Comparative Pharmacology
Head-to-head clinical analysis: QUALAQUIN versus QUINALAN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: QUALAQUIN versus QUINALAN.
QUALAQUIN vs QUINALAN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Quinine is a cinchona alkaloid that acts as a blood schizonticide against Plasmodium species. It inhibits heme polymerase in the parasite, leading to accumulation of toxic heme and parasite death. It also has weak gametocytocidal activity against P. vivax and P. malariae.
Quinidine (the active ingredient in Quinalan) is a class Ia antiarrhythmic agent that binds to and blocks voltage-gated sodium channels in cardiac myocytes, prolonging the action potential duration and effective refractory period. It also has vagolytic effects and blocks potassium channels.
325-650 mg orally every 6 hours as needed for pain; maximum 2.6 g/day.
10 mg orally once daily, may increase to 20 mg after 2 weeks if needed.
None Documented
None Documented
Terminal elimination half-life approximately 8 hours in healthy adults; prolonged in hepatic impairment (up to 12-18 hours) and severe malaria (up to 14-20 hours).
Terminal half-life: 12 hours (range 10-14) in normal renal function; prolonged to 24-30 hours in severe renal impairment (CrCl <30 mL/min).
Renal (approximately 20% unchanged; remainder as metabolites); biliary/fecal (minor).
Renal: 60% unchanged; Biliary/fecal: 30% as metabolites; 10% other.
Category C
Category C
Antiarrhythmic (Class Ia)
Antiarrhythmic (Class Ia)