Side Effects of quinine: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Major Research Findings

Quinine is a widely used antimalarial drug, but it can cause a variety of side effects. The research presented here highlights several key findings related to quinine’s effects and potential risks.

Quinine has shown promise as a treatment for trypanosomiasis. 12 This study found that quinine inhibited the growth of Trypanosoma evansi and triggered apoptosis, leading to its effectiveness. 12

Quinine can also cause immune hemolytic anemia. 13 This occurs when quinine binds to antigens on red blood cells, making them more susceptible to attack by the immune system. 13 Immune hemolytic anemia can develop within a few days of starting quinine treatment. 13

Quinine has also been shown to be effective in treating myasthenia gravis. 25 This is because quinine acts on acetylcholine receptors, promoting the transmission of neurotransmitters. 25

Quinine can affect the electrical activity of the heart and prolong the QT interval. 17 This is because quinine inhibits ion channels in the heart. 17 Prolongation of the QT interval can increase the risk of arrhythmias. 17

Quinine can also cause drug-induced immune thrombocytopenia. 5 This happens because quinine binds to antigens on the surface of platelets, making them more susceptible to attack by the immune system. 5 Drug-induced immune thrombocytopenia can develop within a few days of starting quinine treatment. 5

Quinine can also affect the liver and kidneys. 7 Quinine can damage liver and kidney cells, potentially impairing their function. 7

Quinine can affect the fetus if used during pregnancy. 26 Quinine can inhibit fetal growth or cause birth defects. 26

Reasons for Side Effects

Quinine’s side effects are attributed to its interactions with various cells and tissues. Quinine can affect many organs, including the heart, blood vessels, nerves, liver, and kidneys.

Common Side Effects

Gastrointestinal

Quinine can cause gastrointestinal side effects such as nausea, vomiting, abdominal pain, and diarrhea. 22 2 3

Nervous System

Quinine can cause nervous system side effects such as headache, dizziness, tinnitus, and visual disturbances. 22 25 15

Cardiovascular

Quinine can alter the electrical activity of the heart and cause arrhythmias. 17 It can also lower blood pressure. 13

Hematologic

Quinine can reduce platelet count, making bleeding more likely. 5 It can also destroy red blood cells, causing anemia. 13

Immune System

Quinine can suppress the immune system, making it more susceptible to infection. 13 4

Other

Quinine can cause allergic reactions such as rash, itching, and hives. 13 18 23 It has also been reported to cause side effects such as tinnitus, visual disturbances, dizziness, headache, fatigue, and loss of appetite. 25

Countermeasures for Side Effects

Gastrointestinal

To reduce gastrointestinal side effects, quinine is recommended to be taken with food. 22

Nervous System

To reduce nervous system side effects, quinine is recommended to be taken at bedtime. 22 25 Also, it is recommended to avoid driving or operating machinery while taking quinine. 22 25

Cardiovascular

To reduce cardiovascular side effects, it is recommended to consult your doctor before taking quinine. 17 13

Hematologic

To reduce hematologic side effects, it is recommended to have regular blood tests while taking quinine. 5 13 8

Immune System

To reduce immune system side effects, it is recommended to consult your doctor regularly while taking quinine. 13 4

Other

Quinine can interact with other drugs. 23 It is recommended to consult your doctor about any other drugs you are taking before taking quinine. 23 8

Comparison Between Studies

Similarities

All of these studies indicate that quinine can cause a variety of side effects.

Differences

These studies show that the types and severity of quinine side effects can vary. This may be due to factors such as dosage, duration of treatment, and patient health status.

Precautions for Applying to Real Life

Quinine is an effective drug for the treatment of infections such as malaria, but it also carries the risk of side effects. When taking quinine, it is important to consult your doctor and follow instructions. If you experience any adverse effects while taking quinine, consult your doctor immediately.

Limitations of Current Research

Research on the side effects of quinine is still insufficient. Therefore, not all side effects of quinine are known. Also, the severity and frequency of quinine side effects may vary from person to person.

Future Research Directions

Further research is needed on the side effects of quinine. In particular, it is important to elucidate the mechanisms of quinine side effects and develop safer drugs.

Conclusion

Quinine is an effective drug for the treatment of infections such as malaria, but it also carries the risk of side effects. When taking quinine, it is important to consult your doctor and follow instructions. Further research on the side effects of quinine is needed.

Literature analysis of 26 papers
Positive Content
19
Neutral Content
1
Negative Content
6
Article Type
1
0
1
7
26
1.

Co-nanoencapsulation of antimalarial drugs increases their in vitro efficacy against Plasmodium falciparum and decreases their toxicity to Caenorhabditis elegans.

Author: VelasquesKelle, MacielTamara Ramos, de Castro Dal FornoAna Helena, TeixeiraFlávia Elizabete Guerra, da FonsecaAmanda Luisa, VarottiFernando de Pilla, FajardoAndré Ricardo, ÁvilaDaiana Silva de, HaasSandra Elisa

Anti-plasmodial activity
Minimized toxic effects

Co-encapsulated quinine and curcumin in polysorbate-coated polymeric nanocapsules showed significant anti-plasmodial activity with reduced toxicity in Caenorhabditis elegans.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Establishment and intra-/inter-laboratory validation of a standard protocol of reactive oxygen species assay for chemical photosafety evaluation.

Author: OnoueSatomi, HosoiKazuhiro, WakuriShinobu, IwaseYumiko, YamamotoToshinobu, MatsuokaNaoko, NakamuraKazuichi, TodaTsuguto, TakagiHironori, OsakiNaoto, MatsumotoYasuhiro, KawakamiSatoru, SetoYoshiki, KatoMasashi, YamadaShizuo, OhnoYasuo, KojimaHajime

Photosafety evaluation

A reactive oxygen species (ROS) assay was validated for photosafety evaluation of pharmaceuticals.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

[Unsuspected danger of a medicinal preparation].

Author: GohyS, QuenneryS, PietersT, WeynandB, LiistroG

Caustic airway damage

Inhalation of medications can lead to airway obstruction and even caustic damage. This case report highlights the need to be familiar with the chemical properties of medications when prescribing them to patients at risk of aspiration.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : French

6.

Treatment of cerebral malaria and acute respiratory distress syndrome (ARDS) with parenteral artesunate.

Author: ChaudhariHarshida, MehtaJay B, ChaudhariKetan, FarrowJeff

Improved survival

Cerebral malaria should be suspected in any febrile patient from a malaria-endemic region with loss of consciousness. Intravenous artemisinin compounds are well-tolerated and have fewer side effects than quinine.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Effect of quinine-loaded polysorbate-coated nanocapsules on male and female reproductive systems of rats.

Author: IzaguirryAryele Pinto, PavinNatasha Frasson, SoaresMelina Bucco, SpiazziCristiano Chiapinotto, AraújoFlávio Arci, MichelsLuana Roberta, LeivasFábio Gallas, BrumDaniela Dos Santos, HaasSandra Elisa, SantosFrancielli Weber

Reduced toxicity
Ovarian damage
Testicular damage

Quinine is an antimalarial drug that can have toxic effects on the reproductive system. This study found that loading quinine into polymeric nanocapsules reduced the deleterious effects of quinine on ovaries and partially on testicles in rats.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

[Therapeutic drug monitoring of quinine].

Author: VerdierMarie-Clémence, Bentué-FerrerDanièle, TributOlivier,

Malaria treatment
Toxicity

Quinine, an antimalarial agent, is well absorbed after oral and intramuscular administration. The pharmacokinetic of quinine differs depending on the severity of the disease. Daily monitoring of plasma concentrations is recommended during the first 3 days of treatment to target a trough concentration between 10 and 12 mg/L.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : French

10.

Adverse drug reactions in patients admitted on internal medicine wards in a district and regional hospital in Uganda.

Author: TumwikirizeW A, Ogwal-OkengJ W, VernbyA, AnokbonggoW W, GustafssonL L, LundborgS C

None mentioned
ADRs
Prolonged hospital stay

Adverse drug reactions (ADRs) are an important cause of morbidity in patients, both in the community and in hospitals. The majority are associated with commonly used drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Evaluation of the Effect of 5 QT-Positive Drugs on the JTpeak Interval - An Analysis of ECGs From the IQ-CSRC Study.

Author: DarpoBorje, BensonCharles, BrownRandy, DotaCorina, FerberGeorg, FerryJim, JarugulaVenkat, KeirnsJames, Ortemann-RenonCatherine, PhamThuan, RileySteve, SarapaNenad, TicktinMark, ZarebaWojciech, CoudercJean-Philippe

QT prolongation assessment
Reduced ECG monitoring

The JTpeak interval is a potential new biomarker for detecting mixed ion channel effects of drugs. This study found that pure hERG blockers prolonged both the QTc and JTpeak_c intervals, while drugs with mixed ion channel effects, like dolasetron and quinine, prolonged QTcF but not the JTpeak_c interval. This suggests that JTpeak could be used to differentiate drugs with different mechanisms of action, potentially reducing the need for late-stage ECG monitoring for mildly QT-prolonging drugs.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Savor the flavor: A randomized double-blind study assessing taste-enhanced placebo analgesia in healthy volunteers.

Author: ZunhammerMatthias, GoltzGerrit, SchweifelMaximilian, StuckBoris A, BingelUlrike

Enhanced analgesic treatment outcomes
Side effects

This randomized, double-blind, between-group, single-visit study aimed to estimate how far the taste of an oral medication enhances placebo analgesia. The study found that added taste induced placebo enhancement in the very small effect size range, but accounted for a substantial portion of the overall placebo effect.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Intravenous artesunate versus intravenous quinine in the treatment of severe falciparum malaria: a retrospective evaluation from a UK centre.

Author: EderMarcus, FarneHugo, CargillTamsin, AbbaraAula, DavidsonRobert N

Severe malaria treatment

This retrospective study evaluated the safety and effectiveness of intravenous artesunate (AS) in returning travellers with severe falciparum malaria.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

Implications of the IQ-CSRC Prospective Study: Time to Revise ICH E14.

Author: DarpoBorje, GarnettChristine, KeirnsJames, StockbridgeNorman

QT assessment

This commentary discusses the use of exposure-response (ER) analysis in early phase clinical studies to evaluate the effect of a drug on cardiac repolarization. The results of a recent study suggest that careful ECG evaluation using ER analysis could replace or serve as an alternative to the thorough QT study.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Managing adverse events associated with vismodegib in the treatment of basal cell carcinoma.

Author: FifeKate, HerdRobert, LalondrelleSusan, PlummerRuth, StrongAmy, JonesSarah, LearJohn T

Effective for advanced basal cell carcinoma
Alopecia
Muscle cramps
Taste disturbances

Vismodegib is a hedgehog pathway inhibitor that is effective for treating advanced basal cell carcinomas. Common side effects of vismodegib are taste disturbances, muscle cramps and alopecia. Managing patient expectations, treatment breaks and quinine to alleviate muscle cramps, food swaps and dietician referral for taste disturbances were considered important for successfully managing side effects and allowing optimal treatment duration.

Consensus Development ConferenceA conference organized by the National Institutes of Health (NIH) to develop consensus and recommendations on medical issues.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

21.

Unmet needs in the treatment of autoimmunity: from aspirin to stem cells.

Author: ChangChristopher

Autoimmune disease treatment

This article explores the evolution of treatment for rheumatologic diseases, highlighting the development of various medications, including disease modifying anti-rheumatic agents and biological response modifiers. The emergence of targeted therapies and personalized medicine is also discussed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

22.

[Mood disorder after malaria prophylaxis with mefloquine (two case reports)].

Author: Oueriagli NabihF, TouhamiM, LaffintiA, AbilkacemL

Malaria prophylaxis
Depression
Mania
Mood disorders

Mefloquine, a malaria prophylaxis drug, can cause rare but severe neuropsychiatric side effects, including mania and major depressive episodes.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : French

23.

[Drug-induced acute kidney injury].

Author: DerungsAdrian

Nephrotoxicity

This article provides an overview of drug-induced nephrotoxicity, covering common nephrotoxic drugs, mechanisms of injury, and risk factors.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

24.

In Vitro Evaluation of the Antiviral Activity of Methylene Blue Alone or in Combination against SARS-CoV-2.

Author: GendrotMathieu, JardotPriscilla, DelandreOcéane, BoxbergerManon, AndreaniJulien, DuflotIsabelle, Le BideauMarion, MosnierJoel, FontaIsabelle, HutterSébastien, La ScolaBernard, PradinesBruno

Antiviral activity
Effective against COVID-19

This study investigated the antiviral activity of methylene blue against SARS-CoV-2 in Vero E6 cells. The findings show that methylene blue exhibits antiviral activity against SARS-CoV-2 at both the entry and post-entry stages, supporting its potential for treating COVID-19.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

25.

Quinine sulfate as a therapeutic option in a patient with slow channel congenital myasthenic syndrome.

Author: PeyerAnne-Kathrin, AbichtAngela, HeinimannKarl, SinnreichMichael, FischerDirk

A novel 'de novo' mutation in the α subunit of acetylcholine receptor was identified in a patient with slow channel congenital myasthenic syndrome. The patient showed significant treatment response to both fluoxetine and quinine.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

26.

Mefloquine safety and tolerability in pregnancy: a systematic literature review.

Author: GonzálezRaquel, HellgrenUrban, GreenwoodBrian, MenéndezClara

IPTp
Malaria chemoprophylaxis
Mefloquine efficacy

This article discusses the potential use of mefloquine (MQ) for intermittent preventive treatment in pregnant women (IPTp) to control malaria.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

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