Clinical medicine profile
Quinine
Antimalarial
- Route
- ORAL / PARENTERAL (severe malaria)
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Known hypersensitivity.
- Agent-specific: e.g. mefloquine in active depression/psychosis/seizure disorder
- primaquine in G6PD deficiency (haemolysis).
- Always check agent-specific absolute contraindications.
Precautions
- Confirm species and severity.
- ECG risk with some agents (quinine, piperaquine).
- Pregnancy: follow Kenya/WHO trimester-specific ACT guidance.
- Vomiting within 30–60 min may need redosing per protocol.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
Orally 600mg [of stat] TID x I/52. I.V. infusion: Loading dose: 20mg/kg [max. 1.4g] over hours, then 10mg/kg [max. 700mg] after every 8 hours over 4 hours. When the patient can swallow the dose switch to artemisinin combined therapy. [ACT]
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Supportive care critical in severe malaria; adjust supportive drugs as needed.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Monitor if pre-existing liver disease; many agents hepatically metabolised.
Use, effects & interactions
Indications
- Acute attacks of P. falciparum resistant to common antimalarials.
- Clinical selection for Quinine should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Antimalarial.
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- Visual disturbances, CVS disturbances, blood dyscrasias, GI disturbances, abortion after excessive dosages, cardiac function disturbances, cinchonism, skin rashes, angioedema, asthma precipitation.
Drug interactions
Open multi-drug checker ↗- Kenya: follow current MoH malaria guidelines for uncomplicated vs severe disease.
- Test before treat when feasible.
- Complete full ACT course.
- Severe malaria is an emergency — parenteral artesunate, not oral therapy alone.
Mechanism & disposition
Thought to inhibit heme polymerase activity resulting in the accumulation of free heme, which is toxic to the parasites.
Read complete mechanism
Thought to inhibit heme polymerase activity resulting in the accumulation of free heme, which is toxic to the parasites. Artemisinins generate carbon-centred free radicals after activation by parasite haem-iron, damaging parasite proteins and membranes — rapid blood schizonticidal effect. Partner drugs (lumefantrine, piperaquine, etc.) provide longer-acting clearance of residual parasites. Other classes act on haem detoxification, electron transport, or folate pathways depending on agent.
Hours (artemisinins rapid parasite clearance)
Regimen-dependent (ACT 3 days typical)
ORAL / PARENTERAL (severe malaria)
enhanced by fat-containing food. Complex
(CYP3A4) for several partners. Severe malaria: parenteral artesunate preferred first-line in most guidelines.
Pregnancy, lactation & diet
Treat malaria — untreated infection risks mother and fetus. Use trimester-appropriate regimens per Kenya MoH / WHO.
Most first-line ACTs compatible; continue breastfeeding with maternal treatment.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| Mosqin | Indus | tabs amp | Unavailable |
| Quinine | Laborate | tabs 1ml | Unavailable |
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.