Quinine is prescribed to treat malaria in people who have been bitten by an infected mosquito. It is not suitable for preventing malaria.
Quinine is an ingredient of drinks such as tonic water and bitter lemon - try to avoid these while you are taking quinine tablets.
Contact a doctor immediately if anyone swallows quinine by accident, or if you take more than the prescribed dose.
About quinine for malaria
|Type of medicine||An antimalarial medicine|
|Used for||To treat malaria|
|Also called||Quinine bisulfate, quinine dihydrochloride, quinine sulfate|
|Available as||Tablets and injection|
Malaria is a very serious infection which you can catch from a bite from an infected mosquito. The most common symptom is high temperature (fever) and a flu-like illness. Malaria can occur even up to a year after travelling in an area in which there is malaria. Prompt treatment for malaria is essential. If you feel unwell and have recently visited an area in which there is malaria, you should seek prompt medical advice, even if you have taken your anti-malarial medication correctly.
Malaria is caused by a parasite called plasmodium. The parasite lives inside the stomach of an infected female mosquito and is passed to humans from a mosquito bite. There are four types of plasmodium that cause malaria. Of the four, Plasmodium falciparum is usually the most serious, so this type of malaria is likely to be treated in hospital.
Before taking quinine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking quinine it is important that your doctor knows:
- If you are pregnant or breast-feeding.
- If you have any problems with your eyes, or with your hearing.
- If you have a heart condition.
- If you have any problems with the way your kidneys work, or any problems with the way your liver works.
- If you have blood in your urine.
- If you have a condition causing muscle weakness, called myasthenia gravis.
- If you have glucose 6-phosphate dehydrogenase deficiency. This is a genetic disorder where there is a lack of an enzyme often known as G6PD. People with this disorder have problems after eating foods such as fava beans.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine, or if you have had a bad reaction to quinine in tonic water or any other soft drink.
How to take quinine
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about quinine and will provide you with a full list of the side-effects which you may experience from taking it.
- Take quinine exactly as your doctor tells you to. If you are being treated in hospital, your nurse will tell you when your tablets are due. If you are being treated at home, your doctor or pharmacist will tell you how many tablets to take for each dose, and when the doses should be taken. Your dose will also be printed on the label of the pack to remind you about what the doctor said to you. Space the doses evenly throughout the day and continue to take the tablets until the course is finished, unless your doctor tells you to stop sooner. It is important you do this even if you feel better. It is to make sure that all of the parasite has been removed from your body.
- Swallow your doses with a drink of water. You can take quinine tablets either before or after meals.
- If you forget to take a dose, take it as soon as you remember. Try to take the correct number of doses each day but do not take two doses at the same time to make up for a missed dose.
Getting the most from your treatment
- If you are being treated from home, make sure you keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- Your doctor will discuss with you the possibility of unwanted side-effects of the treatment. It is important that you let your doctor know, before you take your next dose, if you experience any of the following: impaired hearing, ringing noises in your ear, headaches, feeling sick, or any problems with your eyesight.
- Quinine is present in drinks such as tonic water and bitter lemon. It is probably best to avoid these drinks while you are taking quinine tablets.
- Never take more than the prescribed dose. Taking too much quinine can cause serious problems. Also, quinine is dangerous if it is taken by a child, so keep the tablets away from children. If you suspect that someone has taken an overdose of quinine or has swallowed some by accident, you must contact a doctor straightaway. Alternatively, go to the accident and emergency department of a local hospital. Do not delay. Take the container with you, even if it is empty. This is so the doctor knows what has been taken.
- If you buy any medicines, always check with a pharmacist that they are suitable to take with your other medicines. This is because some medicines (such as cimetidine which is taken for heartburn) can interfere with quinine and increase the risk of serious side-effects.
- If you are being treated for diabetes, quinine can lower the level of sugar in your blood. Your doctor will be able to advise you about this.
Can quinine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the side-effects associated with quinine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. Although unwanted effects often improve as your body adjusts to a new medicine, serious side-effects do still sometimes occur. Contact your doctor for advice as soon as possible if you experience any of the following:
|Quinine side-effects||What can I do if I experience this?|
|Diarrhoea, feeling sick, feeling weak or confused, 'ringing' in your ears, headache, having a spinning sensation (vertigo)||Tell your doctor as soon as possible|
|Difficulties seeing, such as blurred vision and colour changes||Tell your doctor as soon as possible. Do not drive while your vision is affected|
|Hot and flushed skin, rashes, muscle weakness, increased sensitivity to light||If any of these become troublesome, let your doctor know|
|Difficulty breathing, swelling around your mouth or face||Speak with your doctor straightaway - these are signs of an allergy to quinine|
|Unexplained bleeding, unusual bruising, sore throats or infections||Tell your doctor as soon as possible - these could be signs of a serious blood disorder and your doctor will want to check for this|
If you experience any other symptoms which you think may be due to the tablets, please speak with your doctor or pharmacist for further advice.
How to store quinine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are using.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- British National Formulary; 69th Edition (Mar 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr John Cox