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Note: This document contains side effect information about quinine. Some of the dosage forms listed on this page may not apply to the brand name Qualaquin.
Applies to quinine: oral capsule, oral tablet
Oral route (Capsule)
Quinine sulfate use for the treatment or prevention of nocturnal leg cramps may result in serious and life-threatening hematologic reactions, including thrombocytopenia and hemolytic uremic syndrome/thrombotic thrombocytopenic purpura (HUS/TTP). Chronic renal impairment associated with the development of TTP has been reported. The risk associated with quinine sulfate use in the absence of evidence of its effectiveness in the treatment or prevention of nocturnal leg cramps outweighs any potential benefit.
Along with its needed effects, quinine (the active ingredient contained in Qualaquin) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking quinine:
Get emergency help immediately if any of the following symptoms of overdose occur while taking quinine:
Symptoms of an overdose
Applies to quinine: compounding powder, oral capsule, oral tablet
This drug adversely affected almost all body systems. The most common side effects associated with this drug were a cluster of symptoms (cinchonism) which occurred to some degree in almost all patients using this drug.
Disseminated intravascular coagulation has been reported in a 79-year-old female within 12 hours after a second 300 mg dose.
Frequency not reported: Agranulocytosis, hypoprothrombinemia, thrombocytopenia (including fatal cases), hemolytic anemia, neutropenia, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, disseminated intravascular coagulation, idiopathic thrombocytopenic purpura, petechiae, ecchymosis, hemorrhage, coagulopathy, blackwater fever, leukopenia, pancytopenia, aplastic anemia, lupus anticoagulant, hemolysis (including acute), thrombocytopenic purpura, intravascular coagulation, immune thrombocytopenia, purpura
Frequency not reported: Cutaneous rashes (including urticarial, papular, scarlatinal), pruritus, bullous dermatitis, exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, rashes, fixed drug eruption (nummular skin lesion), photosensitivity reactions, allergic contact dermatitis, acral necrosis, cutaneous vasculitis (including fatal cases), urticaria, angioedema, eczematous dermatitis, erythema, lichen planus
Fixed drug eruption (nummular skin lesion) has been reported in a 23-year-old female after exposure to quinine in tonic water. An open oral challenge (patient approved) with 30 mg quinine sulfate triggered the appearance of pruritus, erythema, and edema at the usual sites within 40 minutes of ingesting the dose.
Frequency not reported: Nausea, vomiting, diarrhea, abdominal pain, gastric irritation, esophagitis, epigastric pain, gastrointestinal upset
Frequency not reported: Renal failure (including secondary to thrombotic thrombocytopenic purpura-hemolytic uremic syndrome), renal impairment/insufficiency, acute renal failure (due to immune mechanism or circulatory failure), acute interstitial nephritis, anuria, uremia, oliguria
Transient bilateral pulmonary infiltrates have been reported in a 45-year-old woman following a single 325 mg dose for nocturnal cramps. About 45 minutes after taking the dose, the following symptoms were present: sudden onset of dyspnea, wheezing, cough, breathlessness, severe anxiety, dry nonproductive cough, orthopnea, mild fever, chills, and pleuritic chest discomfort.
Frequency not reported: Asthma, dyspnea, pulmonary edema, asthma precipitation, asthmatic symptoms, bronchospasm, hemoptysis, transient bilateral pulmonary infiltrates
Frequency not reported: Diplopia, visual disturbances, blurred vision with scotomata, sudden loss of vision, photophobia, night blindness, diminished/constricted visual fields, fixed pupillary dilatation, disturbed color vision/perception, optic neuritis, blindness, mydriasis, optic atrophy, blurred vision, defective color perception, nystagmus
Angina symptoms have been reported with prolonged therapy in sensitive patients.
Severe cardiovascular toxicity has been reported with rapid IV administration; fatal cases reported.
Frequency not reported: Chest pain, vasodilatation, hypotension, tachycardia, bradycardia, palpitations, atrioventricular block, atrial fibrillation, irregular rhythm, unifocal premature ventricular contractions, nodal escape beats, U waves, QT prolongation, ventricular fibrillation, ventricular tachycardia, torsade de pointes, cardiac arrest, disturbance in cardiac rhythm/conduction, widening of QRS complex, angina symptoms, cardiovascular toxicity, atrioventricular conduction disturbances, fall in blood pressure with feeble pulse, T wave flattening, cardiac dysrhythmias
Frequency not reported: Granulomatous hepatitis, hepatitis, jaundice, abnormal liver function tests, changes in the hepatic enzyme system that synthesizes vitamin K-dependent factors, hepatotoxicity, elevated alkaline phosphatase, elevated lactate dehydrogenase, elevated AST, elevated ALT, elevated GGT
Within 24 hours of taking the first 260 mg dose for leg cramps, a 57-year-old Native American female presented to the hospital with symptoms of nausea, vomiting, generalized myalgia, headache, fever, chills, and rigor. The following liver enzymes were dramatically elevated: alkaline phosphatase, lactate dehydrogenase, AST, ALT, and GGT. After stopping this drug, the patient's symptoms resolved within 48 hours and the liver enzyme levels declined within 72 hours.
Frequency not reported: Headache, seizures, coma, tremors, restlessness, ataxia, acute dystonic reaction, aphasia, syncope, vertigo, tinnitus, hearing impairment, deafness, loss of consciousness, dizziness, hearing loss
Frequency not reported: Hypersensitivity reactions (included asthma, angioneurotic edema, photosensitivity, hot and flushed skin, fever, pruritus, thrombocytopenic purpura, urticaria)
Frequency not reported: Hypoglycemia, anorexia, hypoglycemia aggravated, electrolyte imbalance
Symptoms of mild cinchonism included headache, vasodilation and sweating, nausea, tinnitus, hearing impairment, vertigo/dizziness, blurred vision, and disturbance in color perception; more severe symptoms of cinchonism were vomiting, diarrhea, abdominal pain, deafness, blindness, and disturbances in cardiac rhythm/conduction. Most symptoms of cinchonism were reversible and resolved with discontinuation of this drug.
Frequency not reported: Cinchonism (included deafness, tinnitus, headache, vasodilation and sweating, hearing impairment, rashes, vertigo/dizziness, blurred/disturbed vision, defective/disturbance in color perception, vomiting, diarrhea, abdominal pain, gastrointestinal symptoms, oculotoxicity, central nervous system disturbances, visual field constriction, blindness, nausea, disturbances in cardiac rhythm/conduction, cardiotoxicity, death), fever, chills, sweating, flushing, asthenia, facial edema, death, mucosal bleeding (gingival, gastrointestinal, epistaxis)
Frequency not reported: Lupus-like syndrome, myalgias, muscle weakness, myasthenia gravis aggravated, decreased neuromuscular transmission by increasing excitability threshold at myoneural junction, depressed muscle action potential
Frequency not reported: Confusion, altered mental status, disorientation, suicide, apprehension, agitation
Frequency not reported: Hemoglobinuria, abortion