Quinine Dihydrochloride Injection 600mg 2ml
QUININE DIHYDROCHLORIDE INJECTION 600mg 2ml
Indications:
Quinine Dihydrochloride injection is indicated for the acute treatment of malaria. It may also be used in the treatment of Babesiosis in conjunction with clindamycin.
Dosage and Administration:
Child and adult:
Loading dose: 20 mg/kg administered over 4 hours, then keep the vein open with an infusion of 5% glucose over 4 hours
Maintenance dose: 8 hours after the start of the loading dose, 10 mg/kg every 8 hours (alternate quinine over 4 hours and 5% glucose over 4 hours)
For adults, administer each dose of quinine in 250 ml. For children under 20 kg, administer each dose of quinine in a volume of 10 ml/kg.
Do not administer a loading dose to patients who have received oral quinine or mefloquine within the previous 24 hours: start with maintenance dose.
Duration
Treat parenterally for at least 24 hours, then, if the patient can tolerate the oral route, change to a complete 3-day course of an artemisinin-based combination (or if not available oral quinine to complete 7 days of quinine treatment). If not, continue parenteral treatment until the patient can change to oral route (without exceeding 7 days of parenteral treatment).
Precautions & Warning:
Check for hypersensitivity to quinine or quinidine BEFORE administration. It is important that when given intravenously it should be given by SLOW infusion and the patient observed closely for signs of cardiotoxicity.
The half-life of quinine is prolonged in hepatitis and moderate chronic liver disease.
These symptoms should also be monitored during treatment:
Haemolysis
Prothrombin formation
Atrial fibrillation
Hypersensitivity
Contra-indications:
• Hypersensitivity to quinine or quinidine
• Glucose-6-phosphate dehydrogenase (G6PD) deficiency
• History of Blackwater Fever
• Patients with tinnitus or optic neuritis
• It should not be used in the presence of haemolysis or in the presence of concurrent anticoagulant therapy
• It should not be used in patients with diabetes
Drug interactions:
Urinary alkalinisers
Urinary acidifiers
Cimetidine
Digoxin
Anticoagulants:
Pyrimethamine
Neuromuscular blocking agents
Antiarrhythmics
Anticholinesterases
Diuretics
Antineoplastics
Antibacterials
Ganglion blockers:
General anaesthetics
Magnesium salts
Sympathomimetics (Salbutamol)
Other: Antimyasthenics, haemolytics, neurotoxic medication, ototoxic medication, mefloquine, lithium and quinidine.
Storage instructions:
Store below 25°C and protect from light
