- A bitter, colorless, amorphous powder or crystalline alkaloid, C20H24N2O2·3H2O, derived from certain cinchona barks and used in medicine to treat malaria.
- Any of various compounds or salts of quinine.
|
Results for quinine
|
On this page:
|
The chief alkaloid of the bark of the cinchona tree, which is indigenous to certain regions of South America. The structure of quinine is shown below.

Until the 1920s quinine was the best chemotherapeutic agent for the treatment of malaria. However, clinical studies definitely established the superiority of the newer synthetic antimalarials such as primaquine, chloroquine, and chloroguanide. See also Alkaloid.
Bitter alkaloid extracted from the bark of the cinchona tree (Cinchona officinalis), used to treat or prevent malaria and in aperitif wines, bitters, and tonic water.
[KWI-nine] An alkaloid that comes from the bark of the cinchona tree, an evergreen native to the mountainous areas of Central and South America. Quinine is the base flavor in most bitters and contributes the bitter essence to tonic water.
An alkaloid derived from cinchona that is effective against malaria. It is also used as an antipyretic, analgesic, sclerosing agent, and stomachic and in the treatment of atrial fibrillation and myotonia congenita.
Brand names: Qualaquin
Chemical formula:

Quinine tablets or capsules
What are quinine tablets or capsules?
QUININE (Quinamm®) is an antimalarial agent. It is used with other antimalarial medicines to prevent or treat attacks of malaria. Quinine alone cannot attack all stages of the malarial parasite. Generic quinine tablets are available.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
blackwater fever
blood disorders
eye problems
heart problems
glucose 6-phosphate dehydrogenase (G6PD) deficiency
low blood sugar
muscle weakness or disease
ringing in the ears
an unusual or allergic reaction to quinine, quinidine, other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
breast-feeding
How should I take this medicine?
Take quinine tablets by mouth. Follow the directions on the prescription label. Swallow tablets whole with a drink of water. Do not crush or chew quinine tablets, they are very bitter and can irritate the mouth and throat. If quinine upsets your stomach take it with food or milk. Take your doses at regular intervals. Do not take your medicine more often than directed.
What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.What drug(s) may interact with quinine?
acetazolamide
amantadine
antacids
astemizole
cimetidine
cisapride
cyclosporine
doxercalciferol
ketoconazole
heart medicines
medicines to reduce blood pressure
medicines to treat seizures
mefloquine or other antimalarial drugs
metformin
methazolamide
rifampin, rifabutin, or rifapentine
sodium bicarbonate
terfenadine
tonic water (contains quinine)
warfarin
Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What should I watch for while taking quinine?
Let your prescriber or health care professional know if your symptoms do not improve in 2 or 3 days.
Quinine can affect your eyesight; until you know how it affects you, do not drive, use machinery, or do anything for which you need to see well.
Check with your pharmacist before you visit a new area where there are malaria-carrying mosquitoes. You may need to take a different antimalarial medicine.
While in areas where malaria is common, certain steps can be taken to prevent being bit by mosquitos. They include:
1) Stay in air-conditioned or well-screened rooms to reduce human-mosquito contact.
2) Sleep under mosquito netting, preferably one with pyrethrum-containing insecticide.
3) Wear long-sleeved shirts or blouses and long trousers to protect arms and legs.
4) Apply mosquito repellents containing DEET to uncovered areas of skin.
5) Use a pyrethrum-containing flying insect spray to kill mosquitos.
Inform your health care provider if you are taking quinine prior to any planned surgery, procedure, or dental work. Quinine may interact with some of the medicines used during a surgery or procedure.
What side effects may I notice from taking quinine?
Side effects that you should report to your prescriber or health care professional as soon as possible:
breathing difficulty, wheezing
dark urine
double vision, blind spot, night blindness or other eye problems
fainting spells
fever or chills, sore throat
headache, confusion
hearing loss
increased sensitivity of the eyes to light
irregular heartbeat, palpitations or chest pain
loss of appetite
ringing in the ears
skin rash or redness, itching
unusual bleeding or bruising
unusual weakness or tiredness
Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
stomach pain or cramps
diarrhea
nausea, vomiting
Where can I keep my medicine?
Keep out of the reach of children in a container that small children cannot open.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light, moisture and excessive heat. Throw away any unused medicine after the expiration date.
Last updated: 7/1/2002
Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.
n.a bitter crystalline compound present in cinchona bark, used as a tonic and formerly as an antimalarial drug.
See the Introduction, Abbreviations and Pronunciation for further details.
For more information on quinine, visit Britannica.com.
Certain strains of the malarial parasite Plasmodium falciparum have now developed a resistance to chloroquine, and quinine is again the preferred drug in some regions. Quinine also has been used medicinally to allay fever and pain, to induce uterine contractions during labor, and as a sclerosing, or hardening, agent in the treatment of varicose veins. It is added to soft drinks called tonics, which are often mixed with alcoholic beverages. Excessive dosage or continuous use of quinine may cause cinchonism, characterized by ringing in the ears, headache, dizziness, changes in blood pressure, and even death.
Bibliography
See F. Rocco, The Miraculous Fever-Tree (2003).
An alkaloid from Cinchona spp. plants of South America used in some forms of malaria in humans. Quinine also has analgesic, antipyretic, mild oxytocic, cardiac depressant, and sclerosing properties, and it decreases the excitability of the motor end-plate. It may be the cause of an immune-mediated hemolytic anemia.
|
Quinine
|
|
| Systematic (IUPAC) name | |
| (2-ethenyl-4-azabicyclo[2.2.2]oct-5-yl)- (6-methoxyquinolin-4-yl)-methanol | |
| Identifiers | |
| CAS number | |
| ATC code | M09 P01BC01 |
| PubChem | |
| DrugBank | |
| Chemical data | |
| Formula | C20H24N2O2 |
| Mol. mass | 324.417 g/mol |
| Physical data | |
| Melt. point | 177 °C (351 °F) |
| Pharmacokinetic data | |
| Bioavailability | 76 to 88% |
| Protein binding | ~70% |
| Metabolism | Hepatic (mostly CYP3A4 and CYP2C19-mediated) |
| Half life | ~18 hours |
| Excretion | Renal (20%) |
| Therapeutic considerations | |
| Pregnancy cat. |
X ( |
| Legal status | |
| Routes | Oral, intravenous |
Quinine (IPA: /ˈkwaɪnaɪn, kwɪˈniːn, ˈkwiːniːn/) is a natural white crystalline alkaloid having antipyretic (fever-reducing), anti-smallpox, analgesic (painkilling), and anti-inflammatory properties and a bitter taste. It is a stereoisomer of quinidine.
Quinine was the first effective treatment for malaria caused by P falciparum, appearing in therapeutics in the 17th century. It remained the antimalarial drug of
choice until the 1940s, when other drugs took over. Since then, many effective antimalarials have been introduced, although
quinine is still used to treat the disease in certain critical situations. Quinine is available with a prescription in the
The theorized mechanism of action for quinine and related anti-malarial drugs is that these drugs are toxic to the malaria parasite. Specifically, the drugs interfere with the parasite's ability to break down and digest hemoglobin. Consequently, the parasite starves and/or builds up toxic levels of partially degraded hemoglobin in itself.
Quinine was extracted from the bark of the South American cinchona tree and was isolated and named in 1817 by French researchers Pierre Joseph Pelletier and Joseph Bienaimé Caventou. The name was derived from the original Quechua (Inca) word for the cinchona tree bark, "Quina" or "Quina-Quina", which roughly means "bark of bark" or "holy bark". Prior to 1820, the bark was first dried, ground to a fine powder and then mixed into a liquid (commonly wine) which was then drunk.
Large scale use of quinine as a prophylaxis started around 1850, although it had been used in un-extracted form by Europeans since at least the early 1600s. Quinine was first used to treat malaria in Rome in 1631. During the 1600s, malaria was endemic to the swamps and marshes surrounding the city of Rome. Over time, malaria was responsible for the death of several Popes, many Cardinals and countless common citizens of Rome. Most of the priests trained in Rome had seen malaria victims and were familiar with the shivering brought on by the cold phase of the disease. In addition to its anti-malarial properties, quinine is an effective muscle relaxant, long used by the Quechua Indians of Peru to halt shivering brought on by cold temperatures. The Jesuit Brother Agostino Salumbrino (1561-1642), an apothecary by training and who lived in Lima, observed the Quechua using the quinine-containing bark of the cinchona tree for that purpose. While its effect in treating malaria (and hence malaria-induced shivering) was entirely unrelated to its effect in controlling shivering from cold, it was still the correct medicine for malaria. At the first opportunity, he sent a small quantity to Rome to test in treating malaria. In the years that followed, cinchona bark became one of the most valuable commodities shipped from Peru to Europe.
Quinine also played a significant role in the colonization of Africa by Europeans. As the dawn of modern pharmacology, Quinine was the prime reason why Africa ceased to be the white man's grave. According to Clifford D. Conner in "A People's History of Science", "It was quinine's efficacy that gave colonist fresh opportunities to swarm into the Gold Coast, Nigeria and other parts of west Africa and seize fertile agricultural lands, introduce new livestock and crops, build roads and railways, drive natives into mines, and introduce all the disruptions to traditional lifestyles that cash economies brought."(Conner pp 95-96) also cites Porter, "The Greatest Benefit to Mankind, pp. 465-466)
Cinchona trees remain the only practical source of quinine. However, under wartime pressure, research towards its artificial production was undertaken. A formal chemical synthesis was accomplished in 1944 by American chemists R.B. Woodward and W.E. Doering.[1] Since then, several more efficient quinine total syntheses have been achieved [2] , but none of them can compete in economic terms with isolation of the alkaloid from natural sources.
Quinine is a basic amine and is therefore always presented as a salt. Various preparations that exist include the hydrochloride, dihydrochloride, sulfate, bisulfate and gluconate. This makes quinine dosing very complicated, because each of the salts has a different weight.
The following amounts of each form are equal:
All quinine salts may be given orally or intravenously (IV); quinine gluconate may also be given intramuscularly (IM) or rectally (PR).[3][4] The main problem with the rectal route is that the dose can be expelled before it is completely absorbed, but this can be rectified by giving half dose again.
The IV dose of quinine is 8 mg/kg of quinine base every eight hours; the IM dose is 12.8 mg/kg of quinine base twice daily; the PR dose is 20 mg/kg of quinine base twice daily. Treatment should be given for seven days.
The preparations available in the UK are quinine sulfate (200 mg or 300 mg tablets) and quinine hydrochloride (300 mg/ml for injection). Quinine is not licensed for IM or PR use in the UK. The adult dose in the UK is 600 mg quinine dihydrochloride IV or 600 mg quinine sulfate orally every eight hours.
In the United States quinine sulfate is available as 324 mg tablets under the brand name Qualaquin; the adult dose is two tablets every eight hours. There is no injectable preparation of quinine licensed in the U.S.: quinidine is used instead.[5][6]
Quinine is not recommended for malaria prevention (prophylaxis) because of its side effects and poor tolerability, not because it is ineffective. When used for prophylaxis, the dose of quinine sulphate is 300–324mg once daily, starting one week prior to travel and continuing for four weeks after returning.
It is usual for quinine in therapeutic doses to cause cinchonism; in rare cases, it may even cause death (usually by pulmonary edema). The development of mild cinchonism is not a reason for stopping or interrupting quinine therapy and the patient should be reassured. Blood glucose levels and electrolyte concentrations must be monitored when quinine is given by injection; the patient should also ideally be in cardiac monitoring when the first quinine injection is given (these precautions are often unavailable in developing countries where malaria is most a problem).
Cinchonism is much less common when quinine is given by mouth, but oral quinine is not well tolerated (quinine is exceedingly bitter and many patients will vomit up quinine tablets): other drugs such as Fansidar® (sulfadoxine (sulfonamide antibiotic) with pyrimethamine) or Malarone® (proguanil with atovaquone) are often used when oral therapy is required. Blood glucose, electrolyte and cardiac monitoring are not necessary when quinine is given by mouth.
In 1994, the
Quinine can cause paralysis if accidentally injected into a nerve. It is extremely toxic in overdose and the advice of a poisons specialist should be sought immediately.
In very large doses, quinine also acts as an abortifacient; in the United States quinine is classed as a Category X teratogen by the Food and Drug Administration, meaning that it can cause birth defects (especially deafness) if taken by a woman during pregnancy. In the UK, the recommendation is that pregnancy is not a contra-indication to quinine therapy for falciparum malaria (which directly contradicts the US recommendation), although it should be used with caution; the reason for this is that the risks to the pregnancy are small and theoretical, as opposed to the very real risk of death from falciparum malaria. Futher research, conducted in Sweden's Consug University hospital, has found a weak but significant correlation between dosage increase in pregnancy and Klebs-Loeffler bacillus infections in neonates.
Quinine can cause hemolysis in G6PD deficiency, but again this risk is small and the physician should not hesitate to use quinine in patients with G6PD deficiency when there is no alternative. Quinine can also cause drug-induced immune thrombocytopenic purpura (ITP).
Quinine can cause abnormal heart rhythms and should be avoided if possible in patients with atrial fibrillation, conduction defects or heart block.
Quinine must not be used in patients with hemoglobinuria, myasthenia gravis or optic neuritis, because it worsens these conditions.
Some studies have related the use of quinine and hearing impairment, which can cause some high-frequency loss, but it has not been conclusively established whether such impairment is temporary or permanent.[7]
Quinine is a flavour component of tonic water, bitter lemon, and vermouth. According to tradition, the bitter taste of anti-malarial quinine tonic led British colonials in India to mix it with gin, thus creating the gin and tonic cocktail, which is still popular today in both India and United Kingdom, and in many English speaking countries.
In the United States, the Food and Drug Administration limits tonic water quinine to 83 parts per million, which is one-half to one-quarter the concentration used in therapeutic tonic.
In France, quinine is an ingredient of an apéritif known as Quinquina.
Quinine is often added to street drugs cocaine or ketamine in order to "cut" the product and make more profit.
Because of its relatively constant and well-known fluorescence quantum yield, quinine is also used in photochemistry as a common fluorescence standard.
In the United States, quinine is an ingredient in the Howling monkey energy drink.
In Canada, quinine is an ingredient in the carbonated chinotto beverage called Brio.
In the United Kingdom, quinine is an ingredient in the carbonated and caffeinated beverage, Irn-Bru.
In South Africa and Europe, quinine is an ingredient in the carbonated beverage called Schweppes.
Jeffrey I. Seeman, The Woodward-Doering/Rabe-Kindler Total Synthesis of Quinine: Setting the Record Straight Angew. Chem. Int. Ed. Eng. 2007, 9, 1373.
| Antiprotozoals: Antimalarial drugs (P01B) | |
|---|---|
| Aminoquinolines | Amodiaquine • Chloroquine • Hydroxychloroquine • Pamaquine • Primaquine |
| Biguanides | Proguanil • Cycloguanil embolate |
| Methanolquinolines | Mefloquine • Quinine |
| Diaminopyridines | Pyrimethamine |
| Artemisinin derivatives | Artemisinin • Artemether • Artesunate • Artenimol • Arteether/Artemotil |
| Others | Halofantrine • Lumefantrine |
This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)
Français (French)
n. - quinine
Ελληνική (Greek)
n. - (χημ.) κινίνη, κινίνο
Português (Portuguese)
n. - quinina (f)
Español (Spanish)
n. - quinina
Svenska (Swedish)
n. - kinin, kina
中文(简体) (Chinese (Simplified))
奎宁
中文(繁體) (Chinese (Traditional))
n. - 奎寧
한국어 (Korean)
n. - 퀴린(말라리아 특효약)
العربيه (Arabic)
(الاسم) كينا, دواء ضد الملاريا
עברית (Hebrew)
n. - כינין (תרופה למלריה)
If you are unable to view some languages clearly, click here.
To select your translation preferences click here.
Join the WikiAnswers Q&A community. Post a question or answer questions about "quinine" at WikiAnswers.
Copyrights:
![]() | Dictionary. The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2007, 2000 by Houghton Mifflin Company. Updated in 2007. Published by Houghton Mifflin Company. All rights reserved. Read more | |
![]() | Sci-Tech Encyclopedia. McGraw-Hill Encyclopedia of Science and Technology. Copyright © 2005 by The McGraw-Hill Companies, Inc. All rights reserved. Read more | |
![]() | Food and Nutrition. A Dictionary of Food and Nutrition. Copyright © 1995, 2003, 2005 by A. E. Bender and D. A. Bender. All rights reserved. Read more | |
![]() | Food Lover's Companion. Food Lover's Companion. Copyright © 2001 by Barron's Educational Series, Inc. All rights reserved. Read more | |
![]() | Dental Dictionary. Mosby's Dental Dictionary. Copyright © 2004 by Elsevier, Inc. All rights reserved. Read more | |
![]() | Drug Info. Gold Standard. Copyright © 2008 by Gold Standard. All rights reserved. Read more | |
![]() | US Military Dictionary. The Oxford Essential Dictionary of the U.S. Military. Copyright © 2001, 2002 by Oxford University Press, Inc. All rights reserved. Read more | |
![]() | Britannica Concise Encyclopedia. Britannica Concise Encyclopedia. © 2006 Encyclopædia Britannica, Inc. All rights reserved. Read more | |
![]() | Columbia Encyclopedia. The Columbia Electronic Encyclopedia, Sixth Edition Copyright © 2003, Columbia University Press. Licensed from Columbia University Press. All rights reserved. www.cc.columbia.edu/cu/cup/ Read more | |
![]() | Veterinary Dictionary. Saunders Comprehensive Veterinary Dictionary 3rd Edition. Copyright © 2007 by D.C. Blood, V.P. Studdert and C.C. Gay, Elsevier. All rights reserved. Read more | |
![]() | Wikipedia. This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Quinine". Read more | |
![]() | Translations. Copyright © 2007, WizCom Technologies Ltd. All rights reserved. Read more |
Mentioned In: