(pharmacology) C23H30ClN3O Formerly an important antimalarial drug but now used in the treatment of giardiasis, tapeworm infections, amebiasis, and a variety of other conditions.
Brand names: Atabrine®
Chemical formula:

Last updated: 7/1/2002
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| queuosine, query sequence, quercitrin | |
| quinacrine mustard, quinhydrone, quinhydrone electrode |
An antimalarial, antiprotozoal and anthelmintic used especially for suppressive therapy of malaria in humans and also in the treatment of giardiasis in dogs. Called also mepacrine.
An anthelmintic and antiprotozoal agent used to treat giardiasis and tapeworm infections. It is not effective in treating malaria.
| Systematic (IUPAC) name | |
|---|---|
| (RS)-N'-(6-chloro-2-methoxy-acridin-9-yl)- N, N-diethyl-pentane-1,4-diamine | |
| Clinical data | |
| Trade names | Atabrine |
| AHFS/Drugs.com | Micromedex Detailed Consumer Information |
| Pregnancy cat. | ? |
| Legal status | ? |
| Pharmacokinetic data | |
| Protein binding | 80-90% |
| Half-life | 5 to 14 days |
| Identifiers | |
| CAS number | 83-89-6 |
| ATC code | P01AX05 QP51AX04 |
| PubChem | CID 237 |
| DrugBank | DB01103 |
| ChemSpider | 232 |
| UNII | H0C805XYDE |
| ChEBI | CHEBI:8711 |
| ChEMBL | CHEMBL7568 |
| Chemical data | |
| Formula | C23H30ClN3O |
| Mol. mass | 399.957 g/mol |
| SMILES | eMolecules & PubChem |
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Quinacrine (trade name Atabrine) is a drug with a number of different medical applications. It is related to mefloquine.
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Its main effects are as an antiprotozoal, antirheumatic and an intrapleural sclerosing agent.[1]
Antiprotozoal use include targeting Giardiasis, where quinacrine is indicated as a primary agent for patients with metronidazole-resistant giardiasis and patients who should not receive or can not tolerate metronidazole. Giardiasis that is very resistant may even require a combination of quinacrine and metronidazole.[1]
Quinacrine is also used "off-label" for the treatment of systemic lupus erythematosus,[2] indicated in the treatment of discoid and subcutaneous lupus erythematosus, particularly in patients unable to take chloroquine derivatives.[1]
As an intrapleural sclerosing agent, it is used as pneumothorax prophylaxis in patients at high risk of recurrence, e.g., cystic fibrosis patients.[1]
Quinacrine is not the drug of choice because side effects are common, including toxic psychosis, and may cause permanent damage. View Mefloquine page for more information.
In addition to medical applications, quinacrine is an effective in vitro research tool for the epifluorescent visualization of cells, especially platelets. Quinacrine is a green fluorescent dye taken up by most cells. Platelet store quinacrine in dense granules.
Its mechanism of action against protozoa is uncertain, but it is thought to act against the protozoan's cell membrane.
It is known to act as a histamine N-methyltransferase inhibitor.
It also inhibits NF-κB and activates p53.
Quinacrine was initially approved in the 1930s as an antimalarial drug. This antiprotozoal is also approved for the treatment of Giardiasis (an intestinal parasite),[3] and has been researched as an inhibitor of phospholipase A2.
Scientists at Bayer in Germany first synthesised Quinacrine in 1931 and subsequently marketed as Mepacrine or Atabrine. The product was one of the first synthetic substitutes for quinine although later superseded by chloroquine.
In addition it has been used for treating tapeworm infections.[4]
Quinacrine has been shown to bind to the prion protein and prevent the formation of prion aggregates in vitro,[5] and full clinical trials of its use as a treatment for Creutzfeldt-Jakob disease are under way in the United Kingdom and the United States. Small trials in Japan have reported improvement in the condition of patients with the disease,[6] although other reports have shown no significant effect,[7] and treatment of scrapie in mice and sheep has also shown no effect.[8][9] Possible reasons for the lack of an in-vivo effect include inefficient penetration of the blood brain barrier, as well as the existence of drug-resistant prion proteins that increase in number when selected for by treatment with quinacrine.[10]
The use of quinacrine for non-surgical sterilization for women has also been researched. This method,[11] was developed by Zipper et al. who reported a first year failure rate of 3.1%.[12] However, despite a multitude of clinical studies on the use of quinacrine and female sterilization, no randomized, controlled trials have been reported to date and there is some controversy over its use.[1]
Pellets of quinacrine are inserted through the cervix into a woman's uterine cavity using a preloaded inserter device, similar in manner to IUCD insertion. The procedure is undertaken twice, first in the proliferative phase, 6 to 12 days following the first day of the menstrual cycle and again one month later. The sclerosing effects of the drugs at the utero-tubal junctions (where the Fallopian tubes enter the uterus) results in scar tissue forming over a six week interval to close off the tubes permanently.
In the United States, this method has already undergone Phase I clinical testing for F.D.A. approval. The F.D.A. passed this method during a Phase I clinical trial as showing in a small sample that the method is safe and effective. This was the result of a study published by Dr. Lippes at the SUNY Buffalo (see link below). In addition, the F.D.A. has waived the necessity for Phase II clinical trials because of the extensive data of prior safe use of Quinacine. The next step in the FDA approval process in the United States is a Phase III large multi-center clinical trial. The method is currently legally used "off-label" in the US, until final FDA approval of the method is obtained.
Many peer reviewed studies suggest that[13] quinacrine sterilization (QS) is potentially safer than surgical sterilization.[14][15] Nevertheless, in 1998 the Supreme Court of India banned the import or use of the drug, based on reports that it could cause cancer or ectopic pregnancies.[16]
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