QUININE DIHYDROCHLORIDE 300 mg / mL Anti Malaria 2*10AMPULES / BOX
QUININE DIHYDROCHLORIDE INJECTION 300MG/1ML
Each 1mL ampule contains: Quinine dihydrochloride 300 mg
Quinine acts primarily as a schizontocide ie it suppresses the
asexual cycle of development of malaria parasites in the
erythrocytes. It has little effect on sporozoites or
pre-erythrocytic forms of malarial parasites. It does not,
therefore, prevent the relapse of Plasmodium vivax infections.
Quinine is also gametocidal for P. vivax and P. malariae but not
for P. falciparum, and therefore does not prevent transmission of
this infection by the mosquito.
Plasma concentrations of quinine between 8 and 15 mg/litre are
effective clinically and are generally non-toxic; such values are
usually achieved with the standard therapeutic dose.
For the treatment of acute attacks of malaria, including attacks
due to chloroquine-resistant or multi-drug-resistant strains of
Quinine is used parenterally for cerebral, severe or complicated
malaria, or when vomiting prevents retention of an orally
Quinine dihydrochloride is the salt usually employed for the
preparation of injections.
Quinine is contra-indicated in patients with a history of
hypersensitivity to quinine especially if it takes the form of
cutaneous, angioedematous, visual or auditory symptoms. It is also
contra-indicated in the presence of haemolysis, and in patients
with tinnitus or optic neuritis.
Quinine must be used with caution in patients with atrial
fibrillation or other serious heart disease.
Quinine may aggravate symptoms of myasthenia gravis and should be
used with care if at all in such patients.
Quinine may cause hypoprothrombinaemia and enhance the effects of
anticoagulants. Quinine must be stopped immediately if evidence of
DOSAGE AND DIRECTIONS FOR USE:
In severe or complicated malaria, when the patient is unable to
take oral medication, a slow intravenous infusion of quinine is
In severely ill adults, a loading dose of 20 mg quinine
dihydrochloride per kg may be administered by slow, constant rate
intravenous infusion diluted in either isotonic fluid or 5% glucose
solution (5-10 mL per kg bodyweight depending on the patient's
overall fluid balance) over four hours provided that the patient
has not received quinine, quinidine or mefloquin during the
previous twelve to twenty-four hours, and reliable hospital
facilities are available, including cardiac monitoring.
The maintenance dose is 10 mg of quinine dihydrochloride per kg in
250 to 500 mL of diluent, preferably 5% glucose solution, by
intravenous infusion over four hours, repeated at eight to twelve
For children, a dose of 25 to 30 mg per kg body-mass daily in three
divided doses has been recommended.
Quinine should not be withheld from pregnant women with
life-threatening malaria if other less hazardous agents are
unavailable or inappropriate.
SIDE EFFECTS AND SPECIAL PRECAUTIONS:
Cinchonism, Hypersensitivity, Renal Damage, Cardiovascular
Store below 25°C. Protect from light. Keep out of reach of