INN monograph
Quinine
Antimalarial · POM
Verified · Updated 01 Aug 2026 · Source: Local active-ingredient clinical extract; FDA drug label via OpenFDA/DailyMed; RxNorm (NLM RxNav); PubChem
Kenya market
Wholesale / list prices where loaded
Risk first
Contraindications
- Known hypersensitivity.
- Agent-specific: e.g. mefloquine in active depression/psychosis/seizure disorder
- primaquine in G6PD deficiency (haemolysis).
- Always check agent-specific absolute contraindications.
Precautions
- Confirm species and severity.
- ECG risk with some agents (quinine, piperaquine).
- Pregnancy: follow Kenya/WHO trimester-specific ACT guidance.
- Vomiting within 30–60 min may need redosing per protocol.
Point of care
Dosing
Adult
Orally 600mg [of stat] TID x I/52. I.V. infusion: Loading dose: 20mg/kg [max. 1.4g] over hours, then 10mg/kg [max. 700mg] after every 8 hours over 4 hours. When the patient can swallow the dose switch to artemisinin combined therapy. [ACT]
Paediatric
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Renal
Supportive care critical in severe malaria; adjust supportive drugs as needed.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Hepatic
Monitor if pre-existing liver disease; many agents hepatically metabolised.
Safety
Drug interactions
- Kenya: follow current MoH malaria guidelines for uncomplicated vs severe disease.
- Test before treat when feasible.
- Complete full ACT course.
- Severe malaria is an emergency — parenteral artesunate, not oral therapy alone.
Safety
Adverse effects
- Visual disturbances, CVS disturbances, blood dyscrasias, GI disturbances, abortion after excessive dosages, cardiac function disturbances, cinchonism, skin rashes, angioedema, asthma precipitation.
Use
Indications
- Acute attacks of P. falciparum resistant to common antimalarials.
- Clinical selection for Quinine should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Antimalarial.
- Confirm site-specific dose, duration and monitoring before prescribing.
Pharmacology
Mode of action
Thought to inhibit heme polymerase activity resulting in the accumulation of free heme, which is toxic to the parasites.
Full mechanism text
Thought to inhibit heme polymerase activity resulting in the accumulation of free heme, which is toxic to the parasites. Artemisinins generate carbon-centred free radicals after activation by parasite haem-iron, damaging parasite proteins and membranes — rapid blood schizonticidal effect. Partner drugs (lumefantrine, piperaquine, etc.) provide longer-acting clearance of residual parasites. Other classes act on haem detoxification, electron transport, or folate pathways depending on agent.
ADME
Pharmacokinetics & PD
| Onset | Hours (artemisinins rapid parasite clearance) |
|---|---|
| Duration | Regimen-dependent (ACT 3 days typical) |
| Route | ORAL / PARENTERAL (severe malaria) |
| Absorption | enhanced by fat-containing food. Complex |
| Metabolism | (CYP3A4) for several partners. Severe malaria: parenteral artesunate preferred first-line in most guidelines. |
Kenya
Brands & prices
| Brand | Company | Pack | KES |
|---|---|---|---|
| Curaquine | Regal Pharmaceuticals | Standard Commercial Pack | — |
| Mosqin | Indus Pharma | Standard Commercial Pack | — |
| Quinalin | Shelys Pharmaceuticals Ltd. | Standard Commercial Pack | — |
| Quinamor | Sphinx Pharmaceuticals Ltd | Standard Commercial Pack | — |
| Quinax | Troikaa Pharmaceuticals | Standard Commercial Pack | — |
| Quinidil | Biodeal Laboratories Ltd. | Standard Commercial Pack | — |
| Quinine | Independent / Registered Supplier | Standard Commercial Pack | — |
| Quinine, by Allied | Laboratory & Allied Ltd. | Standard Commercial Pack | — |
| Quinine, by Laborate | Laborate | Standard Commercial Pack | — |
| Quinine, by Medisel | Distributed by Medisel (K) Limited | Standard Commercial Pack | — |
| Quinine-Universal | Universal Corporation Ltd. | Standard Commercial Pack | — |
| Quinine Mixture | Laboratory & Allied Ltd. | Standard Commercial Pack | — |
| Topquine | Dawa Limited | Standard Commercial Pack | — |
Special populations
Pregnancy & lactation
Pregnancy
Treat malaria — untreated infection risks mother and fetus. Use trimester-appropriate regimens per Kenya MoH / WHO.
Lactation
Most first-line ACTs compatible; continue breastfeeding with maternal treatment.
Diet
Food & alcohol
- Food
- Food
Trust
Sources & disclaimer
Source: Local active-ingredient clinical extract; FDA drug label via OpenFDA/DailyMed; RxNorm (NLM RxNav); PubChem
Last reviewed: 01 Aug 2026
Decision support only — not a substitute for clinical judgment, product SmPC, or Kenya STG/EML.