Quinine Sulfate, Oral

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KEY POINTS

• This medicine is taken by mouth to treat malaria. Take it exactly as directed.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antimalarial

Generic and brand names: quinine sulfate, oral; Qualaquin

What is this medicine used for?

This medicine is taken by mouth to treat malaria. Do not confuse this medicine (quinine) with quinidine. Quinidine is used to treat heart conditions.

Because of the potential for severe side effects, quinine is no longer recommended to treat night-time leg cramps. Talk with your healthcare provider about this.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A blood disorder
• Blackwater fever
• Problems with the nerves in your eyes
• G6PD deficiency
• Heart disease, including irregular heartbeat
• Kidney or liver problems
• Long QT syndrome (problems with electrical activity in the heart muscle)
• Myasthenia gravis
• Problems with low blood sugar
• Ringing in the ears

Tell your provider if you smoke. Smoking cigarettes can affect how this medicine works.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant while taking this medicine. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill.

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or take it longer than prescribed. Do not stop taking this medicine without your healthcare provider's approval. Taking too much of this medicine may cause side effects.

Check with your healthcare provider before using this medicine in children under age 16.

Take this medicine with or after meals to lessen stomach upset, unless your healthcare provider tells you otherwise. Take the capsules whole. Do not chew, break, or crush them. If you take the medicine at bedtime, eat a snack or drink a glass of milk or juice.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. If it has been more than 4 hours since the missed dose, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: headache, confusion, dizziness, ringing in the ears, hearing loss, vision problems, stomach pain, severe nausea or vomiting, sweating, irregular heartbeat, lightheadedness, fainting.

What should I watch out for?

This medicine may cause dizziness, blurred vision, or other changes in your vision. Do not drive or operate machinery unless you are fully alert and can see clearly.

You may need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

You may have low blood sugar while taking this medicine. Symptoms of low blood sugar include shaking, anxiety, cold sweats, irritability, fast heartbeat, feeling faint, strong hunger, vision problems, headache, nausea, slurred speech, confusion, unusual mood changes, tingling in the lips or tongue, and weakness. You can eat honey or candy, or drink a glass of orange juice or nondiet soda to quickly raise your blood sugar level. Do not use chocolate because the fat content slows down the sugar entering the bloodstream. Talk about this with your healthcare provider.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Irregular or fast heartbeat, chest pain, flushing, ringing in your ears, trouble seeing or hearing, change in color vision, severe headache, severe dizziness, fever, trouble urinating, blood in the urine, unusual bruising or bleeding or red spots on the skin; unexplained swelling.

Other: Diarrhea, nausea, vomiting, stomach pain, confusion, sweating, loss of appetite, headache.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Acetazolamide (Diamox)
• Alpha blockers such as alfuzosin (Uroxatral), silodosin (Rapaflo), and tamsulosin (Flomax)
• Antacids that contain aluminum or magnesium, such as Gaviscon, Maalox, and Mylanta (Take antacids at least 2 hours before or 2 hours after you take this medicine.)
• Antibiotics such as azithromycin (Zithromax, Zmax), clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), rifabutin (Mycobutin), rifampin (Rifadin), telithromycin (Ketek), tetracycline
• Antidepressants such as amitriptyline, citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), imipramine (Tofranil), nortriptyline (Pamelor), sertraline (Zoloft), and trazodone
• Antifungal medicines such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Monistat, Oravig), posaconazole (Noxafil), terbinafine (Lamisil), and voriconazole (Vfend)
• Antipsychotic medicines such as asenapine (Saphris), chlorpromazine, clozapine (Clozaril, FazaClo), haloperidol (Haldol), iloperidone (Fanapt), paliperidone (Invega), pimozide (Orap), quetiapine (Seroquel), thioridazine, and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), phenobarbital, and phenytoin (Dilantin, Phenytek)
• Bupropion (Aplenzin, Forfivo, Wellbutrin, Buproban, Zyban)
• Cancer medicines such as arsenic trioxide (Trisenox), crizotinib (Xalkori), nilotinib (Tasigna), toremifene (Fareston), vandetanib (Caprelsa), and vemurafenib (Zelboraf)
• Cholesterol-lowering medicines such as atorvastatin (Lipitor), lovastatin (Altoprev), pravastatin (Pravachol), and simvastatin (Zocor)
• Cimetidine (Tagamet)
• Cyclosporine (Gengraf, Neoral, Sandimmune)
• Dextromethorphan, an ingredient in many cough, cold, or allergy medicines such as Robitussin-DM
• Doxepin (Silenor)
• Fingolimod (Gilenya)
• Heart medicines such as amiodarone (Cordarone, Pacerone), digoxin (Lanoxin), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), flecainide, procainamide, quinidine, sotalol (Betapace, Sorine), and verapamil (Calan, Covera, Verelan)
• HIV medicines such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Invirase)
• Medicines to treat breathing or lung problems such as aminophylline and theophylline
• Medicines to treat or prevent blood clots such as dabigatran (Pradaxa) and warfarin (Coumadin)
• Methadone (Dolophine, Methadose)
• Mifepristone (Korlym, Mifeprex)
• Natural remedies such as black cohosh, California poppy, goldenseal, hawthorn, and St. John's wort
• Other malaria medicines such as artemether/lumefantrine (Coartem) and mefloquine
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Potassium supplements
• Sodium bicarbonate (Alka-Seltzer)
• Tramadol (ConZip, Ultram)

Do NOT eat or drink products that contain grapefruit, Seville oranges, and tangelos at any time while you are taking this medicine. These fruits and juices affect the way this medicine works and increase your risk of serious side effects. Talk with your healthcare provider or pharmacist about this.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.