Comparative Pharmacology
Head-to-head clinical analysis: DEXTROMETHORPHAN HYDROBROMIDE AND QUINIDINE SULFATE versus QUINATIME.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DEXTROMETHORPHAN HYDROBROMIDE AND QUINIDINE SULFATE versus QUINATIME.
DEXTROMETHORPHAN HYDROBROMIDE AND QUINIDINE SULFATE vs QUINATIME
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Dextromethorphan is an uncompetitive NMDA receptor antagonist and sigma-1 receptor agonist; quinidine is a CYP2D6 inhibitor that increases dextromethorphan bioavailability.
Quinine acts by interfering with the parasite's ability to break down hemoglobin, leading to accumulation of toxic heme and parasite death. It also inhibits nucleic acid and protein synthesis in the parasite.
One capsule (dextromethorphan 20 mg/quinidine 10 mg) orally once daily, with a maximum dose of two capsules per day.
600 mg (base) orally every 8 hours for 7 days; or 10 mg/kg (base) intravenously loading dose over 1 hour, then 0.02 mg/kg/min continuous infusion for 3 days, then switch to oral.
None Documented
None Documented
Dextromethorphan: 2-4 hours (extensive metabolizers); quinidine: 6-8 hours (inhibits CYP2D6, prolonging dextromethorphan half-life in poor metabolizers to >20 hours)
Terminal elimination half-life 10-12 hours in healthy adults; prolonged in hepatic impairment.
Renal: quinidine 15-25% unchanged, dextromethorphan <1% unchanged; biliary/fecal: quinidine metabolites ~5%, dextromethorphan metabolites ~60-80% as dextrorphan conjugates
Renal: ~20% unchanged; hepatic metabolism (CYP3A4) major route; biliary/fecal: ~80% as metabolites.
Category A/B
Category C
Antiarrhythmic (Class Ia)
Antiarrhythmic (Class Ia)