Quinine dihydrochloride Injection 300 mg / mL Anti Malaria Medicine

QUININE DIHYDROCHLORIDE 300 mg / mL Anti Malaria  2*10AMPULES / BOX

QUININE DIHYDROCHLORIDE INJECTION 300MG/1ML

COMPOSITION:

Each 1mL ampule contains: Quinine dihydrochloride      300 mg

PHARMACOLOGICAL ACTION:

Quinine acts primarily as a schizontocide ie it suppresses the asexual cycle of development of malaria parasites in the erythrocytes. It has little effect on sporozoites or pre-erythrocytic forms of malarial parasites. It does not, therefore, prevent the relapse of Plasmodium vivax infections.
Quinine is also gametocidal for P. vivax and P. malariae but not for P. falciparum, and therefore does not prevent transmission of this infection by the mosquito.
Plasma concentrations of quinine between 8 and 15 mg/litre are effective clinically and are generally non-toxic; such values are usually achieved with the standard therapeutic dose.

INDICATIONS: 
For the treatment of acute attacks of malaria, including attacks due to chloroquine-resistant or multi-drug-resistant strains of Plasmodium falciparum.
Quinine is used parenterally for cerebral, severe or complicated malaria, or when vomiting prevents retention of an orally administered drug.
Quinine dihydrochloride is the salt usually employed for the preparation of injections.

CONTRA-INDICATIONS:
Quinine is contra-indicated in patients with a history of hypersensitivity to quinine especially if it takes the form of cutaneous, angioedematous, visual or auditory symptoms. It is also contra-indicated in the presence of haemolysis, and in patients with tinnitus or optic neuritis.

WARNINGS:
Quinine must be used with caution in patients with atrial fibrillation or other serious heart disease.
Quinine may aggravate symptoms of myasthenia gravis and should be used with care if at all in such patients.
Quinine may cause hypoprothrombinaemia and enhance the effects of anticoagulants. Quinine must be stopped immediately if evidence of haemolysis appears.

DOSAGE AND DIRECTIONS FOR USE:

In severe or complicated malaria, when the patient is unable to take oral medication, a slow intravenous infusion of quinine is used.
In severely ill adults, a loading dose of 20 mg quinine dihydrochloride per kg may be administered by slow, constant rate intravenous infusion diluted in either isotonic fluid or 5% glucose solution (5-10 mL per kg bodyweight depending on the patient's overall fluid balance) over four hours provided that the patient has not received quinine, quinidine or mefloquin during the previous twelve to twenty-four hours, and reliable hospital facilities are available, including cardiac monitoring.
The maintenance dose is 10 mg of quinine dihydrochloride per kg in 250 to 500 mL of diluent, preferably 5% glucose solution, by intravenous infusion over four hours, repeated at eight to twelve hourly intervals.
For children, a dose of 25 to 30 mg per kg body-mass daily in three divided doses has been recommended.

Quinine should not be withheld from pregnant women with life-threatening malaria if other less hazardous agents are unavailable or inappropriate.

SIDE EFFECTS AND SPECIAL PRECAUTIONS:

Cinchonism, Hypersensitivity, Renal Damage, Cardiovascular Symptoms.

STORAGE INSTRUCTIONS: 
Store below 25°C. Protect from light. Keep out of reach of children.