Quinopic Forte Injection

injection is a medicine used to treat chloroquine-resistant Plasmodium falciparum malaria in adults and children over 5 years of age who weigh at least 20 kg. It contains quinine as an active ingredient. It works by killing the malaria parasite in the blood, specifically during the stage where it feeds on haemoglobin.

This helps stop the parasite from multiplying and reduces symptoms of malaria. The injection is given by a doctor or nurse in a hospital or clinic. It is not meant for self-use.

After the injection, some common side effects may occur, including nausea, vomiting, ringing in the ears, headache, dizziness, or sweating. A drop in blood sugar and pain at the injection site may also happen, but are usually mild. This medicine should not be used by individuals who are allergic to quinine or those with conditions such as tinnitus, optic neuritis, blood in the urine, or myasthenia gravis.

It needs to be used with caution in people with heart conditions, liver or kidney disease, G6PD deficiency, and those who bruise or bleed easily. Quinine should only be used during pregnancy or breastfeeding if clearly needed and prescribed by a doctor. injection can interact with many other medicines.

Some drugs can increase the risk of side effects, while others can reduce the effectiveness of quinine. These include antifungals, HIV medicines, antibiotics, malaria treatments, epilepsy drugs, and blood thinners. Your doctor may adjust the dose or monitor you closely if you are on these medicines.

The medicine should be stored at a temperature below 25°C, away from sunlight and moisture, and kept out of the reach of children. Since it is administered by healthcare professionals, the risk of overdose or missed doses is low. However, if any signs of overdose or allergic reaction occur, medical help should be sought immediately.

Dosage

Overdose

injection will be given to you by a doctor or nurse. Therefore, it is less likely that you may get an overdose of the medicine. If you experience symptoms right after taking the injection, seek medical help.

Missed a Dose

You will be monitored by the doctor or nurse as to when injection should be given to you. Thus, it is unlikely that a dose of the injection will be missed. If the doctor or nurse might have missed a dose, inform them.

Mode of Action

How Does It Work?

injection is an antimalarial medication that targets the malaria parasite during its blood stage, specifically the trophozoite stage. It interferes with the parasite's ability to digest haemoglobin, leading to its death. This action helps prevent the parasite from multiplying and causing illness.

Directions for Use

injection will be given in the hospital or clinic by the doctor or nurse as an injection. Do not self-inject the medicine. Follow the aftercare instructions provided by the doctor or nurse.

Precautions and Warnings

Pregnancy

Can I take injection during pregnancy?

injection should not be used during pregnancy unless the benefits outweigh the risks.

Breast Feeding

Can I take injection while breastfeeding?

Quinine is excreted in breast milk, but no issues in humans have been reported. Nevertheless, injection should not be administered to nursing mothers unless the benefits outweigh the risks.

Driving

Can I drive if I have consumed injection?

injection may cause visual disturbances and vertigo; hence, patients should be advised that if affected, they should not drive or operate machinery.

Alcohol

Can I consume alcohol with injection?

No known interactions with alcohol.

Other General Warnings

Talk to your doctor if

• You take more than the prescribed dose, you may develop serious side effects like ringing in the ears, hearing loss, or vision problems.
• You notice signs of cinchonism (headache, nausea, tinnitus).
• You have heart problems.
• You bruise or bleed easily; this may be a sign of low platelets.
• You have G6PD deficiency, quinine can cause red blood cell breakdown.
• You are pregnant; quinine should only be used for malaria, not for leg cramps.
• You take quinine for leg cramps, but it should only be used if other treatments have failed.
• You have kidney or liver disease, your dose may need to be adjusted.
• You are lactose intolerant; avoid this medicine as it contains lactose.

Contraindications

• If you are allergic to quinine or any other ingredients of injection.
• If you have tinnitus, optic neuritis, haemoglobinuria and myasthenia gravis.

Side effects

• Nausea or vomiting
• Ringing in the ears (also called tinnitus)
• Dizziness or headache
• Sweating or flushing
• A mild drop in blood sugar levels, which can make you feel shaky or sweaty
• Pain or irritation at the injection site

Interactions

Interactions with other medicines

• Some medicines can increase quinine levels in the body (like antifungals and HIV drugs), which may lead to more side effects.
• Other medicines can reduce quinine's effectiveness (such as rifampicin, carbamazepine, and phenytoin), making it less effective.
• Quinine can affect heart rhythm, especially if taken with other heart or antibiotic medicines that also affect the heart (like amiodarone or moxifloxacin).
• Quinine can interact with malaria drugs, like mefloquine, chloroquine, and artemether/lumefantrine, leading to reduced effectiveness or increased risk of side effects.
• It can raise or lower levels of other medicines such as digoxin, ciclosporin, and diabetes medications, so your doctor may need to adjust the doses.
• Combining with blood thinners or epilepsy drugs may require close monitoring due to increased risk of side effects or changes in drug levels.

Storage and disposal

• Store injection below 25°C, protect it from direct sunlight.
• Do not store above 25°C or freeze.
• Keep it away from children and pets.
• Discard the unused medicine.

Frequently Asked Questions (FAQs)

What is Blackwater fever, and can quinine cause it?

Blackwater fever is a rare but severe complication of malaria, characterised by a severe breakdown of red blood cells. It may occur with quinine treatment, especially in people with G6PD deficiency or previous long-term malaria.

Can I use injection for leg cramps?

Quinine is sometimes used for severe leg cramps, but only when other treatments fail and under strict medical supervision because of possible serious side effects.