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Quinine is rapidly absorbed from the GI tract and toxicity is dose related. Quinine can cause cinchonism, hypoglycemia, serious hematologic disorders, urticaria, contact dermatitis, and other hypersensitivity reactions. For additional information please refer to the "Evidence-Based Herb-Drug Interactions" appendix. Close monitoring of neuromuscular function is required. 3, 6, 8, 9 Quinine may enhance the effects of nondepolarizing muscle relaxants and succinylcholine. Serum levels of amantadine, carbamazepine, digoxin, phenobarbital, and warfarin may be elevated by quinine. 3, 4, 5, 6, 7 Cimetidine 3, 6 and ketoconazole 4, 6 decrease the clearance of quinine. Rifamycins and cigarette smoking increase the elimination of quinine. However, high doses of quinine can cause uterine stimulation in pregnant women and deafness and optic nerve hypoplasia in children. Quinine has been shown to be secreted into breast milk, but insignificant amounts are ingested by the infant. 1 A review of the safety of antimalarial drugs in pregnancy state that standard (antimalarial) doses of quinine showed no evidence of increased risk of abortion or preterm delivery. Quinine has been previously listed as being contraindicated during pregnancy because of fetal and abortifacient effects. ContraindicationsĬontraindications have not yet been identified. Classical doses of the crude bark were approximately 1 g. Quinine has been widely studied as an antimalarial, and has been used at doses of 325 mg to 1 g as the sulfate salt. Quinine has been used for the treatment of malaria and associated febrile states, leg cramps caused by vascular spasm, internal hemorrhoids, varicose veins, and pleural cavities after thoracoplasty. ex Klotsch (red cinchona)Ĭommon Name(s): China bark, Cinchona bark, Fever tree, Jesuit's bark, Peruvian bark, Quina-quina, Red bark (yellow cinchona), Cinchona succirubra Pav. Scientific Name(s): Cinchona calisya Wedd., Cinchona ledgeriana Moens ex Trim.