txt\/"},"modified":"2025-03-31T18:12:04","modified_gmt":"2025-03-31T18:12:04","slug":"quinine-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/quinine-txt\/","title":{"rendered":"Quinine.txt"},"content":{"rendered":"

CLINICAL USE <\/H3>
\nSevere and complicated falciparum malariaNocturnal cramp

DOSE IN NORMAL RENAL FUNCTION <\/H3>IV: Quinine dihydrochloride: Loading dose 20 mg\/kg to maximum 1.4 g, then after 8 hours, maintenance 10 mg\/kg (up to maximum 700 mg) 8 hourly, reduced to 5\u20137 mg\/kg if parenteral treatment required for more than 48 hoursOral: Quinine sulphate 600 mg every 8 hours for 5\u20137 daysNocturnal cramp: Quinine sulphate 200\u2013 300 mg at night

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :324.4 (397.3 as dihydrochloride); (782.9 as sulphate)<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :70\u201390<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 5\u201320<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :2.5\u20137.1 <\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :11 (healthy), 18 (malaria)\/26

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Malaria: 5\u20137 mg\/kg every 8 hours Cramp: Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Malaria: 5\u20137 mg\/kg every 8\u201312 hours Cramp: Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Malaria: 5\u20137 mg\/kg every 24 hours Cramp: Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • HDF\/high flux &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR=10\u201320 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Anti-arrhythmics: flecainide levels increased; increased risk of ventricular arrhythmias with amiodarone \u2013 avoid concomitant use\n
  • Antibacterials: increased risk of ventricular arrhythmias with moxifloxacin \u2013 avoid concomitant use\n
  • Antimalarials: increased risk of convulsions with mefloquine; avoid concomitant use with artemether\/lumefantrine\n
  • Antipsychotics: increased risk of ventricular arrhythmias with pimozide \u2013 avoid concomitant useCardiac glycosides: levels of digoxin increased (halve maintenance dose)\n
  • Ciclosporin: decreased ciclosporin levels reportedCimetidine: may increase plasma levels of quinine

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>_

    Route <\/H4>

    IV infusion <\/H4>, oral

    Rate of Administration <\/H4>4 hours

    Comments<\/H4>Add to sodium chloride 0.9% or glucose 5% for infusionLoading dose of 20 mg\/kg may be required in some cases (refer to specialist treatment). Not to be given if patient has had quinine or mefloquine in previous 12\u201324 hours

    OTHER INFORMATION <\/H4>Quinine dihydrochloride injection is available as a special orderMonitor for signs of cardiotoxicity Give doses after haemodialysis on dialysis daysMonitor quinine levels if patient exhibits any symptoms of toxicity.
    \n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Severe and complicated falciparum malariaNocturnal cramp DOSE IN<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4312","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4312","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4312"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4312\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4312"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4312"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4312"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}