Can I take Quinine and Ropinirole together?

Why this happens

Quinine can interfere with the way the liver breaks down ropinirole (by inhibiting the CYP1A2 enzyme), leading to higher levels of the medicine in your blood. Additionally, both drugs can potentially affect the electrical activity of the heart.

What you should do

You should speak to your doctor before taking these two medicines together. Your doctor may need to adjust your dose of ropinirole or monitor your heart health more closely. If you feel dizzy, faint, or experience a racing heartbeat, seek medical advice immediately.

Important precautions

Heart rhythm disorders (Long QT syndrome)

Quinine can cause serious, potentially life-threatening heart rhythm problems. You must not take it if you have a history of heart rhythm disorders or a condition called Long QT syndrome.

Sudden onset of sleep

Ropinirole can cause you to fall asleep suddenly without any prior warning or feeling of tiredness. Do not drive or operate machinery if you experience daytime sleepiness or sudden sleep episodes.

Impulse control disorders

Ropinirole can cause strong urges to behave in ways that are unusual for you, such as excessive gambling, binge eating, or increased sexual drive. Contact your doctor immediately if you or your family notice these behaviours.

Tinnitus (ringing in the ears) or optic neuritis

Stop taking quinine immediately and seek medical advice if you experience any changes to your hearing (such as ringing) or any sudden changes to your vision.

Thrombocytopenia (low blood platelets)

Quinine can cause a dangerous drop in blood platelets. Seek urgent medical help if you notice unexplained bruising, nosebleeds, or purple spots on your skin.

Food and drink warnings

Alcohol

It is best to avoid or strictly limit alcohol while taking quinine. Both alcohol and quinine can cause dizziness or blurred vision; combining them can make these effects worse and increase the risk of falls or accidents.

It is best to avoid or strictly limit alcohol while taking ropinirole. Both alcohol and ropinirole can cause drowsiness and dizziness; combining them increases these effects and may lead to fainting or sudden sleep onset.

Grapefruit juice

Grapefruit juice can increase the amount of quinine in your blood, which may increase the risk of side effects such as heart rhythm problems or hearing changes. It is best to avoid drinking grapefruit juice while taking this medicine.

Tonic water

Tonic water contains small amounts of quinine. While the levels are low, consuming large amounts of tonic water while taking quinine tablets could potentially increase your risk of side effects.

Caffeine (Coffee, Tea, Energy Drinks)

Ropinirole can increase the effects of caffeine in your body, potentially making you feel more jittery, anxious, or causing a racing heart. Conversely, caffeine may interfere with how well ropinirole works for some conditions. Monitor your caffeine intake carefully.

High-fat meals

Taking ropinirole with a very high-fat meal may increase the amount of the drug absorbed into your bloodstream and change how quickly it works. While you can take it with or without food, it is best to be consistent in how you take it (e.g., always with a meal or always on an empty stomach) to keep your symptoms stable.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.