- March 15, 2022
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Brand Name :
Quinaglute, Quinidex, Quinidine gluconate
Synonyms :
quinidine
Class :
Antiarrhythmics, Antimalarials
Dosage Forms & Strengths
Tablet (as sulfate form)
200 mg
300 mg
Tablet (extended release)
300 mg (as sulfate form)
324 mg (as gluconate form)
injectable solution
80mg/ml (as gluconate form):- discontinued from U.S.
Take a dose of 100 to 600 mg orally each 4 to 6 hours
Start with dose of 200 mg and titrate to desired effect
Daily dose should not be more than 3 to 4 g
for Extended Release:
Take a dose of 324 to 648 mg (as gluconate form) orally each 8 to 12 hours OR
Intravenous:
Dose of 800 mg of quinidine gluconate diluted up to 50 ml and administer at a rate not more than 1 ml/min
for Regimen I:
Dose of 24 mg/kg as loading dose of quinidine gluconate diluted in 250 ml which infused up to 4 hours
Initiate maintenance dose within 24 hours of 12 mg/kg of quinidine gluconate diluted in 250 ml over 4 hours each 8 hours for 1 week
for Regimen II:
Dose of 10 mg/kg as loading dose of quinidine gluconate diluted in 250 ml which infused over 1 to 2 hours
Administer maintenance dose of 0.02 mg/kg/min of quinidine gluconate for up to 3 days
Dosage Forms & Strengths
Tablet (as sulfate form)
200 mg
300 mg
Tablet (extended release)
300 mg (as sulfate form)
324 mg (as gluconate form)
injectable solution
80mg/ml (as gluconate form):- discontinued from U.S.
Take dose of 30 mg/kg daily orally given in 5 divided doses
Take dose of 2 mg/kg orally of quinidine sulfate and test dose should not be more than 200 mg
for Regimen I:
Dose of 24 mg/kg as loading dose of quinidine gluconate diluted in 250 ml which infused up to 4 hours
Initiate maintenance dose within 24 hours of 12 mg/kg of quinidine gluconate diluted in 250 ml over 4 hours each 8 hours for 1 week
for Regimen II:
Dose of 10 mg/kg as loading dose of quinidine gluconate diluted in 250 ml which infused over 1 to 2 hours
Administer maintenance dose of 0.02 mg/kg/min of quinidine gluconate for up to 3 days
Refer to adult dosing
It may enhance QTc interval when combined with perphenazine
when both drugs are combined, there may be an increase in qtc interval
may have an increased QTc-prolonging effect when combined with quinidine
QTc interval is increased both by lenvatinib and quinidine
the effect of quinidine is decreased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism
CYP3A strong enhancers of the small intestine may reduce the bioavailability of quinidine
it increases the effect or level of ruxolitinib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
it enhances by affecting the hepatic enzyme CYP2D6 metabolism
may increase the level of effectiveness through P-glycoprotein MDR1 efflux transporter
antacids reduce the excretion of quinidine
antacids reduce the excretion of quinidine
antacids reduce the excretion of quinidine
antacids reduce the excretion of quinidine
antacids reduce the excretion of quinidine
it increases the effect of neuromuscular blockage of neuromuscular-blocking agents
it increases the effect of neuromuscular blockage of neuromuscular-blocking agents
it increases the effect of neuromuscular blockage of neuromuscular-blocking agents
it increases the effect of neuromuscular blockage of neuromuscular-blocking agents
it increases the effect of neuromuscular blockage of neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
It may increase serum concentration when combined with CYP3A4 Inhibitors (Moderate)
It may increase serum concentration when combined with CYP3A4 Inhibitors (Moderate)
It may increase serum concentration when combined with CYP3A4 Inhibitors (Moderate)
It may increase serum concentration when combined with CYP3A4 Inhibitors (Moderate)
It may increase serum concentration when combined with CYP3A4 Inhibitors (Moderate)
It may enhance the serum concentration when combined with alkalinizing agents
It may enhance the serum concentration when combined with alkalinizing agents
It may enhance the serum concentration when combined with alkalinizing agents
It may enhance the serum concentration when combined with alkalinizing agents
It may enhance the serum concentration when combined with alkalinizing agents
quinidine: they may enhance the serum concentration of alkalinizing agents
quinidine: they may enhance the serum concentration of alkalinizing agents
quinidine: they may enhance the serum concentration of alkalinizing agents
quinidine: they may enhance the serum concentration of alkalinizing agents
quinidine: they may enhance the serum concentration of alkalinizing agents
quinidine: they may diminish the serum concentration of CYP3A4 Inducers
quinidine: they may diminish the serum concentration of CYP3A4 Inducers
quinidine: they may diminish the serum concentration of CYP3A4 Inducers
quinidine: they may diminish the serum concentration of CYP3A4 Inducers
quinidine: they may diminish the serum concentration of CYP3A4 Inducers
when bromazepam and quinidine are used together, there is a potential reduction in the bromazepam's metabolism
increase the therapeutic effect of daunorubicin by P-glycoprotein efflux transporter
it increases the effect or level of palbociclib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
it increases the concentration of loperamide in serum
increase the therapeutic effect of idarubicin by P-glycoprotein efflux transporter
may enhance the risk of hypertension when combined with quinidine
Actions and Spectrum
quinidine blocks sodium channels in cardiac cells, particularly during phase 0 of the cardiac action potential. By inhibiting sodium influx, it slows down the rate at which the cell depolarizes, leading to a decrease in conduction velocity and an increase in the refractory period.
Frequency defined
1-10%
Syncope (1-8%)
Fatigue (7%)
Rash (5%)
Weakness (5%)
Incoordination (1%)
Wheezing
Tremor (2%)
Angina (6%)
Blurred vision
Tinnitus
Sleep disturbance (3%)
Nervousness (2%)
Palpitation (7%)
Headache (7%)
>10%
Diarrhea (35%)
Upper GI distress (>10%)
Vomiting (>10%)
Anorexia (>10%)
Diarrhea (>10%)
Nausea (>10%)
Bitter taste (>10%)
Lightheadedness (15%)
Stomach cramping (22%)
Frequency Not defined
Diplopia
Night blindness
Hepatotoxicity
Arthralgia
Hypotension
Black Box Warning
quinidine has the potential to cause proarrhythmic effects, meaning it can lead to new or worsened arrhythmias. These arrhythmias can be life-threatening and other ventricular arrhythmias.
quinidine use has been linked to a rare but serious blood disorder known as thrombocytopenic purpura, which involves a low platelet count and bleeding into the skin and mucous membranes.
quinidine can cause cinchonism, a condition characterized by symptoms such as ringing in the ears, headache, dizziness, blurred vision, and confusion.
Contraindication/Caution:
Contraindication:
Caution:
Pregnancy consideration:
Pregnancy category: N/A
Lactation: It is present in human breast milk.
Pregnancy Categories:
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: There is no data available for the drug under this category.
Pharmacology
quinidine’s main pharmacological action is blocking sodium channels and these channels reduce the influx of sodium ions, slowing down the rate of depolarization and decreasing conduction velocity within the heart.
Pharmacodynamics
quinidine prolongs the duration of the cardiac action potential, particularly the repolarization phase (phase 3). The repolarization phase is primarily mediated by delayed rectifier potassium channels.
Pharmacokinetics
Absorption
quinidine is well-absorbed in the gastrointestinal tract.
Distribution
quinidine is extensively distributed throughout the body.
Metabolism
quinidine undergoes metabolism in the liver through the cytochrome P450 enzyme system.
Elimination and excretion
quinidine and its metabolites are excreted through the kidneys.
Administration
quinidine is commonly available as oral tablets and the usual route of administration orally.
quinidine also administered intravenously in some cases.
Patient information leaflet
Generic Name: quinidine
Why do we use quinidine?
quinidine is used to treat atrial fibrillation and atrial flutter.
quinidine may be used to treat certain types of ventricular arrhythmias.
quinidine is used to manage supraventricular tachycardias (SVTs), including paroxysmal supraventricular tachycardia (PSVT).
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