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Quinidine Injection

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Quinidine Injection

Quinidine Injection

Quinidine Injection Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Quinidine gluconate injection is an antimalarial and an antiarrhythmic used to treat life-threatening Plasmodium falciparum malaria. It is also used as a means of restoring normal sinus rhythm in patients with symptomatic atrial fibrillation/flutter whose symptoms are not adequately controlled by measures that reduce the rate of ventricular response, and to treat documented ventricular arrhythmias, such as sustained ventricular tachycardia, that in the judgment of the physician are life-threatening. Common side effects include diarrhea, nausea, vomiting, and heartburn/esophagitis.

Dosage of quinidine gluconate injection is individualized and depends on the condition being treated. Quinidine gluconate injection may interact with carbonic-anhydrase inhibitors, sodium bicarbonate, diuretics, amiodarone, cimetidine, calcium channel blockers, phenobarbital, phenytoin, rifampin, ketoconazole, propranolol, verapamil, digoxin, warfarin, mexiletine, phenothiazines, antidepressants, narcotics, procainamide, haloperidol, neuromuscular blocking agents, and diltiazem. Tell your doctor all medications and supplements you use. During pregnancy, quinidine gluconate injection should be used only if prescribed. This drug passes into breast milk. Breastfeeding while taking this drug is not recommended.

Our Quinidine gluconate injection Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is Prescribing information?

The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.

Quinidine Injection FDA Prescribing Information: Side Effects
(Adverse Reactions)

SIDE EFFECTS

Quinidine preparations have been used for many years, but there are only sparse data from which to estimate the incidence of various adverse reactions. The adverse reactions most frequently reported have consistently been gastrointestinal, including diarrhea, nausea, vomiting, and heart-burn/esophagitis. In one study of 245 adult outpatients who received quinidine to suppress premature ventricular contractions, the incidences of reported adverse experiences were as shown in the table below. The most serious quinidine-associated adverse reactions are described above under Warnings.

Adverse Experiences in a 245-Patient PVC Trial

  Incidence (%)
diarrhea 85 (35)
upper gastrointestinal distress 55 (22)
lightheadedness 37 (15)
headache 18 (7)
fatigue 17 (7)
palpitations 16 (7)
angina-like pain 14 (6)
weakness 13 (5)
rash 11 (5)
visual problems 8 (3)
change in sleep habits 7 (3)
tremor 6 (2)
nervousness 5 (2)
discoordination 3 (1)

Intramuscular injections of quinidine gluconate (quinidine gluconate (quinidine gluconate injection) injection) are typically followed by moderate to severe local pain. Some patients will develop tender nodules at the site of injection that persist for several weeks.

Vomiting and diarrhea can occur as isolated reactions to therapeutic levels of quinidine, but they may also be the first signs of cinchonism, a syndrome that may also include tinnitus, reversible high-frequency hearing loss, deafness, vertigo, blurred vision, diplopia, photophobia, headache, confusion, and delirium. Cinchonism is most often a sign of chronic quinidine toxicity, but it may appear in sensitive patients after a single moderate dose.

A few cases of hepatotoxicity, including granulomatous hepatitis, have been reported in patients receiving quinidine. All of these have appeared during the first few weeks of therapy, and most (not all) have remitted once quinidine was withdrawn.

Autoimmune and inflammatory syndromes associated with quinidine therapy have included fever, urticaria, flushing, exfoliative rash, bronchospasm, pneumonitis, psoriasiform rash, pruritus and lymphadenopathy, hemolytic anemia, vasculitis, thrombocytopenic purpura, uveitis, angioedema, agranulocytosis, the sicca syndrome, arthralgia, myalgia, elevation in serum levels of skeletal-muscle enzymes, and a disorder resembling systemic lupus erythematosus.

Convulsions, apprehension, and ataxia have been reported, but it was not clear that these were not simply the results of hypotension and consequent cerebral hypoperfusion. There are many reports of syncope. Acute psychotic reactions have been reported to follow the first dose of quinidine, but these reactions appear to be extremely rare.

Other adverse reactions occasionally reported include depression, mydriasis, disturbed color perception, night blindness, scotomata, optic neuritis, visual field loss, photo-sensitivity, and abnormalities of pigmentation.

Read the entire FDA prescribing information for Quinidine Injection (Quinidine Gluconate Injection) »

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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.


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