Quinine
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.
