Malaquin 300 mg

Malaria, Nocturnal leg cramps Hypersensitivity to quinine, mefloquine or quinidine. Patients w/ nocturnal leg cramps; prolonged QT interval, tinnitus or optic neuritis, myasthenia gravis, G6PD deficiency, haemolysis and who had suffered from black water fever. Concomitant use w/ ritonavir, mefloquine, rifampicin, class IA and class III antiarrhythmic agents, neuromuscular blocking agents, other drugs known to cause QT prolongation, and Al- and/or Mg-containing antacids.

Administration: Should be taken with food. Take w/ food to minimise GI discomfort. Adult Dose: Oral Malaria Adult: As sulfate: 648 mg 8 hrly for 7 days. Nocturnal leg cramps Adult: 200-300 mg once at night. Hepatic impairment: Mild to moderate (Child-Pugh class A and B): No dosage adjustment needed. Child Dose: Oral Malaria Child: As sulfate: >8 yr10 mg/kg 8 hrly for 7 days. Renal Dose: Renal impairment: Severe: Initially, 648 mg followed after 12 hr by maintenance doses of 324 mg 12 hrly.

Reduced renal clearance of amantadine. Reduced clearance w/ cimetidine. Increased anticoagulant effect of warfarin and other anticoagulants. Reduced plasma levels of ciclosporin. Increased plasma levels of digoxin. Increased risk of myopathy and rhabdomyolysis w/ atorvastatin. May enhance hypoglycaemic effects of oral antidiabetics. Potentially Fatal: Increased risk of QT prolongation and torsade de pointes w/ mefloquine, class IA antiarrhythmic agents (e.g. quinidine, procainamide, disopyramide) and class III antiarrhythmic agents (e.g. amiodarone, sotalol, dofetilide) and other drugs known to cause QT prolongation (e.g. halofantrine, pimozide, thioridazine). Potentiates neuromuscular blockade w/ neuromascular blocking agents. Decreased plasma levels w/ rifampicin. Increased serum levels w/ ritonavir. May delay or decrease absorption w/ Al- and/or Mg-containing antacids.

Hypersensitivity to quinine, mefloquine or quinidine. Patients w/ nocturnal leg cramps; prolonged QT interval, tinnitus or optic neuritis, myasthenia gravis, G6PD deficiency, haemolysis and who had suffered from black water fever. Concomitant use w/ ritonavir, mefloquine, rifampicin, class IA and class III antiarrhythmic agents, neuromuscular blocking agents, other drugs known to cause QT prolongation, and Al- and/or Mg-containing antacids.

<1% Flushing of the skin,Anginal symptoms,Fever,Rash,Pruritus,Hypoglycemia,Epigastric pain,Hemolysis in G6PD deficiency,Thrombocytopenia,Hepatitis,Nightblindness,Diplopia,Optic atrophy,Impaired hearing,Hypersensitivity reaction Frequency Not Defined Severe headache,Nausea,Vomiting,Diarrhea,Blurred vision,Tinnituscinchonism (risk of cinchonism is directly related to dose and duration of therapy) Potentially Fatal: Sinus arrest, AV block, ventricular fibrillation and sudden death especially with IV use.

Precaution: Patients w/ cardiac conduction defects, heart block or AF. Pregnancy and lactation. Monitoring Parameters Monitor for signs of cardiotoxicity. Monitor blood glucose levels, CBC w/ platelet count, LFT, ECG; ophthalmologic exam.

Quinine is a cinchona alkaloid and a 4-methanolquinoline. It rapidly acts on blood schizontocide by interfering w/ lysosomal function or nucleic acid synthesis in the Plasmodia spp. It has no activity against exoerythrocytic forms.