Last update Feb. 5, 2022

Quinine

Compatible

Safe substance and/or breastfeeding is the best option.

Cinchona alkaloid used in the prophylaxis and treatment of malaria (Pérez 2009). Oral or intravenous administration.

It is excreted in human milk in a clinically non-significant amount (Mathew 2004, Phillips 1986, Terwilliger 1934), much lower than the dose used in newborns and infants. (Fulton 1992)

No problems have been observed in infants whose mothers took it. (FDA 2008, Terwilliger 1934)

Its use is authorized in infants and children.

Avoid in case of glucose-6-phosphate-dehydrogenase deficiency (Mathew 2004, WHO/UNICEF 2002, Fulton 1992). Cases of hemolytic crisis have been published on breastfed infants by mothers who drank tonic, a carbonated drink made with quinine plant extract. (Bichali 2017)

American Academy of Pediatrics: medication usually compatible with breastfeeding. (AAP 2001)

WHO List of Essential Medicines: compatible with breastfeeding. (WHO / UNICEF, 2002)


See below the information of this related product:

  • Tonic water (Safe substance and/or breastfeeding is the best option.)

Alternatives

We do not have alternatives for Quinine since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Other names

Quinine is also known as


Quinine in other languages or writings:

Group

Quinine belongs to this group or family:

Tradenames

Main tradenames from several countries containing Quinine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 76 - 88 %
Molecular weight 324 daltons
Protein Binding 69 - 95 %
VD 2.5 - 7.1 l/Kg
pKa 9.1 - 13.9 -
Tmax 3 hours
T½ 9.7 - 12.5 hours
M/P ratio 0.3 ( 0.1 - 0.5) -
Theoretical Dose 0.4 (0.08 - 0.5) mg/Kg/d
Relative Dose 1.3 (0.3 - 1.7) %
Ped.Relat.Dose 1.3 (0.3 - 1.7) %

References

  1. Bichali S, Brault D, Masserot C, Boscher C, Couec ML, Deslandes G, Pissard S, Leverger G, Vauzelle C, Elefant E, Rozé JC, Cortey A, Chenouard A. Maternal consumption of quinine-containing sodas may induce G6PD crises in breastfed children. Eur J Pediatr. 2017 Oct;176(10):1415-1418. Abstract
  2. Pérez JL, Carranza C, Mateos F. Antiparasitarios. Revisión de los fármacos útiles en el tratamiento de parasitosis clásicas y emergentes. \ [Antiparasitic drugs. Review of the useful drugs in the treatment of classic and emergent parasitic diseases]. Rev Esp Quimioter. 2009 Jun;22(2):93-105. Review. Spanish. Abstract Full text (link to original source) Full text (in our servers)
  3. FDA Quinine. Drug Summary. 2008 Full text (in our servers)
  4. Acofarma. Quinina. Ficha técnica. 2008 Full text (in our servers)
  5. Mathew JL. Effect of maternal antibiotics on breast feeding infants. Postgrad Med J. 2004 Abstract
  6. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  7. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  8. Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992 Dec;8(4):221-3. Review. No abstract available. Abstract
  9. Phillips RE, Looareesuwan S, White NJ, Silamut K, Kietinun S, Warrell DA. Quinine pharmacokinetics and toxicity in pregnant and lactating women with falciparum malaria. Br J Clin Pharmacol. 1986 Abstract
  10. Terwilliger WG, Hatcher RA. The elimination of morphine and quinine in human milk. Surg Gynecol Obstet. 1934;58:823–826. 1934

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