In Summary

It is best advised that quinine is not given with drugs like moxifloxacin, an antibiotic, a combination of artemether and lumefantrine commonly known as Coartem/Artefan/lumartem because of eventual heart problems that might happen.

Some one I know recently lost a very close relative to malaria. The person had been taken to a clinic for medical treatment. At the clinic they were treated with quinine, diclofenac and chloramphenicol injections. Now death is a sad fatality, it could have come from a case of complicated malaria that went unnoticed or as some suspect, it was the cocktail of drugs the patient was given. The patient simply fainted and did not recover.

The answers will never be found because no postmortem was done. Today we are going to look at quinine. It is advised that quinine is given through the vein (intravenously) if the patient is seriously ill or cannot swallow the tablets. The adult dose is 600mg given three times daily for 5-7days.

This is about two tablets each time. The dose through the veins is set against the patient’s body weight with a high dose at the start that is given for over four hours and then a standard dose is then given eight hours later over four hours every eight hours until the patient can swallow tablets (BNF 2009).

However, the drug is said to lower the body’s levels of glucose especially when given intravenously and people are encouraged to keep replenished. It is also associated with ringing sounds in the ears, headaches, nausea, abdominal pain, visual disturbances and confusion.

Quinine is also associated with effects on the heart and blood vessels otherwise called cardiovascular effects. People with heart disease, the elderly, those with liver and kidney problems are cautioned against taking this medicine.

It is best advised that quinine is not given with drugs like moxifloxacin, an antibiotic, a combination of artemether and lumefantrine commonly known as Coartem/Artefan/lumartem because of eventual heart problems that might happen.

There is also an increased risk of convulsions when the medicine is given with another antimalarial called mefloquine. Antiulcer medicine called cimetidine is not advised for these patients.
It is therefore advised that one goes to a qualified medical practitioner and they are closely monitored as they are given this drug.

The author is a pharmacist