Positive evidence of fetus risks but benefits may outweigh risks in some cases
How it works
Mechanism information is still being processed. Check the DailyMed link in the sidebar for the official prescribing information.
Dosing & administration
Dosing varies by indication and patient profile. Always follow your institution's current prescribing guidelines.
Renal impairment
Consult protocols for adjustment.
Liver impairment
Consult protocols for adjustment.
Use during pregnancy
1st trimester
Caution. Acceptable for uncomplicated malaria with clindamycin. Not teratogenic at therapeutic doses.
2nd trimester
Use for severe malaria (IV) when artesunate unavailable. ACTs preferred for uncomplicated.
3rd trimester
Same as T2. Monitor glucose with IV administration.
Clinical note
Historical first-line antimalarial now reserved primarily for severe malaria (IV quinine or artesunate) or T1 uncomplicated malaria when ACTs are not preferred. At high doses or therapeutic doses, quinine can cause cinchonism (tinnitus, headache) and, in overdose, uterine stimulation. Hypoglycemia is a significant maternal risk with IV quinine — monitor blood glucose closely. For severe malaria in pregnancy, IV artesunate is now preferred by WHO over IV quinine.
Breastfeeding
Caution. Compatible with breastfeeding in standard doses; monitor infant for haemolysis in G6PD deficiency.
